Parathyroid gland

Parathyroid glands are small

glands of the endocrine system
which are located in the neck
behind the thyroid. There are
four parathyroid glands which are
normally the size and shape of a
grain of rice. Occasionally they can
be as large as a pea and still be
normal. The four parathyroids are
shown in this picture as the
mustard yellow glands behind the
pink thyroid gland. Normal
parathyroid glands are the color of
spicy yellow mustard
 The sole purpose of the parathyroid
glands is to control calcium within the blood
in a very tight range between 8.5 and 10.2. In
doing so, parathyroids also control how much
calcium is in the bones, and therefore, how
strong and dense the bones are.

The thyroid gland regulates the bodys

metabolism and has no effect on calcium
levels while parathyroid glands regulate
calcium levels and have no effect on
metabolism.
 Parathyroid hormone (PTH)

Release controlled by ionized calcium level with negative

feedback system
*Five major actions
1-Activates and increases the number of osteoclasts,
which mobilizes calcium from bone
2-Increases renal tubular reabsorption of calcium
3-Increases conversion of Vitamin D to active dihyoxy
form in kidneys
4-Increases urinary phosphate excretion, which reduces
calcium loss
5-Increases GI calcium absorption
 The Role of Calcium in the Human
Body...
1-To provide the electrical energy for
our nervous system.
2-To provide the electrical energy for
our muscular system.
3-To provide strength to our skeletal
system
Thus, calcium is the most closely regulated element
in our bodies! In fact, calcium is the ONLY
element / mineral that has its own regulatory
system (the parathyroid glands).
 Parathyroid Function

1-The parathyroid glands monitor the

calcium in the blood 24 hours per day.
2-The four parathyroid glands make more or
less parathyroid hormone (PTH) in response
to the level of calcium in the blood.
3-When the calcium in our blood goes too
high, the parathyroid glands STOP making
PTH--they shut down.
4-When the calcium in our blood goes too
low, the parathyroid glands make more PTH.
Increased PTH causes the body to put more
calcium into the blood.
Increased PTH causes the bones to release
their calcium into the blood.
5-Calcium is the most important element for
the nervous system, the muscular system,
and the skeletal system.
This is why parathyroid disease (over-
production of PTH) causes symptoms of the
brain, muscles, and bones.
Hyperparathyroidism is a disease of the
parathyroid glands...Too much parathyroid
hormone is produced by an overactive
parathyroid gland.
The most common cause of excess hormone
production (hyperparathyroidism) is the
development of a benign tumor in one of
the parathyroid glands.
 Symptoms of Parathyroid Disease

1-Loss of energy. Don't feel like doing

much. Tired all the time.
2-Kidney Stones.
3-High Blood Pressure .
4-Tired during the day and frequently feel
like you want a nap.
5-Can't concentrate, or can't keep your
concentration like in the past.
6-Decrease in sex drive.
7-Thinning hair (predominately in older
females).
8-Don't sleep like you used to. Wake up
in middle of night.
9-frequent headaches

Most people with hyperparathyroidism **

will have 2-4 of these symptoms. Some
will have lots of them.
 Hypoparathyroidism

Diagnosis and Causes

1 - Damage to the Parathyroid Glands from Surgery
2 - Developmental Defects in the
Parathyroid Glands
3 - Autoimmune Hypoparathyroidism
4 - Defects in the Parathyroid Hormone Molecule
5 - Defective Regulation of Parathyroid Hormone
Secretion
Treatment of Hypoparathyroidism

Calcium and Vitamin D Analogues

Parathyroid-Tissue Transplantation or
Parathyroid Hormone
WHAT CAUSES EXCESS PARATHYROID
HORMONE PRODUCTION?

The most common cause of

excess hormone production
(hyperparathyroidism) is the
development of a benign tumor
.in one of the parathyroid glands
HOW MANY PEOPLE GET PARATHYROID DISEASE
Hyperparathyroidism) ?

The incidence of parathyroid disease

(hyperparathyroidism) is about one in 20,000 people. Its
fairly uncommon--actually sort of rare, thus most
surgeons only see one patient with this disease per year
or two! It occurs in women more often than men (almost
exactly 75% women, 25% men), and the average age is
about 58 years old--but people of any age can get it.
.Young people do get parathyroid disease, but this is rare
 The 10 Parathyroid Rules of "
Norman"

1-There are no drugs that will make .1

parathyroid disease better.None.
2-Nearly all parathyroid patients have symptoms; 95% know
it--and feel bad. Most of the rest just dont know it
.until the disease is fixed
3-Symptoms of parathyroid disease do NOT correlate
with the level of calcium in the blood. Many patients
with only slightly elevated calcium and parathyroid
hormone will have BAD symptoms and develop severe
.osteoporosis
4-All patients with parathyroid disease have
calcium levels and PTH levels that go up and
down. Fluctuating levels of calcium are typical of
parathyroid disease
5-All patients with hyperparathyroidism will
develop osteoporosis. ALL
6-Taking Fosamax or Actonel will NOT help bones
that are being attacked by a bad
7-Parathyroid disease will get worse with time in
all patients. It will not stay the same, nor will it
get better on its own.
8-There is only one treatment for parathyroid
disease (hyperparathyroidism): Surgery
9-Nearly all parathyroid patients can be cured
with a minimal operation. The days of big
dangerous parathyroid surgery are gone (so
don't let your surgeon perform one on you!).
10-The success rate and complication rate
for parathyroid surgery is VERY dependent
upon the surgeons experience.
 summary
*There are 4 parathyroids glands. We all have 4
parathyroids.
*Except in rare cases, parathyroid glands
.are in the neck behind the thyroid
*Parathyroids are NOT related to the thyroid
.)(except they are neighbors in the neck
*The thyroid gland controls much of your body's
metabolism, but the parathyroid glands control
body calcium. They have no relationship except
.they are neighbors
.
*Parathyroid glands make a hormone, called
"Parathyroid Hormone".
*Doctors and labs abbreviate Parathyroid Hormone
as "PTH".
*Just like calcium, PTH has a normal range in our
blood...we can measure it to see how good or bad
a job the parathyroid glands are doing.
*All four parathyroid glands do the exact same
thing.
*Parathyroid glands control the amount of calcium
in your blood and bones.
*You can easily live with one (or even 1/2)
parathyroid gland.
Removing all 4 parathyroid glands will cause very
bad symptoms of too little calcium
(hyp0parathyroidism). Hyp0parathyroidism is the
opposite of hypERparathyroidism and it is very
rare...
*When parathyroid glands go bad, it is just one
gland that goes bad about 96-98% of the time--it
just grows big (develops a benign tumor) and
makes too much hormone.
*There is only ONE way to treat parathyroid
problems--Surgery.
 56 year old female
Parathyroid adenoma
Pre-op Calcium 10.5
Pre op PTH 75
Reno, Nevada
 year old male 51
Pre-op CA = 12.1
Pre-op PTH = 150
Seattle, Washington