While most patients have a general idea that the thyroid produces a hormone that plays a part in controlling metabolic activity of the body, most have never heard of a parathyroid.

Parathyroid gland consists of four pea sized glands which lie behind the thyroid and produce parathyroid hormone which is important in controlling calcium levels in your blood and bones. Correct calcium levels are important to many important functions in the body including nervous, muscles, and brain function. When functioning normally each of your four parathyroid gland senses calcium levels and responds to decreasing calcium levels by increasing production of parathyroid hormone which in turn increases calcium in your blood by effect of your GI tract (absorption of calcium) kidney (affect how calcium kidneys preserve or eliminates) and affect whether calcium is being stored in bone.

Hyperparathyroidism occurs when usually one of your four parathyroids enlarges and produces parathyroid hormone continuously rather than in response to decreasing calcium levels in your blood. This is usually due to a begign adenoma. Parathyroid cancer does occur but is so rare it does not warrant incision here.

The effect of an overactive parathyroid are numerous and can include production of kidney stones, depression or change in mood, memory loss, muscle aches, or muscle weakness. It frequently has symptoms similar to normal aging. In addiction hyperparathyroidism can accelerate osteoporosis.

Occasionally patients will be diagnosed with hyperparathyroidism due to development of kidney stones or specific symptoms. Frequently however the process of diagnosis is started by your doctor noting slightly elevated calcium on routine blood work. The diagnosis is confirmed by obtaining a blood test indicating elevated parathyroid hormone levels. Occasional collection of urine to determine calcium elevation in urine is also helpful.

Once the diagnosis is confirmed, ultrasound of the neck and sometimes a nuclear medicine scan of the neck are done in an attempt to determine which of the four parathyroid glands is overactive and enlarge. These studies confirm the correct location of the enlarged parathyroid about 80% of the time and are helpful in surgery planning. Negative ultrasound and nuclear medicine studies however do not mean that an overactive parathyroid is not present. It does however mean that your surgeon will have to search all four glands to find the offending gland.

Treatment of hyperparathyroidism requires surgery to remove the enlarged parathyroid gland. There is no definitive medical treatment of this malody.

Surgical time varies depending whether we are able to determine before surgery which of the gland is enlarged and therefore limit our exploration of the neck but generally is in the 1-2 hour range. We commonly monitor the patient overnight in the hospital.

Recovery involves limited strenuous activity for about a week. Pain after surgery is mostly a sore throat and some pain with swallowing for a couple of days.

The majority of patients who undergo removal of an overactive parathyroid feel better in subtle ways after the surgery. Common comments on follow up in the office include more energy, better memory, less aches and pain. About 20% of patients feel no different than before surgery. However despite symptom relieve consideration of surgery should be entertained due to effects of hyperparathyroidism according osteoperous as well as the many suitable symptoms which are difficult to discern from effects of normal aging.