Leaving primary hyperparathyroidism untreated can shorten your life expectancy, with some studies suggesting up to 5 years shorter, depending on the length of time the disease is allowed to fester. Fortunately, early diagnosis and treatment of hyperparathyroidism has beneficial effects throughout the body, which can ultimately lead to increased life expectancy after parathyroid surgery.

Let's dive deep into life expectancy after parathyroid surgery

Life expectancy after parathyroid surgery: Improved cardiac function = less risk for heart attack and stroke

As the calcium is driven back into the bones where it belongs, the benefits to the heart are seen and felt; life expectancy after parathyroid surgery is improved. Less calcium in the cardiovascular system allows for the blood to flow against less resistance. Blood pressure is reduced, less calcium is built-up in the arterial walls, and total cholesterol goes down. The heart muscles do not have to work as hard as they did when the elevated blood calcium was present. The heart size is reduced, and the heart valves have less failure from excess, caked-on calcium. The risk of heart attack and stroke is also reduced after parathyroidectomy, further exhibiting improved life expectancy after parathyroid surgery.

Even glucose control is better, with less insulin resistance in diabetics and pre-diabetics, making blood sugars easier to predict and treat. Life expectancy after parathyroid surgery improves as the heart and blood vessels are now capable of better optimization, humming like a fine-tuned car. The reset button on your calcium metabolism is pressed after parathyroid surgery, allowing for your entire system (all cells in the body rely on calcium to function properly!) to start working like new.

Life expectancy after parathyroid surgery: Improved bone density = less frailty, less fractures

Many studies in the last five years have looked at bone loss as a contributor to a patient being frail. Being labeled as “frail” has several implications in the medical context. Essentially, if you are considered “frail,” your life expectancy after parathyroid surgery (and really any surgery, for that matter) is deemed decreased. Studies have supported that frail individuals are not able to heal as well after a surgery, with a higher propensity for falls, infections, poor nutrition, and overall inability to care for themselves. Why would you want significant bone loss to be a contributor to this label? Even life insurance companies recognize significant bone loss as a contributor to frailty and decreased life expectancy, denying you for long term care coverage?  

Parathyroid surgery can and will help your bones. Parathyroid surgery alone can provide upwards of 6% regrowth in bone density within the 1st year after surgery, to a maximum of 12% regrowth after two years. Life expectancy after parathyroid surgery will improve by improving the bone density. Denser bones allow for less fractures and less catastrophic injuries if a fall does occur.

Life expectancy after parathyroid surgery: Improved kidney function = less risk for kidney stones

Unfortunately we have heard this story way more than the medical community should be willing to admit. Whether you are a patient in your 40s, 80s, or anywhere in between, you are told to  “watch and wait” your calcium with your local provider, and low and behold, you develop a kidney stone. What if that kidney stone is so large, it obstructs the urine flow from the kidney, requiring surgery? What if the kidney swells (hydronephrosis)? What if you develop urosepsis (infection throughout the urinary tract involving the kidneys [pyelonephritis] or bladder [cystitis]), causing you to have significant fevers, confusion, and low blood pressure, resulting in the need for a stay in the intensive care unit on IV antibiotics? What if the stones cause your kidneys to shut down, requiring temporary or long-term dialysis?

I wish we could say that we have not heard these stories from our patients. How has their life expectancy been affected by their calcium mismanagement? We do know that their life expectancy after parathyroid surgery would have been drastically improved had they not become septic, while “waiting” for a kidney stone to form, before seeking out a surgeon!

Adequate kidney function is paramount to survival. This is why patients without at least one working kidney will require a dialysis machine to help excrete toxins metabolized by the kidneys. The kidneys can be negatively affected by having to filter all the calcium-rich blood in the patient with primary hyperparathyroidism. The kidneys are unique organs in that they can take a pretty good beating and rebound; however, eventually, they will take a hit and not be able to get off the mat. Think of your kidneys as a prized heavyweight fighter, if they get beat up enough, they will be down for the count!

Decreased kidney optimization (as measured by the GFR, or glomerular filtration rate) is another independent indicator to consider parathyroid surgery in several “Guidelines,” published to discuss when to consider surgery for your parathyroid disease. We know that if you develop these end stage conditions (osteoporosis, kidney function decline, kidney stones) this is bad! Your life expectancy after parathyroid surgery can only increase with early intervention!

These Guidelines do not seem to be benefiting our patients (our your endocrinologist trying to follow them), especially since watching and waiting contradicts improved life expectancy after parathyroid surgery (as we have discussed)!

Life expectancy after parathyroid surgery: Improved quality of life

Subjective symptoms of high blood calcium from primary hyperparathyroidism can be MANY! Fatigue, low energy, difficulty sleeping (getting a restful night’s sleep, not able to quiet your mind to fall, or stay, asleep), anxiety, depression, headaches, imbalance, brain fog, irritability, and decreased sex drive are all related to high calcium affecting the neurocognitive system (how you think and feel). Many hyperparathyroidism patients will come to us having already seen (AND having been given medications to treat!) a psychiatrist, a neurologist, an ENT (ear-nose-and-throat), a sleep disorder specialist, and/or hormone imbalance expert. Some of these specialists cost a lot of out-of-pocket money (not covered by insurance), and the treatments prescribed have their own costs and side effects.

Imagine a world where primary hyperparathyroidism was better understood by these providers and they could look at your high calcium and say, “You don’t need medications, you need a good endocrine surgeon to improve your quality of life AND life expectancy after parathyroid surgery!”

We have heard horror stories from patients, some have been involuntarily hospitalized for a psychotic break and treated with Lithium for bipolar disorder (a medicine known to increase your blood calcium and promote multigland hyperparathyroidism!). Meanwhile, if the providers just recognized that the patient’s calcium is 11, and this IS the reason for the completely “out-of-the-ordinary” mood episode!

Can you imagine the stress and mental anguish on you and your family, being told you must enter a psychiatric ward, yet you insisting there is something “wrong here,” but no one is looking OR listening? I know this would take years off my life!

Granted these are extreme (and unfortunately true) cases, but our patients tell us these stories. They KNOW something is WRONG, but no one (their DOCTORS included) are understanding and listening. Fortunately, life expectancy after parathyroid surgery can improve, making your life brighter, more fulfilled, and clearer, as the blood calcium goes down AND the fog lifts!  

No one is trying to scare you into parathyroid surgery. Instead, I am hoping to provide you with the harsh realities of leaving primary hyperparathyroidism untreated and a glimpse into how you may achieve improved life expectancy after parathyroid surgery!  If you are reading this, we know you want to live a longer, healthier, and more fulfilled life for yourself and your loved ones. Gaining improved life expectancy after parathyroid surgery is an important and exciting step to achieving your health goals. Become our patient at the new Hospital for Endocrine Surgery and let us help, it is never too late!

If you suspect you may have hyperparathyroidism or suffer from persistent hypercalcemia, schedule a consultation with us to discuss the details of your case with one of our world-renowned experts.

Additional Resources:

• Learn more about the Norman Parathyroid Center.
• Read more on the Parathyroid blog.
• Become our patient.
• Check out our sister surgeons at the Clayman Thyroid Center, the Scarless Thyroid Surgery Center and the Carling Adrenal Center. We are now united under one roof, operating at the Hospital for Endocrine Surgery.