When and why does the parathyroid gland cause an issue?

The parathyroid glands are four small glands located behind the thyroid in the neck, responsible for regulating calcium levels in the blood. They achieve this by producing parathyroid hormone (PTH), which helps control calcium absorption from food, release from bones, and excretion through the kidneys. However, when these glands become overactive or dysfunctional, they can cause significant health issues.

One of the most common disorders affecting the parathyroid glands is primary hyperparathyroidism (PHPT). This condition occurs when one or more of the glands produce excessive PTH, leading to abnormally high calcium levels in the blood (hypercalcemia).

The most common cause of PHPT is a benign tumour (adenoma) on one of the glands, though in some cases, all four glands may become enlarged (hyperplasia). High calcium levels can result in a range of symptoms, including fatigue, muscle weakness, kidney stones, osteoporosis, digestive problems, and cognitive difficulties such as memory loss and depression. If left untreated, long-term complications can arise, including an increased risk of fractures and cardiovascular disease.

Another condition, secondary hyperparathyroidism, occurs when the parathyroid glands become overactive in response to chronically low calcium levels. This is often seen in patients with chronic kidney disease, where impaired kidney function leads to difficulty maintaining proper calcium and vitamin D levels. In response, the parathyroid glands continuously produce excess PTH, which can weaken bones over time. If untreated, this condition may progress to tertiary hyperparathyroidism, in which the glands remain permanently overactive even after calcium levels are restored.

In rare cases, hypoparathyroidism occurs, where the parathyroid glands produce insufficient PTH, leading to low blood calcium levels (hypocalcemia). This can result in muscle cramps, tingling sensations, seizures, and cardiac complications. Causes include surgical removal of the glands, autoimmune conditions, or genetic disorders.

Recognising symptoms of parathyroid dysfunction early is crucial for effective treatment. Management options vary from monitoring mild cases to surgical removal of affected glands in more severe conditions. With timely intervention, patients can prevent complications and maintain balanced calcium levels for overall well-being.