Parathyroid Disorders

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for parathyroid disorders. As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.

Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our multidisciplinary team of world-renowned specialists has pioneered many of the otorhinolaryngological techniques used today and is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety.

When you need parathyroid disorder care, turn to our dedicated multidisciplinary team for a personalized treatment plan.

What Are Parathyroid Disorders?

The parathyroid glands play an important role in regulating calcium levels in the body through the production and secretion of parathyroid hormone (PTH). Parathyroid disorders occur when overactive or underactive parathyroid glands cause abnormal calcium levels, either too high or too low, which can negatively affect your bones, muscles, nerves and cardiovascular system.

Types of parathyroid disorders include:

  • Hyperparathyroidism: The parathyroid glands produce too much PTH, causing calcium levels to rise. This can lead to bone and organ damage.
  • Hypoparathyroidism: The parathyroid glands do not produce enough PTH, causing calcium levels to fall. This can lead to low calcium and high phosphorus levels.
  • Hypercalcemia: There is too much calcium in the blood, which can lead to organ failure, coma or death.
  • Hypocalcemia: There is too little calcium in the blood, which can lead to seizures or tetany (severe muscle spasms).

Causes of Parathyroid Disorders

The parathyroid glands, typically four pea-shaped glands located near or attached to the thyroid, produce and secrete PTH, which regulates calcium levels in the body. The parathyroid glands also help regulate magnesium and phosphorus levels. When the parathyroid glands make too much or too little PTH, calcium levels increase or decrease, causing a range of disorders, including:

  • Hyperparathyroidism: Excess PTH causes calcium levels to increase above normal. There are three types of hyperparathyroidism:
    • Primary hyperparathyroidism: An enlarged parathyroid gland, benign tumors on one or more of the parathyroid glands or, in rare cases, parathyroid cancer are typical causes.
    • Secondary hyperparathyroidism: Vitamin D deficiencies or kidney failure cause atypical levels of calcium and phosphate, causing the parathyroid to overcompensate and produce excess PTH.
    • Tertiary hyperparathyroidism: This disorder is typically seen in patients who have undergone kidney transplants.
  • Hypoparathyroidism: A less active parathyroid produces insufficient PTH causing lower-than-normal blood calcium levels. Injury to one or more parathyroid glands, congenital defects, autoimmune diseases, family history of hypoparathyroidism or surgical removal of the parathyroid gland are some causes of this disorder.

Signs & Symptoms of Parathyroid Disorders

Symptoms of parathyroid disorders may be subtle and present as other health conditions. Some signs include:

  • Bone and joint pain
  • Chronic fatigue
  • Kidney stones
  • Osteoporosis
  • Mental fogginess
  • Cardiovascular conditions (associated with high levels of calcium)
  • Pins and needles sensation in the hands, feet or mouth
  • Spasms of the face, hands, arms and feet
  • Seizures

Diagnosing Parathyroid Disorders

After a comprehensive physical examination and a review of your medical history, the physician will conduct tests to check your PTH, calcium and phosphorus levels. Other diagnostic tests may be used to understand more about the condition of your parathyroid, including:

  • Bone density scans
  • Ultrasound scan
  • Parathyroid nuclear scan 
  • Computerized tomography scan (CT)
  • Magnetic resonance imaging (MRI)
  • X-rays

Treating Parathyroid Disorders

Treatment plans for parathyroid conditions are developed based on the patient’s age and overall health, the severity of the condition and the underlying cause(s).

Primary and tertiary hyperparathyroidism may require surgery, usually to remove the enlarged or overactive gland.

Secondary hyperparathyroidism can be controlled with medication but, in some cases, may require surgery after the medication has failed or for those who are unable to take the medications.

Your health care provider may recommend a parathyroidectomy if one or more of your parathyroid glands is producing too much parathyroid hormone. A parathyroidectomy is surgery to remove the parathyroid glands or parathyroid tumors. The specific type of surgery depends on where the diseased parathyroid glands are. Surgery is done, most commonly, through a minimally invasive approach with a small incision in the lower neck.

Hypoparathyroidism is often treated by supplementing Vitamin D and calcium, which must be monitored carefully to optimize dosage.