Parathyroid glandParathyroid 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 The sole purpose of the parathyroid glands is to control parathyroid glands is to control calcium within the bloodcalcium within the blood in a very tight in a very tight range between 8.5 and 10.2.  In doing so, range between 8.5 and 10.2.  In doing so, parathyroids also control how much parathyroids also control how much calcium is in the bones, and therefore, calcium is in the bones, and therefore, how strong and dense the bones are.how strong and dense the bones are. The The thyroidthyroid gland regulates the gland regulates the body’s metabolism and has no effect body’s metabolism and has no effect on calcium levels while parathyroid on calcium levels while parathyroid glands regulate calcium levels and glands regulate calcium levels and have no effect on metabolismhave no effect on metabolism..

Parathyroid hormone (PTH)Parathyroid hormone (PTH)

Release controlled by ionized calcium level with negative feedback system

*Five major actions1-Activates and increases the number of osteoclasts, which mobilizes calcium from bone 2-Increases renal tubular reabsorption of calcium3-Increases conversion of Vitamin D to active dihyoxy form in kidneys4-Increases urinary phosphate excretion, which reduces calcium loss 5-Increases GI calcium absorption

The Role of Calcium in the Human The Role of Calcium in the Human Body... 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 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.

44--When the calcium in our blood goes When the calcium in our blood goes too low, the parathyroid glands make too low, the parathyroid glands make moremore PTH. PTH. Increased PTH causes the body to put Increased PTH causes the body to put more calcium into the blood.more calcium into the blood. Increased PTH causes the bones to Increased PTH causes the bones to release their calcium into the blood.release their calcium into the blood.55-Calcium is the most important -Calcium is the most important element for the nervous system, the element for the nervous system, the muscular system, and the skeletal muscular system, and the skeletal system.system. This is why parathyroid disease (over- This is why parathyroid disease (over-production of PTH) causes symptoms of production of PTH) causes symptoms of the brain, muscles, and bonesthe 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 DiseaseSymptoms 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.

77--Thinning hair (predominately in Thinning hair (predominately in older females).older females).8-Don't sleep like you used to. Wake 8-Don't sleep like you used to. Wake up in middle of night.up in middle of night.9-frequent headaches9-frequent headaches

****Most people with Most people with hyperparathyroidism will have 2-4 of hyperparathyroidism will have 2-4 of these symptoms. Some will have lots these symptoms. Some will have lots of themof them..

HypoparathyroidismHypoparathyroidism

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 Treatment of HypoparathyroidismHypoparathyroidism

Calcium and Vitamin D AnaloguesCalcium and Vitamin D Analogues Parathyroid-Tissue Parathyroid-Tissue Transplantation or Parathyroid Transplantation or Parathyroid HormoneHormone

WHAT CAUSES EXCESS WHAT CAUSES EXCESS PARATHYROID HORMONE PARATHYROID HORMONE

PRODUCTION?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 HOW MANY PEOPLE GET PARATHYROID DISEASE Hyperparathyroidism) ?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 The 10 Parathyroid Rules of Norman"Norman"

1. 1-There are no drugs that will make parathyroid disease better….None.

2-Nearly all parathyroid patients have symptoms; 95% know it--and feel bad. Most of the rest just don’t 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.

44--All patients with parathyroid disease have All patients with parathyroid disease have calcium levels and PTH levels that go up and calcium levels and PTH levels that go up and down. Fluctuating levels of calcium are down. Fluctuating levels of calcium are typical of parathyroid diseasetypical of parathyroid disease5-All patients with hyperparathyroidism will 5-All patients with hyperparathyroidism will develop osteoporosis.  ALLdevelop osteoporosis.  ALL6-Taking Fosamax or Actonel will NOT help 6-Taking Fosamax or Actonel will NOT help bones that are being attacked by a bad bones that are being attacked by a bad 7-Parathyroid disease will get worse with 7-Parathyroid disease will get worse with time in all patients. It will not stay the same, time in all patients. It will not stay the same, nor will it get better on its own.nor will it get better on its own.8-There is only one treatment for parathyroid 8-There is only one treatment for parathyroid disease (hyperparathyroidism): Surgerydisease (hyperparathyroidism): Surgery

99--Nearly all parathyroid patients can be Nearly all parathyroid patients can be cured with a minimal operation. The cured with a minimal operation. The days of big dangerous parathyroid days of big dangerous parathyroid surgery are gone (so don't let your surgery are gone (so don't let your surgeon perform one on you!).surgeon perform one on you!).10-The success rate and complication 10-The success rate and complication rate for parathyroid surgery is VERY rate for parathyroid surgery is VERY dependent upon the surgeon’s dependent upon the surgeon’s experienceexperience..

summarysummary*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 glands make a hormone, called "Parathyroid Hormone"."Parathyroid Hormone".**Doctors and labs abbreviate Parathyroid Doctors and labs abbreviate Parathyroid Hormone as "PTH".Hormone as "PTH".*Just like calcium, PTH has a normal range in *Just like calcium, PTH has a normal range in our blood...we can measure it to see how our blood...we can measure it to see how good or bad a job the parathyroid glands are good or bad a job the parathyroid glands are doing.doing.**All four parathyroid glands do the exact All four parathyroid glands do the exact same thing.same thing.*Parathyroid glands control the amount of *Parathyroid glands control the amount of calcium in your blood and bones.calcium in your blood and bones.**You can easily live with one (or even You can easily live with one (or even 1/2) parathyroid gland1/2) parathyroid gland..

Removing all 4 parathyroid glands will Removing all 4 parathyroid glands will cause very bad symptoms of too little cause very bad symptoms of too little calcium (hypcalcium (hyp00parathyroidism). parathyroidism). Hyp0parathyroidism is the opposite of Hyp0parathyroidism is the opposite of hypERparathyroidism and it is very rare...hypERparathyroidism and it is very rare...**When parathyroid glands go bad, it is just When parathyroid glands go bad, it is just one gland that goes bad about 96-98% of one gland that goes bad about 96-98% of the time--it just grows big (develops a the time--it just grows big (develops a benign tumor) and makes too much benign tumor) and makes too much hormone.hormone.*There is only ONE way to treat parathyroid *There is only ONE way to treat parathyroid problems--Surgeryproblems--Surgery..

56 year old female Parathyroid adenomaPre-op Calcium 10.5

Pre op PTH 75Reno, Nevada

year old male 51

Pre-op CA = 12.1Pre-op PTH = 150

Seattle, Washington