While there’s much hue and cry about thyroid gland and disorders, little do we know about parathyroid diseases. Blood calcium balance is attributed to Vitamin D levels in body; however, there’s another very significant aspect in our body, that is silently maintaining calcium equilibrium. Yes, you got it right. It is the parathyroid glands that are being referred to here.
The worst part is, parathyroid disorders don’t come up with vivid symptoms. Early signs which have been discussed later in the post, mostly include general weakness and associated pain. Fatigue can be a result of multiple health disorders, and tracking it down to small parathyroid glands in the endocrine system becomes impossible in the beginning.
Individuals mostly tend to ignore these generic symptoms and only visit doctors when discomfort levels are high and hinder regular day to day activities. Doctors order couple of tests for diagnosing causatives. These mostly include thyroid tests or diabetes examination and may or may not have parathyroid examination as a mandatory lab test in the beginning.
Thus, finally when an individual undergoes specific parathyroid diagnosis, he/she is detected to be in the intermediate or advanced stages of disorder.
Hence, knowing about parathyroid glands, disorders and more importantly the symptoms indicative of parathyroid diseases is essential. Therefore, to make our readers aware about these parathyroid diseases, this post is dedicated to provide every single information you may require.
Parathyroid Or “Para to” thyroid gland:
One of the most commonly used prefixes, “para” in medical terms mean adjacent or near by. Therefore, evident from the word, the human body has four parathyroid glands that are positioned at the back of the thyroid gland. And since these are in close proximity to the thyroid gland, these small glands have earned the name parathyroid.
As fetuses develop within mother’s womb, these rice grain sized parathyroid glands travel from brain and reach the neck and settle near the thyroid glands. The upper pair of parathyroid glands position behind the upper part of thyroid gland. These are known as Superior parathyroid glands. The second pair is positioned behind the lower part of thyroid gland and are known as inferior parathyroid glands.
However, sometimes, this may not be the case, and glands may find a different route and reach other parts of the body; such as, chest or may move further down the neck in the esophagus. These locations are known as “ectopic” position. Presence of parathyroid glands in less common or ectopic regions is not a concern until tumorous growth occurs. And this may very well happen when organs are placed at expected locations.
Parathyroid and Thyroid glands – Isolated Neighbors!
On contrary to what seems to be obvious, thyroid gland and parathyroid glands have nothing in common despite being vicinal. The thyroid gland secretes essential hormones that regulate entire metabolism of body. More importantly, it does not play any significant role in maintaining calcium levels in body.
Conversely, parathyroid glands are present to maintain calcium stability. They do not contribute in any of the metabolic functions that are looked after by the thyroid gland. It must be noted that calcium levels are not only vital for our bone health, but also count significant for other organs, such as, kidneys, brain or the entire nervous system.
The parathyroid glands secrete a hormone known as Parathyroid hormone (PTH). All functions performed by the parathyroid gland are in real carried out by the PTH. The glands filter blood supply in body and detect calcium content. Depending on the amount of calcium in blood, parathyroid glands secrete required amount of PTH.
The parathyroid hormone balances calcium level in the following ways:
- PTH causes calcium release from bones when it is found to be deficient in blood
- PTH also enhances calcium absorption from food
- PTH improves kidney functions, so that it can hold on to more calcium when needed which otherwise gets eliminated through urine
- In conditions where calcium levels are normal or more than expected, PTH secretion is stopped by the gland
Hyperparathyroidism and Parathyroid Adenoma:
Hyperparathyroidism, as evident from the name is a condition where one or more parathyroid glands develop tumors resulting in excess secretion of parathyroid hormone in body. The gland/s with the tumorous growth is/are known as Parathyroid Adenoma.
Presence of excess PTH in body causes bones to release more than required levels of calcium into blood stream; thus, causing Hypercalcemia and reduced bone density. If this condition is not taken care of at early stages, bone disorders such as Osteoporosis become inevitable later.
In addition, as blood is filtered through kidneys, presence of excess calcium damages kidneys as well. Kidney stones are one of the common aftermaths of abnormal blood calcium. Besides, it can also affect brain and nervous system functionalities.
When there is only one parathyroid gland with tumorous growth, the condition is known as single parathyroid adenoma. Similarly, involvement of two or three glands results in double parathyroid adenoma or triple parathyroid adenoma. In rarest of cases, all the four glands may be involved in tumor formation and the condition is known as four gland hyperplasia.
What causes parathyroid adenoma and hyperparathyroidism?
Parathyroid Adenoma or tumor growth cannot be attributed to one or more reasons. Every organ in the body may develop a tumor for reasons unknown. And so it is for Parathyroid adenoma. However, there are a few things that may make people more susceptible in developing benign (non cancerous) tumors around the four parathyroid glands.
Listed below are some of these factors:
Females (mostly above the age of 50 years) remain more prone to develop Parathyroid adenoma. Now, this gender discrimination is also not very well understood, that why elderly women have greater chances of suffering from hyperparathyroidism. However, it has always been seen that majority of parathyroid adenoma or hyperparathyroidism cases have been reported by women above the age of 50 years.
Radiation therapy using iodine:
Iodine therapy had been a preferred treatment option for thyroid gland disorders, lymphoma, breast cancer etc. However, very high exposure to iodine may lead to adenoma formations and thus hyperparthyroidism.
Radiation induced parathyroidism involves only one single gland in 90 percent of cases. Such implications are seen much after and prolonged exposure to iodine therapy.
Exposure to Lithium:
Prescribed drugs used to treat psychiatric problems often contain lithium. Besides, there can be other drugs that contain lithium in small amounts. Prolonged exposure to lithium can result in hyperparathyroidism in individuals.
