Frequently Asked Questions Regarding Parathyroid Disease

What is a parathyroid gland?
The parathyroid glands are endocrine glands (organs in the body that make hormones) located in the neck. There are usually 4 parathyroid glands, although some people may be born with more or fewer glands. The parathyroid glands make parathyroid hormone, which increases the amount of calcium in the body, raising the calcium level in blood.

What is hyperparathyroidism?
In parathyroid disease, there are abnormalities of blood calcium. High levels of blood calcium due to high levels of parathyroid hormone is hyperparathyroidism.

Who gets parathyroid disease?
Anyone can develop parathyroid disease. However, the disease is more common in women than men. The disease is also more common in older women than younger women. It is important to remember that parathyroid disease can occur in both women and men at any age.

How do I know if I have parathyroid disease?
Most people are unaware they have parathyroid disease until a high calcium level is identified on routine blood tests. If a high calcium level is fine, your doctor or an endocrinologist will evaluate you for parathyroid disease with additional blood tests such as parathyroid hormone levels and possibly a radiographic test to image the parathyroid glands.

What is the normal calcium level?
The normal calcium level varies slightly for each laboratory that is running the test. Generally, the normal level in adults is 8.5 to 10.5 mg/dL.

What is ionized calcium?
Ionized calcium is the term for the active calcium in the blood. Calcium levels on routine blood tests measure the total amount of calcium in the blood. Some of that calcium is bound to proteins and not active. The total amount of calcium in the blood may fluctuate with the amount of protein in the blood and the level of hydration. Ionized calcium, however, is kept within a more narrow, precise range. Ionized calcium and parathyroid disease may be evaluated together. If calcium levels are found to be high, one test in the evaluation of parathyroid disease may be ionized calcium. Hyperparathyroidism will cause and increase in both total calcium and ionized calcium.

What is the normal Parathyroid hormone level?
The nomal parathyroid hormone level may vary slight for each laboratory running the test. Generally, the normal level in adults is between 10 and 72 pg/L.

What is the treatment of parathyroid disease?
Primary hyperparathyroidism must be treated surgically, with removal of the abnormal parathyroid gland or glands. Secondary hyperparathyroidism (hyperparathyroidism that is due to another condition such as renal disease) can sometimes be treated medically.

What kind of scar will I have after surgery for parathyroid disease?
All surgeries will result in a scar. Because the parathyroid glands are located in the neck, the incision (and therefore scar), will be located on the neck. They type of scar will depend on the type of surgery. The type of surgery will depend on the type of parathyroid disease. If only one parathyroid gland is abnormal and can be easily found during surgery, the incision will be smaller than if all parathyroid glands need to be examined.

Can I take a pill to treat my parathyroid disease?
Surgery is the only definitive treatment for parathyroid disease. There are no pills that can treat primary hyperparathyroidism; therefore surgery is the only treatment option. In some cases of secondary hyperparathyhroidism, a pill can be used. After throurough evaluation, the doctor will go over the possible treatment options.

How do I find a parathyroid surgeon?
It is important to find a parathyroid surgeon with experience in parathyroid surgery. There are many important structures located in the neck in close proximity to the parathyroid glands. An expereicned parathyroid surgeon will know how to minimize the risk of injury to the important structures. Dr. Michael Friedman at the Advanced Center for Specialty Care has been performing parathyroid surgery for over 30 years and is committed to providing safe and effective surgical treatment for patients with parathyroid disease.

Do I really need surgery?
Yes. Surgery is the only definitive treatment for primary hyperparathyroidism. A less common condition, secondary hyperparathyroidism, is caused by disease at another organ, such as kidney disease. In these cases, surgery may not be necessary.

How long will I have to stay in the hospital after surgery?
The length of hospital stay depends on the type of parathyroid surgery and the calcium levels following surgery. If only one gland is removed and calcium and parathyroid hormone levels return to normal, the patient may leave the hospital the same day. If all four parathyroid glands must be removed or if calcium levels fall too low after surgery, the patient will need to stay in the hospital at least one night.