Parathyroid Disorders

The parathyroid glands are situated adjacent to the thyroid gland which is found in the neck region. These glands help in the regulation of parathyroid hormone and the levels of serum calcium and phosphorus. When calcium levels are low, the parathyroid hormone is released which stimulates the releases of calcium by bones into the bloodstream. It also inhibits the excretion of calcium through the kidneys and increases the absorption of calcium through the digested food in the intestine. Both calcium and vitamin D provide negative feedback i.e., when calcium and vitamin D levels increase, they bind to the receptors of parathyroid glands, thus inhibiting parathyroid hormone.

The disorders of parathyroid can result in various complications such as brittle bones, kidney stones, fatigue, weakness, etc. Comprehensive testing is required to diagnose parathyroid disorders which includes complete patient history, physical exam, blood work and other types of laboratory testing. Imaging tests are rarely used.

Parathyroid Types

Hyperparathyroidism – Due to multiple reasons, parathyroid glands could deteriorate into the condition of producing higher levels of parathyroid hormone. The causality must be understood as it determines the appropriate treatment. Hyperparathyroidism can cause osteoporosis, increased risk of fractures, kidney stones, decreased kidney function, heart disease, pancreatitis, increased acid secretion in the stomach, ulcers, etc. There are various types of hyperparathyroidism.

Primary hyperparathyroidism: This type of hyperparathyroidism begins in the parathyroid glands, rather than occurring from any other prevailing health problems such as kidney failure.
Secondary hyperparathyroidism: This type of hyperparathyroidism occurs usually as a complication from chronic renal failure. Surgical management currently is the only radical treatment.
Tertiary hyperparathyroidism: In this type of hyperparathyroidism, the excessive secretion of parathyroid hormone is caused due to longstanding secondary hyperparathyroidism, ensuing hypercalcemia. It typically occurs in men and women with chronic kidney disease usually after kidney transplant.

Hypoparathyroidism – A rare endocrine abnormality resulting in parathyroid hormone deficiency. This starts a cascade of conditions such as hypocalcaemia (low calcium in blood), hyperphosphatemia (low levels of phosphates in blood), and increased neuromuscular irritability, and in extreme cases chronic kidney disease and kidney stones. Other parathyroid disorders complications include cataracts, cognitive dysfunction, cardiac arrhythmias, anxiety, and depression.

Parathyroid Disorders Symptoms

The symptoms of parathyroid disorders arise gradually and it could be years before they are diagnosed for parathyroid disorders.

Hyperparathyroidism symptoms include:

Depression: Mood disorder of persistent sadness and general loss of interest in things and activities were once enjoyed by the individual.
Polydipsia and excessive micturition: Feeling thirsty and frequent urination
Anorexia: Loss of appetite
Muscle weakness
Constipation

Hypoparathyroidism symptoms may include:

Tingling lips, fingers, and toes (most common)
Muscle cramps (most common)
Muscle spasms called tetany (can affect the larynx, causing breathing difficulties)
Abdominal pain
Abnormal heart rhythm
Brittle nails

Parathyroid Disorders Causes

The causes of parathyroid disorders vary:

Primary Hyperparathyroidism: Typically results from a benign tumor on a parathyroid gland or hyperplasia (enlargement) of the glands.
Secondary Hyperparathyroidism: Often caused by chronic kidney disease, which results in low calcium levels.
Tertiary Hyperparathyroidism: Develops when prolonged secondary hyperparathyroidism leads to persistent overactivity of the parathyroid glands.
Hypoparathyroidism: Can result from surgical removal of parathyroid glands, autoimmune diseases, or genetic factors.

When to See a Doctor?

If you experience symptoms such as persistent fatigue, muscle cramps, or unusual bone pain, it's essential to seek medical advice. Early diagnosis and intervention are vital in managing parathyroid disorders effectively. Contact Dr. Prudwiraj Sanamandra for expert evaluation and treatment.

Risk Factors of Parathyroid Disorders

Several risk factors may predispose individuals to parathyroid disorders:

Family History: A genetic predisposition can increase the risk of certain disorders, particularly primary hyperparathyroidism.
Age: Individuals over 50 are at a higher risk for developing parathyroid disorders, especially hyperparathyroidism.
Chronic Kidney Disease: Increases the likelihood of secondary hyperparathyroidism.
Previous Neck Surgery: Can lead to complications affecting parathyroid gland function.

Parathyroid Disorders Complications & Prevention

Untreated parathyroid disorders can lead to significant complications, such as osteoporosis, kidney stones, and cardiovascular problems. Parathyroid disorders prevention strategies include regular health check-ups, maintaining a balanced diet rich in calcium and vitamin D, and managing underlying conditions like kidney disease. Early detection of hormonal imbalances through routine health screenings can help mitigate complications.

Parathyroid Disorders Diagnosis

Diagnosis typically involves a combination of:

Blood Tests: To measure levels of calcium, phosphorus, and parathyroid hormone.
Urine Tests: To assess calcium excretion.
Imaging Studies: Ultrasound or nuclear medicine scans may be used to detect abnormalities in the parathyroid glands.

Parathyroid Disorders Treatments

Parathyroid disorders treatment options depend on the specific disorder:

Primary Hyperparathyroidism: Surgical removal of the affected gland is often the most effective treatment.
Secondary Hyperparathyroidism: May involve treating the underlying condition (e.g., kidney disease) and, in some cases, medications to manage PTH levels.
Hypoparathyroidism: Typically treated with calcium and vitamin D supplements to restore normal levels.

Do's and Don'ts for Managing Parathyroid Disorders

Do's:

Regularly consult your healthcare provider for monitoring and treatment adjustments.
Maintain a balanced diet rich in calcium and vitamin D to support bone health.
Educate yourself about your condition to better manage your symptoms.
Monitor for any new symptoms or changes in your condition and report them to your doctor.

Don'ts:

Avoid self-medicating or making changes to your treatment plan without consulting your healthcare provider.
Don’t ignore symptoms; early intervention can prevent complications.
Avoid high-stress environments whenever possible, as stress can exacerbate symptoms.
Don’t skip regular follow-up appointments; consistent monitoring is vital for effective management.

Care at Dr. Prudwiraj Sanamandra Endocrinology Clinic

At the Dr. Prudwiraj Sanamandra Endocrinology Clinic, we specialize in diagnosing and treating parathyroid disorders with a comprehensive, patient-centered approach. Dr. Prudwiraj Sanamandra is dedicated to providing tailored treatment plans, utilizing the latest diagnostic tools and therapeutic options to ensure optimal health outcomes for every patient.