Rare hereditary conditions:
Although it is rare, there have been cases where parathyroidism disease occurred due to wrong gene inheritance. This is known as Multiple Endocrine Neoplasia (MEN) which is of two types. MEN type 1 results in parathyroid adenoma, along with pituitary and pancreatic tumors. MEN type 2 relates to thyroid cancer and adrenal gland tumor. Thyroid cancer can be efficiently treated by thyroid cancer surgery. There can also be other reasons causing tumor growth in the endocrine system and thus parathyroid adenoma.
Hyperplasia is a condition where the parathyroid glands just grow bigger in size; however, there is no tumorous growth. These fat and bigger cells produce excess PTH and are known as Hyperplastic parathyroid glands. The condition involves all the four glands and not just in pairs or triplets.
Parathyroid disease that occurs due to kidney malfunction is known as Secondary Hyperparathyroidism. This condition is seen in patients who have been under renal treatment and dialysis for prolonged years. In this case as well, no adenoma is formed and it is only the parathyroid glands that get bigger and abnormal in size.
Can you suffer from hypoparathyroidism ?
YES, but one in million cases. Hypoparathyroidism is very rare and therefore many say that overactive parathyroid gland is the only disease related to the four glands.
Hypoparathyroidism is lack of PTH and mostly occurs when there is a severe damage of the four glands or a surgical removal to treat hyperparathyroidism. Thyroid gland surgery may even rarely lead to this condition.
Hypoparathyroidism causes significant lack of calcium in body and thus brings about related symptoms. You may know more about calcium levels and hypocalcemia here.
THE LINK : Vitamin D – Calcium – Parathyroid Hormone:
Well, most of us know that body’s acquirement of calcium from food is dependent on vitamin D. However, the lesser known fact is that, it is the parathyroid hormone (PTH) that triggers available vitamin D to strengthen the gastrointestinal system so that it can absorb sufficient amount of calcium from food intake.
Now, a body deficient in vitamin D will not have sufficient calcium absorption. In such a case, parathyroid gland produces excess PTH that stimulates secretion of required calcium from bones. Therefore, people suffering from renal troubles or vitamin D deficiency are very likely to have high PTH secretion from the glands.
What are the symptoms of Parathyroid disorders?
As already mentioned, symptoms of parathyroid diseases are not very obvious and therefore there can be an endless list . Most of these signs relate to other health disorders and it takes a considerable time to relate it back to these small glands of the endocrine system.
In addition, individuals suffering from severe discomfort discuss with doctors and may get diagnosed at an early stage. However, those who have mild issues such as headache or fatigue can take years to know about their diseased parathyroid conditions.
Nevertheless, listed below are few of the symptoms of hyperparathyroidism:
- You feel a constant lack of energy almost every day and every time
- Depression and irritation. Friends and family always complain about your cranky behavior.
- Nothing in the world seems to interest you now and this is something very unlike you
- Not being able to have a sound sleep. You find yourself waking after few hours of sleep.
- Confusion, lack of concentration and forgetfulness
- Lack of libido
- Receding hair line; especially, in women
- Bone and joint pain
- Diagnosis of osteoporosis
- Increased renal troubles and diagnosis of kidney stones
- Abnormal results of liver function tests
- Fluctuating blood pressure levels
- Mild abdominal troubles such as burning sensation
What are the diagnosis options for hyperparathyroidism?
Hyperparathyroidism diagnosis requires blood tests that measure two parameters simultaneously. One is the parathyroid test that essentially provides PTH levels in body. Second is calcium test to know blood calcium levels.
Under normal conditions, high PTH level needs to have low blood calcium and low PTH level needs to have high blood calcium. However, patients suffering from hyperparathyroidism have both these tests showing elevated levels.
In addition to this, your doctor may order a phosphate test, Vitamin D test, Urine Calcium and Creatinine test. Bone density test is also carried out to know if decreased calcium levels have affected bone health adversely; causing Osteopenia and Osteoporosis.
Parathyroidism – Treatment measures and how well it is treated:
Treatment options for parathyroidism require wide range of options. Depending on the severity of cases, your doctor will suggest an apt treatment procedure. Below explained are few of the treatment measures for parathyroidism:
No treatment for early stages:
Although this is rare, people diagnosed at early stages may not need any medicated or surgical intervention. Your doctor will take necessary steps to monitor your condition and suggest timely and effective life style changes.
You will be required to undertake different lab tests periodically. Calcium levels in both blood and urine, kidney function examinations, bone density test etc., are few of the laboratory tests you will need to undergo periodically and frequently.
If you can adopt every remedial measure (food habits and lifestyle) suggested by doctor, you can fight against the disease without any medical aid or surgery.
Surgical Treatment for Parathyroidism:
In most cases, parathyroidism requires surgical intervention. Moreover, it is only surgeries that guarantee complete cure and treatment.
The treatment approach involves removal of those glands that have developed adenoma or tumors. The procedure is minor and can be carried out within few hours. Patients who are otherwise healthy can leave for their homes on the same day with their surgeon’s permission. However, staying back for the night is always a good option and recommended by most surgeons.
Tumorous glands are surgically removed; however, if all the four glands show adenoma growth, only three of your glands will be removed leaving behind a part of the forth gland that shows least damage.
Post surgery, you can get back to your regular activities within a few weeks. Some patients need to take calcium and vitamin D supplements for a life time.
This was all about parathyroidism and treatment options. Taking good care of your health is the best way you can keep away from any disease; including Parathyroidism. However, if preventing the disease is no longer feasible, opting for immediate treatment is the only resolve. And now that you know that surgical remedies are not very difficult to undergo, opting for the same will not be very difficult, isn’t it?
And once you are done with the operation, taking care of yourself is elementary. Try to follow a good lifestyle where you are into regular exercising, following a good healthy diet, taking up regular health checkups and abstaining from smoking or alcohol intake.