The 4 parathyroid glands are located next to the thyroid gland in the
lower front part of the neck. Athough they are close to the thyroid gland,
the parathyroid glands function independently from the thyroid. The parathyroid
glands make a substance called parathyroid hormone (PTH), which regulates the level of calcium in the blood.
By helping the body absorb calcium from food, PTH maintains a healthful level
of calcium for strong bone function. Also, PTH helps to control the amount
of calcium that is released from bones and then excreted in urine. When the
parathyroid glands make too much PTH, a condition called primary hyperparathyroidism exists, causing abnormally high levels
of calcium in the blood. Hyperparathyroidism can also occur as a result of
other medical problems, such as kidney disease, and is then called secondary hyperparathyroidism. The April 13, 2005, issue of JAMA includes an article about primary hyperparathyroidism.
Because hyperparathyroidism often begins without symptoms, it may be
diagnosed by high calcium levels on a routine blood test. Confirmation of
high levels of PTH in the blood establishes the diagnosis of hyperparathyroidism.
Sometimes x-ray examination of the abdomen shows kidney stones caused by the
high calcium levels. Bone density tests may be performed to indicate the extent
of calcium loss from the bones.
Age older than 60 years
Multiple endocrine neoplasia (an inherited
condition involving the endocrine glands, including the parathyroid glands)
Kidney failure (risk factor for secondary hyperparathyroidism)
Pain in other areas of the body
High blood pressure
Osteoporosis (thin bones)
Fractures of weak bones
Surgery is the usual treatment for primary hyperparathyroidism. The
glands are surgically removed (parathyroidectomy)
through a small incision in the neck. The most common complications of this
surgery are damage to the nerve supplying the vocal cords (causing hoarseness
or voice loss) and low blood levels of calcium (hypocalcemia). Hypocalcemia following surgery can be treated with medication and
often resolves in a few months after the operation. If an individual does
not have any symptoms from hyperparathyroidism, close monitoring of blood
calcium levels may be chosen for treatment instead of surgery. This monitoring
includes checking blood calcium levels and examinations by a doctor looking
for possible complications of hyperparathyroidism. Bone density tests may
be used to follow progression of hyperparathyroidism.
National Institute of Diabetes and Digestive and Kidney Diseaseshttp://www.niddk.nih.gov
Thyroid Foundation of America 800/832-8321 http://www.tsh.org
To find this and previous JAMA Patient Pages, go to the Patient Page
Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Source: National Institute of Diabetes and Digestive and Kidney Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: ENDOCRINE DISEASE
Torpy JM, Lynm C, Glass RM. Hyperparathyroidism. JAMA. 2005;293(14):1818. doi:10.1001/jama.293.14.1818