Parathyroid glands are tiny organs that reside deep in the neck that function as the master “thermostats” for calcium in the body. When blood calcium levels dip too low, the glands activate and release parathyroid hormone (PTH). This PTH circulates throughout the body, signaling the bones, kidneys, and the gut to work together to drive the blood calcium level up.

In hyperparathyroidism, one or more of these glands grows into a tumor and produces too much PTH hormone, which drives the calcium level up to an unhealthy level. Inappropriately high PTH levels cause damage to the bones, kidneys, gut, heart, and other organs. The cure for hyperparathyroidism is simple: remove the abnormal parathyroid tissue (almost always a benign parathyroid tumor).

Since parathyroid surgery to remove a bad parathyroid gland tumor (called parathyroidectomy) is how hyperparathyroidism is treated, let’s look at:

The Top 5 Things to Know About Parathyroidectomy

#1 Parathyroidectomy is the only cure for hyperparathyroidism

#2: Parathyroidectomy provides numerous health benefits

#3: Parathyroidectomy improves quality of life

#4 Parathyroidectomy is the only way to improve bone health in people with hyperparathyroidism

#5: Parathyroidectomy outcomes are better with experienced surgeons

1) Parathyroidectomy is the only cure for hyperparathyroidism

Hyperparathyroidism happens when one or more parathyroid tumors overproduce PTH. Like a broken thermostat unable to turn off, these tumors cannot stop producing PTH, even when the calcium level is already too high.

Neither medications nor lifestyle modifications can fix the “broken thermostat” of a parathyroid tumor. Removing these tumors is the only way to cure hyperparathyroidism.

Hyperparathyroidism shares many similarities with diabetes and high blood pressure, the most common causes of death in this country. People with diabetes, high blood pressure, and hyperparathyroidism can appear well while their underlying condition slowly and silently ruins their health.

However, unlike diabetes and high blood pressure, you cannot treat hyperparathyroidism with drugs. Still, some doctors prescribe medications to treat the complications of hyperparathyroidism. This is unfortunate, because no drug can cure or prevent the inevitable damage that hyperparathyroidism causes to the bones, kidneys, etc..

There are three classes of drugs that doctors sometimes prescribe to treat hyperparathyroidism: vitamin D supplementation, Sensipar (cinicalcet), and osteoporosis medications. Treating hyperparathyroidism with drugs is a mistake, because some of these medications actually worsen bone loss, they have miserable side effects, and attempts to treat with drugs typically delays getting to the cure (parathyroidectomy).

Another key difference between diabetes/high blood pressure and hyperparathyroidism is that lifestyle changes, such as weight loss and dietary modifications, cannot improve hyperparathyroidism. Every patient with hyperparathyroidism should be promptly referred to a surgeon for curative parathyroidectomy.

2) Parathyroidectomy provides numerous health benefits

Pathology doctors classify parathyroid tumors as “benign” because these growths do not invade or spread to other organs. However, living with hyperparathyroidism is anything but harmless.

Over time, hyperparathyroidism causes devastating injury to the bones, kidneys, and cardiovascular system. People living with hyperparathyroidism are at high risk of fractures, kidney failure, kidney stones, heart attacks, and stroke. Not surprisingly, people with hyperparathyroidism have shortened life spans and incur high medical expenses.

The good news is that the damage caused by hyperparathyroidism is reversible. After successful parathyroidectomy, bone density improves and the risk of fracture drops. Parathyroidectomy also halts the decline in kidney function, and in many patients, kidney function increases. Blood pressure typically improves after parathyroidectomy, and the risk of having a heart attack or stroke declines.To learn more about the symptoms and health benefits read this page: Parathyroid Symptoms

3) Parathyroidectomy improves quality of life

People living with hyperparathyroidism suffer both at work and at home. The most common symptoms of hyperparathyroidism are chronic fatigue, body aches, difficulty sleeping, bone pain, memory loss, poor concentration, depression, sexual dysfunction, and headaches.

These symptoms usually take a serious toll on job performance and satisfaction. It is not uncommon for people with hyperparathyroidism to miss work days or to leave their employment altogether from disability.

Furthermore, it is common for people with hyperparathyroidism to neglect the things in life that used to bring them joy. Whether it’s playing a sport like tennis or taking walks with their family and pets, people living with hyperparathyroidism miss out on the things that bring them happiness.

4) Parathyroidectomy is the only way to improve bone health in people with hyperparathyroidism

Osteoporosis, a term to describe the loss of calcium from bones resulting in weakness and a higher risk of fracture, occurs in virtually all patients with hyperparathyroidism. Bones with osteoporosis can ache as the high PTH levels drive the destruction of bone.

People with hyperparathyroidism are often treated with drugs in an effort to strengthen thin and brittle bones. However, studies have found that those drugs can actually increase the risk of fracture in patients with hyperparathyroidism.

After successful parathyroidectomy, both bone density and bone strength improve and the risk of fracture drops. People with hyperparathyroidism should proceed directly to surgical consultation, as this offers the only effective treatment to prevent unnecessary bone loss and fractures.

5) Parathyroidectomy outcomes are better with experienced surgeons

In 2008, Malcolm Gladwell wrote the book Outliers which popularized the “10,000 hour rule”. This provocative work generalized that it takes 10,000 hours of practice to become an expert or master performer in a given field.

It should not surprise anyone that when it comes to proficiency in performing parathyroidectomy, experience matters. Numerous studies published in medical journals have shown that the cure rate following parathyroid surgery is related to the number of parathyroid operations the surgeon has performed. Additionally, the risk of having a permanent complication from parathyroid surgery is also higher when performed by an inexperienced surgeon.

Furthermore, expert surgeons can perform parathyroidectomy in only a fraction of the time it takes inexperienced surgeons. The less time spent on the operating room table under anesthesia translates to a shorter recovery time from surgery. Longer surgeries are associated with worse outcomes and longer recoveries.

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.