A brief analysis of hyperparathyroidism

A high level of calcium in the blood can sometimes be related to an enlarged, over functioning parathyroid gland, resulting in Hyperparathyroidism. This can often be detected by chance on blood tests, which might show a high calcium and high parathyroid hormone level. A high blood calcium level can cause various symptoms and potential complications. Leading ENT consultant Miss Natasha Choudhury provides a brief analysis of the condition, including details of surgery for Primary Hyperparathyroidism.

What are the symptoms of hyperparathyroidism?

Hyperparathyroidism results in a high circulating calcium levels or hypercalcaemia, which can impact a number of our bodily systems. Left untreated,it can increase the risk of osteoporosis and bony fractures, even from minor falls. It can also increase the risk of developing kidney stones, manifesting as pain and colic. It can also cause abdominal discomfort and constipation, and can even affect mood, leading to feelings of low mood or depression. Furthermore, high calcium levels have been linked to a variety of non-specific symptoms such as general fatigue and tiredness, a feeling of brain fog, poor concentration, and genralised aches and pains in the arms and legs and in the bones. These symptoms have also be shown to improve after parathyroid surgery (Quality of life improvement following parathyroid surgery: A preliminary 3 year review of 56 patients from a single surgical centre; Caton N and Choudhury N; Clin Otolaryngol 2019; 44(3):396-401. https://pubmed.ncbi.nlm.nih.gov/30588752/).

Treatment for Primary Hyperparathyroidism

If hyperparathyroidism is suspected due to a high calcium and parathyroid hormone level in the blood, a number of further investigations are needed to confirm the diagnosis, including further blood tests, urine analysis, and scans to identify which of the parathyroid glands may be affected. Once confirmed, surgery can be considered as a curative form of treatment for this condition.

What happens during parathyroid surgery?

Parathyroid surgery is performed through a small incision in the front of the neck, whilst the patient is under general anaesthetic. The scar produced is normally very small, and usually heals very well. Patients typically spend just one night in the hospital and are usually discharged the following day. Upon returning home, they can resume all normal daily activities such as walking around normally, and eating and drinking without any restrictions.

What risks are linked to surgery for parathyroid surgery?

Parathyroid surgery is usually very successful, with more than 90% cure rate; this will often correct the calcium levels and many of the symptoms, very quickly. All surgeries however, can carry some risks and for parathyroid surgery, there is a very small risk to the recurrent laryngeal nerve, which could potentially result in hoarseness of the voice if the nerve is bruised or injured. Additionally, there is a rare possibility of this affecting swallowing or breathing.

Although rare, there is also a possibility that the problematic parathyroid adenoma may not be located during surgery. In such cases, calcium levels would remain elevated. Alternatively, for those who opt against surgery or for whom it is not recommended, medical treatment is available to lower calcium levels, but this is not curative of the overfunctioning parathyroid gland. Parathyroid surgery is therefore the preferred option to provide curative treatment for this condition.

If you are experiencing problems hyperparathyroidism and would like to book a consultation with Miss Choudhury, simply visit her Top Doctors profile today.