As part of your endocrine system, your thyroid is responsible for releasing hormones that help your body to produce energy and function normally. Your parathyroid glands, located near your thyroid glands, play another crucial role.
Parathyroid hormone helps to keep you healthy, and if you produce too much or too little parathyroid hormone, you’re likely to experience symptoms. Here’s what you need to know about your parathyroid glands and when to talk to your doctor if you have concerns.
What Are the Parathyroid Glands?
The thyroid is a butterfly-shaped gland right in the front of the throat. The thyroid has two distinct lobes, one on each side. The four parathyroid glands sit behind the thyroid, with two on each side. These glands are similar in size and shape to a grain of rice.
What Do the Parathyroid Glands Do?
Your thyroid produces thyroid hormone, and your parathyroid glands produce parathyroid hormone. Parathyroid hormone is very different in form and function from thyroid hormone.
The most important role of parathyroid hormone is to regulate the amount of calcium circulating in your blood.
What Does Parathyroid Hormone Do For Your Body?
Your body needs a steady amount of calcium circulating throughout the bloodstream. Although people sometimes associate calcium strictly with teeth and bones, calcium is just as important to muscles.
Throughout your muscles and your nervous system are calcium channels. Your body uses calcium to transmit signals from nerves to other parts of your body. Your body needs calcium to report sensations from your body to your brain and to help your muscles contract and release on demand, and for optimum bone, kidney, and intestine health.
Your bones constantly undergo a process called remodeling. They release calcium into your blood when your body needs it and they repair themselves with the calcium you ingest through your diet. Parathyroid hormone tells your body when this process needs to happen.
In addition to directing the process of bone remodeling, parathyroid hormone also assists your digestive system in the process of absorbing calcium (in conjunction with vitamin D) and tells your kidneys when to retain calcium for use in the near future.
What Happens if You Have Too Much Parathyroid Hormone?
Excessive production of parathyroid hormone is a condition called hyperparathyroidism. There are two types of hyperparathyroidism.
Primary hyperparathyroidism is caused by one or more enlarged parathyroid glands that overproduce parathyroid hormone.
Secondary hyperparathyroidism can be genetic or occur as a result of a related medical condition that causes low calcium levels. The parathyroid glands respond by overproducing hormones.
Hyperparathyroidism can cause the bones to receive too little calcium to properly remodel themselves. If that happens, it could cause calcium levels in the blood and bodily fluids to increase beyond the normal threshold.
The Symptoms of Hyperparathyroidism
Mild cases of hyperparathyroidism may not present immediate symptoms. Many of the effects of hyperparathyroidism are cumulative and worsen with time.
- Bone pain
- Joint pain
- Kidney stones
- Frequent urges to urinate
- Mental fatigue
- Low mood
What Happens If You Have Too Little Parathyroid Hormone?
Hypoparathyroidism occurs when the parathyroid glands fail to produce sufficient amounts of parathyroid hormones, or when the parathyroid hormones that do secrete don’t work correctly. These hormones also decrease phosphate reabsorption, since the hormone also assists with phosphorus regulation. These inefficient processes can lead to a significant imbalance of the things your body needs, like calcium.
With hypoparathyroidism, excessive calcium circulating in the body can cause uncomfortable, painful, and profound side effects.
The Symptoms of Hypoparathyroidism
While both hypoparathyroidism and hyperparathyroidism can be dangerous, hypoparathyroidism is more likely to present immediate and significant symptoms.
- Uncontrollable muscle twitching
- Muscle cramps
- Hair loss
- Dental cavities
- Trachea spasms
How Are Parathyroid Conditions Diagnosed?
If you suspect you may be experiencing a parathyroid health issue, see your doctor as soon as possible. Your doctor will ask you questions and give you a general examination, in addition to ordering tests and scans to check hormone levels. A parathyroid hormone (PTH) test can help better determine if you have low or high calcium levels.
People with parathyroid conditions will have low blood calcium levels while in a fasted state, and may not have enough PTH. Your doctor will monitor your PTH levels to see where your levels fall. An increase in PTH levels can lead to kidney disease.
Your endocrinology specialist may request blood tests on separate occasions. Your doctor will then compare the blood sample results to determine the common cause and if the issue is persistent.
Your kidneys excrete calcium through your urine. Your doctor may want to monitor your urine over a period of 24 hours to determine how much calcium is being excreted by your body.
Medical imaging tests like ultrasounds can be used to check your kidneys for kidney stones and to check the health of your parathyroid glands. Your doctor will be able to determine if any of your four glands are abnormal in shape or size.
In some cases, your doctor may order imaging tests that utilize sestamibi. Sestamibi is a radioactive material that is quickly absorbed by hyperactive parathyroid glands. This compound is highly visible on imaging tests, and the amount of sestamibi your parathyroid glands absorb will tell your doctor a lot about the health of the glands.
Bone Density Tests
A bone mineral density test will give your health care provider insight into the overall health of your bones to see if your calcium levels fall within normal range. If your bones have low levels of calcium, your doctor will be able to tell.
How Are Parathyroid Conditions Treated?
There are several different approaches to treating parathyroid conditions. The appropriate treatment will depend on whether you have hypoparathyroidism or hyperparathyroidism, although both conditions will require similar approaches to normalize thyroid hormone levels.
The “Watch and Wait” Approach
If your results show mild abnormalities or are inconsistent, your doctor may prefer to keep an eye on the situation rather than take more drastic measures like prescribing hormone replacement therapy or surgical intervention.
During this time, your doctor may recommend things like specific calcium supplements to help prevent a calcium levels drop, or activated vitamin D supplements if you have a vitamin D deficiency. Your doctor may also recommend healthy lifestyle changes like increasing activity or losing weight if necessary. Some hormone imbalances may improve when the general health of your body improves.
Even if the issue doesn’t improve, the end result could be an improved state of health. It’s always a good idea to make mindful choices.
In severe cases, doctors may recommend full removal of most of the parathyroid glands, known as a parathyroidectomy. When possible, doctors try not to remove more than 3 ½ parathyroid glands, leaving a small amount of natural thyroid tissue behind.
Surgical removal of these glands will completely cure the condition, just like having an appendectomy will cure appendicitis. Despite the fact that this treatment is curative, many patients choose not to undergo this surgery because it can create new complications.
Surgery to the parathyroid glands risks injury to the vocal cords. It could also mean additional supplementation of things like calcium and vitamin D for the rest of your life.
Drugs called calcimimetics outsmart the parathyroid gland by making it perceive more calcium circulating in the blood than there actually is. This can cause the parathyroid glands to self correct in response.
Some medications designed to preserve or maintain bone density may also be used to support patients dealing with significant bone health side effects related to their parathyroid condition. Magnesium and other supplements may be prescribed as necessary.
Hormone Replacement Therapy
Hormone imbalance and hormone deficiency are usually treated with hormone replacement therapy. Hormone therapy can also be used to treat symptoms of osteoporosis in women. Since many women with parathyroid health issues will likely have simultaneous bone health concerns, it’s likely that hormone replacement therapy could prove to be an invaluable tool for helping to restore the body to a healthier state.
Explore Your Treatment Options with Elite HRT
Elite HRT’s team of highly experienced doctors can help to evaluate your candidacy for hormone replacement therapy and nutraceutical therapy from the comfort of your couch. We’ll work with you to schedule relevant tests, review the results, and help to create a treatment plan tailored to your specific needs. Contact us to get started.