Summary about Disease
Parathyroid disease encompasses conditions where the parathyroid glands, four small glands located in the neck near the thyroid, malfunction. These glands regulate calcium levels in the blood. The most common problem is hyperparathyroidism, where one or more glands become overactive, leading to elevated calcium levels (hypercalcemia). Hypoparathyroidism, where the glands are underactive, is less common and results in low calcium levels (hypocalcemia). Both conditions can cause a variety of symptoms and, if left untreated, can lead to serious health problems.
Symptoms
Symptoms vary depending on whether the condition is hyperparathyroidism or hypoparathyroidism and the severity of the calcium imbalance.
Hyperparathyroidism (High Calcium):
Bone pain
Fatigue
Weakness
Frequent urination
Excessive thirst
Kidney stones
Constipation
Nausea and vomiting
Depression, anxiety, or cognitive problems
High blood pressure
Hypoparathyroidism (Low Calcium):
Muscle cramps, spasms, or twitching (tetany)
Numbness or tingling in the fingers, toes, or around the mouth
Seizures
Dry skin
Brittle nails
Hair loss
Fatigue
Anxiety or depression
Causes
Hyperparathyroidism:
Parathyroid adenoma: A noncancerous tumor on one of the parathyroid glands is the most common cause.
Parathyroid hyperplasia: Enlargement of all four parathyroid glands.
Parathyroid cancer: A rare cause of hyperparathyroidism.
Kidney disease: Can lead to secondary hyperparathyroidism.
Hypoparathyroidism:
Surgical damage: Most commonly due to damage or removal of the parathyroid glands during thyroid or other neck surgery.
Autoimmune disease: The body's immune system attacks the parathyroid glands.
Genetic conditions: Certain inherited disorders can cause hypoparathyroidism.
DiGeorge syndrome: A genetic disorder causing incomplete development of several body systems.
Magnesium deficiency: Low magnesium levels can impair parathyroid function.
Radiation therapy: Radiation treatment to the neck can damage the parathyroid glands.
Medicine Used
Hyperparathyroidism:
Calcimimetics (e.g., Cinacalcet): These medications mimic calcium and trick the parathyroid glands into releasing less parathyroid hormone (PTH).
Bisphosphonates (e.g., Alendronate): These medications help strengthen bones and reduce the risk of fractures, especially if surgery is not an option.
Vitamin D supplements: Sometimes used cautiously, as Vitamin D can increase calcium absorption.
Hypoparathyroidism:
Calcium supplements: Oral or intravenous calcium to raise blood calcium levels.
Vitamin D supplements (Calcitriol): To help the body absorb calcium.
Recombinant human parathyroid hormone (rhPTH): This injectable medication can help regulate calcium and phosphate levels and reduce the need for high doses of calcium and vitamin D.
Thiazide diuretics: Can help the kidneys retain calcium in some cases.
Is Communicable
No, parathyroid disease is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Hyperparathyroidism:
Stay well hydrated to reduce the risk of kidney stones.
Avoid excessive calcium intake.
Engage in weight-bearing exercise to strengthen bones.
Regular monitoring of calcium and PTH levels is crucial.
Hypoparathyroidism:
Adhere strictly to the prescribed medication regimen (calcium and vitamin D supplements).
Follow a diet rich in calcium and low in phosphorus.
Avoid certain medications that can interfere with calcium absorption.
Wear a medical alert bracelet indicating the condition.
Regular monitoring of calcium, PTH, and phosphate levels is crucial.
How long does an outbreak last?
Parathyroid disease is not an "outbreak" in the traditional sense of an infectious disease. It is a chronic condition. The duration of symptoms and the course of the disease vary depending on the underlying cause, severity, and treatment effectiveness. If left untreated, the complications can be life long and progressive.
How is it diagnosed?
Blood tests:
Measuring calcium levels (serum calcium) is the primary diagnostic test.
Parathyroid hormone (PTH) levels are also measured.
Kidney function tests (BUN and creatinine).
Vitamin D levels.
Urine tests:
24-hour urine collection to measure calcium excretion.
Bone density test (DEXA scan): To assess bone health.
Imaging studies:
Sestamibi scan: A nuclear medicine scan used to locate overactive parathyroid glands.
Ultrasound: Can visualize the parathyroid glands and identify enlarged glands or tumors.
CT scan or MRI: May be used in specific cases for further evaluation.
Timeline of Symptoms
The onset and progression of symptoms vary considerably.
Hyperparathyroidism: Symptoms can develop gradually over months or years. Some people may be asymptomatic for a long time. As calcium levels rise, symptoms like fatigue, bone pain, and kidney stones may appear.
Hypoparathyroidism: Symptoms can appear rapidly, especially after surgery (acute hypoparathyroidism). In other cases, the onset may be more gradual. Symptoms like muscle cramps, tingling, and seizures are common.
Important Considerations
Early diagnosis and treatment are crucial to prevent serious complications.
Surgery (parathyroidectomy) is often the primary treatment for hyperparathyroidism caused by a single adenoma.
Long-term management of hypoparathyroidism requires careful monitoring of calcium and vitamin D levels.
Individuals with parathyroid disease should consult with an endocrinologist (a specialist in hormone disorders).
Genetic testing may be appropriate in some cases, especially if there is a family history of parathyroid disorders.