PARATHYROID CONDITIONS

Understanding the Parathyroid Glands

The parathyroid glands are four tiny glands located behind the thyroid in the neck. Despite their name, they have nothing to do with the thyroid’s function. Their main role is to regulate the body's calcium levels by producing parathyroid hormone (PTH), which helps control calcium absorption from the gut, release from bones, and excretion by the kidneys. Even small abnormalities in the parathyroid glands can cause significant health issues. Fortunately, most conditions are curable with focused surgery when performed by an experienced surgeon. 

Common Parathyroid Conditions

Blog: Primary Hyperparathyroidism

Primary Hyperparathyroidism:
This is the most common parathyroid disorder, often caused by a benign tumour (adenoma) in one of the glands. It leads to high calcium levels in the blood, which can cause:

  • Fatigue, brain fog, and low mood

  • Bone thinning (osteopenia/osteoporosis)

  • Kidney stones

  • Abdominal pain and digestive issues

  • Muscle weakness and joint aches

If a parathyroid adenoma is identified on imaging a minimally invasive parathyroidectomy can cure this condition in 98% of the cases. Please check out my dedicated blog post on primary hyperparathyroidism for details of assessment and management of this condition.

Secondary  and Tertiary Hyperparathyroidism:
These forms of hyperparathyroidism occur in people with chronic kidney disease or those on long-term dialysis. The parathyroid glands become enlarged over time due to persistently low calcium or vitamin D levels. When medical management is no longer effective, surgery may be required.

Unlike primary hyperparathyroidism, which typically involves a single overactive gland, secondary hyperparathyroidism usually affects all four glands. In these cases, the standard surgical approach is a bilateral neck exploration with subtotal parathyroidectomy — removal of three and a half glands — to restore calcium balance while preserving some parathyroid function.

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