Parathyroid disease describes a group of diseases in which there is an excess of parathyroid hormone. These conditions can cause bone loss, kidney stones, kidney damage, increased cardiovascular risk, bone pain, fatigue, sleep issues, brain fog… the list goes on. Patients with untreated parathyroid disease have a shorter lifespan, and their quality of life suffers greatly.

What kind of doctor treats parathyroid disease?

If you have parathyroid disease, how do you get this problem fixed? First, you need to educate yourself, and this page on our website is a great resource. Second, you will need the help of a doctor to navigate your care successfully. But what kind of doctor treats parathyroid disease?

What kind of doctor diagnoses parathyroid disease?

The first step in treating parathyroid disease is diagnosis. Diagnosing parathyroid disease is primarily done through blood work or other laboratory testing. Parathyroid disease, or hyperparathyroidism, is a condition in which the parathyroid glands secrete excess PTH. This can be divided into three main groups: primary, secondary, and tertiary. The majority of people have primary, a condition where one or more parathyroid glands over-secrete PTH. In secondary, something else is the main problem (like vitamin D deficiency), causing low calcium, and causing the parathyroid glands to reactively increase PTH secretion. Even less people have tertiary, which is when parathyroid glands in a patient with long standing secondary disease become abnormal. Primary and tertiary are surgically treated, while secondary usually can be treated medically.

The types of doctors that diagnose parathyroid disease is very broad, and includes primary care providers, endocrinologists, nephrologists, rheumatologists, and oncologists, among others. An elevated calcium level, new bone loss or fracture, new-onset kidney stones, and other findings may be the sign that investigating for parathyroid disease is warranted. The next step is confirming the disease with blood testing that includes calcium and PTH, because the relationship between these two numbers determines what therapy is the next step. Primary and tertiary have elevations in both numbers and are treated surgically, while secondary has a low calcium and high PTH, and is usually treated medically. Depending on the provider that gets to this point, they may or may not feel comfortable enough with parathyroid disease to complete diagnosis. For more information on diagnosing parathyroid disease, read this.

Endocrinologists typically serve as the next step for most people trying to treat their parathyroid disease. After completing training in medicine, these doctors go to additional training to focus on diseases of the endocrine system, including diseases like parathyroid disease, thyroid disease, and diabetes. This special training helps the endocrinologist confirm the diagnosis and direct the next phase of care.

It is worth noting here that seeing an endocrinologist is NOT required in parathyroid disease. The majority of patients with parathyroid disease have primary hyperparathyroidism, and the diagnosis can be made simply by having a calcium and PTH checked at the same time. At this point, if both numbers are elevated, the diagnosis is made and the patient should be evaluated by a surgeon.

What kind of doctor treats secondary parathyroid disease?

This section could also be titled “What kind of doctor treats parathyroid disease with medicine?” Secondary parathyroid disease is a compensatory elevation of PTH in response to another main problem, such as vitamin D deficiency, inadequate calcium intake/absorption, and kidney issues. In most cases, non-surgical treatments can treat and fix the underlying problem and reverse the excess parathyroid hormone production.

Further investigation is required to identify the root cause, including kidney function, vitamin D levels, calcium intake, and urine studies. Depending on the type of underlying issue, secondary hyperparathyroidism can be treated by the same group of doctors that diagnose it. One specialist may be better suited than another depending on the issue, such as a nephrologist when kidney function is compromised. In more simple cases such as vitamin D deficiency, replacing the vitamin D with over the counter supplements may be all that is required.

The major pitfall we see is not the treatment of secondary hyperparathyroidism, but the misdiagnosis of primary hyperparathyroidism as secondary. The fundamental aspect of secondary hyperparathyroidism is low blood calcium, but many providers see high parathyroid hormone and low vitamin D and connect the dots, ignoring the elevate calcium level (primary hyperparathyroidism causes low vitamin D as well). An elevated calcium and PTH level at the same time is primary parathyroid disease, and there is no medical treatment that works. Read about other common mistakes here.

What kind of doctor treats primary parathyroid disease? Tertiary?

Again, the section could have a different title, something like “What kind of doctor treats parathyroid disease with surgery?” Primary and tertiary parathyroid disease are treated with surgery. In some cases when people fail medical therapy for secondary hyperparathyroidism, surgery is the next step for them.

Parathyroid surgery is performed by two broad types of surgeons: general surgeons and otolaryngologists (ENT). Some members of this group go on to get specially trained, but they start out their training in one of these two areas. The surgeons that treat parathyroid disease can be divided into groups based on level and training and specialization.

Do general surgeons and otolaryngologists treat parathyroid disease?

Both of these types of surgeons have some training in parathyroid disease. General surgeons treat everything from skin infections to pancreatic cancers. Otolaryngologists (ENT) treat conditions limited to the ears, nose, throat, and neck area. After graduation, case volume can vary widely depending on multiple factors, but the average volume of parathyroid surgery during residency is relatively similar. The average for general surgery residents and ENT residents is around only 5-10 parathyroidectomies over a 5 year period.

Do head and neck surgeons treat parathyroid disease?

These are surgeons who undergo special training after residency (either general surgery or ENT) to specialize in complex cases in the head and neck region. The training includes endocrine surgery (thyroid and parathyroid), but the primary focus is on treating cancers of the head and neck as well as reconstruction afterwards. This training allows for an in-depth understanding of the neck anatomy, but focus on parathyroid function and malfunction is not the primary training goal. This specialty training leads to a greater comfort navigating the neck, but lacks the emphasis on parathyroid disease.

Do endocrine surgeons treat parathyroid disease?

Endocrine surgery is additional training almost exclusively for general surgeons in thyroid, parathyroid adrenal, and pancreatic surgery, although the experience in each type varies depending on training site. These surgeons are specialized in all aspects of parathyroid disease, but typically continue to perform other endocrine surgeries as well. Since thyroid disease is more common than parathyroid disease, most endocrine surgeons spend more time doing thyroid surgery than parathyroid surgery.

Do parathyroid surgeons treat parathyroid disease?

Yes, and that’s all they do. No thyroid. No hernias. No colon, breast, nasal, or any other surgery. When we are not operating on parathyroid disease, we are talking to patients about parathyroid disease. It’s not rocket science to say that doing more of something makes you better at it, but this has been backed up by research. Although anyone can decide that they will only do parathyroid surgery, not all parathyroid surgeons are created equal.

All parathyroid surgeons at the Norman Parathyroid Center are general surgeons who then completed an endocrine surgery fellowship, learning both the surgery and the disease. Many of the surgeons were in charge of training future endocrine surgeons. In addition, our surgeons then chose to focus on only parathyroid disease. Every day, every patient, only parathyroid disease.

When it comes to your body, your voice, why trust anyone other than highly trained surgeons who focus on your exact disease? Read more about what makes our center and approach better here.

The Norman Parathyroid Center is part of the world’s largest endocrine surgery practice. We perform parathyroid surgery only, but we are part of a large group of surgeons who also specialize in surgery of the thyroid and adrenal glands as well. We practice exclusively at the brand-new Hospital for Endocrine Surgery, a full-service hospital dedicated to the surgical treatment of tumors and cancers of the thyroid, parathyroid and adrenal glands. As a group we have performed over 60,000 parathyroid operations, over 40,000 thyroid operations, and over 2500 adrenal operations--more than 20 times the experience of any other US hospital or university. Our surgeons are recognized as the highest level of experts worldwide.

• 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.