Hernia and 
General Surgeon  
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Parathyroid Glands

Both over-active (hyper) and under-active (hypo) parathyroids can cause disease conditions. Hyperparathyroidism and Hypoparathyroidism are distinct syndromes with different symptoms, risks and treatments.

We have 4 of these glands because they are so important. We only need one or two to function normally so have 2-3 spare!  We offer advice on the investigation, diagnosis and treatment of these conditions.

Click here for advice on the function of the parathyroid glands.

Dr Richard Owen was the first to identify the Parathyroid gland. He found them in an Indian Rhinoceros at London Zoo in 1852. It wasn't till the 1980's that the role of PTH in fine-tuning blood calcium levels was demonstrated in the US. In 2011 their normal size was first described in a study by Mr Kirkby-Bott.

Hyperparathyroidism (overactive parathyroid function)

is the over expression of a hormone called PTH (parathyroid hormone). There are 3 different types of hyperparathyroidism. These are known as:

Usually when we talk about Hyperparathyroidism we are talking about Primary hyperparathyroidism or Primary HPT.  

PTH fine tunes the blood calcium level as very tight control is needed for efficient bodily function. As calcium is an important part of cell signalling, muscle contraction, neurone (nerve) function and skeletal strength a high blood calcium can have lots of effects on the body. Objectively, this can cause kidney stones as having a high concentration of calcium in your urine can make kidney stones that cause pain and or recurrent urine infections. PTH is also important in bone strength and overactive parathyroids secrete a lot of PTH which takes calcium out of the bone and into the blood reducing your bone mineral density and increasing the risk of osteoporosis and bone fractures. Hyperparathyroidism can make osteoporosis worse and develop at a younger age. Because calcium levels are important to muscle and nerve function as well as telling cells what to do you can get generalised symptoms such as tiredness. Excessive thirst and excessive urination that keeps you up at night can worsen this. Muscle (rather than joint) aches and pains, an upset tummy and abdominal pains can occur. It often causes a fogging of the brain with altered concentration, poor memory, anxiety, depression and emotional lability (flying off the handle or crying for no reason).

These symptoms can be reversed by successful surgery. It is important to note here that a lot of these symptoms can come from modern life. They won't all get 100% better. Population based studies though have shown that more than 70-80% of patients having surgery report a significantly improved quality of life after surgery.

Learn more about the benefits of Parathyroid surgery

What is Minimally invasive Parathyroid surgery?

This operation is used for successfully localised primary hyperparathyroidism where we know where the abnormal gland is. It is the operation we usually offer in over 95% of cases. It is a 2-3cm incision in the neck over where the gland is. It is done under a general anaesthetic and nerve block to smooth recovery. It carried out as a day case. Frozen section and intra-operative PTH measurement can have a role in a few cases, but don't reduce the risk of failure by any more than an additional 1%. The chance of surgery being successful in first time surgery is around 96-97% without using them.

No operation is without some risks and these are discussed here. 

Post operation advice for parathyroid surgery can be found here

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