What causes parathyroid disease? A simple guide
Parathyroid disease affects small glands in the neck that are responsible for regulating calcium levels in the body.
In this article, ENT consultant Mr Todd Kanzara explains the causes of parathyroid disease and who may be at risk.
What are the parathyroid glands?
Although they sit just behind the thyroid gland, the parathyroid glands are entirely separate and have a different function. Most people have four parathyroid glands, each roughly the size of a lentil.
Their main role is to produce parathyroid hormone (PTH), which helps regulate calcium and phosphate levels in the blood. These minerals are essential for normal function of the bones, nerves, and muscles.
What is parathyroid disease?
Parathyroid disease occurs when the glands produce either too much or too little parathyroid hormone.
Hyperparathyroidism:
Overactive glands produce too much PTH, raising calcium levels. Symptoms include fatigue, muscle weakness, low mood, bone pain, kidney stones, and abdominal discomfort.
Hypoparathyroidism:
Underactive glands produce too little PTH, lowering calcium levels. Symptoms include tingling in the hands or face, muscle cramps, dry skin, irritability, and in severe cases, seizures.
What causes hyperparathyroidism?
Hyperparathyroidism is more common and develops in one of the following ways:
Primary hyperparathyroidism
A benign tumour (parathyroid adenoma) causes one of the glands to release excess PTH. Less commonly, all four glands may be enlarged (parathyroid hyperplasia), often due to inherited conditions.
Secondary hyperparathyroidism
This form occurs when another condition (usually chronic kidney disease) leads to low calcium levels. In response, the parathyroid glands become overactive to compensate.
Tertiary hyperparathyroidism
In long-standing secondary hyperparathyroidism, the glands may remain overactive even after the original problem is corrected. Tertiary hyperparathyroidism is often seen in patients with kidney transplants.
What causes hypoparathyroidism?
This condition is much less common and has a different set of causes:
Surgical injury
Accidental damage or removal of the parathyroid glands during thyroid, parathyroid, or neck surgery.
Autoimmune conditions
In rare cases, the immune system mistakenly attacks the parathyroid glands, reducing hormone production.
Genetic causes
Some individuals are born with underdeveloped or malfunctioning parathyroid glands due to inherited conditions.
Low magnesium levels
Magnesium is needed for PTH secretion. Severely low levels can temporarily suppress hormone production.
Who is at risk of parathyroid disease?
Parathyroid disease can affect anyone, but certain factors increase the risk:
- Being over 50 years old.
- Being female (especially for primary hyperparathyroidism).
- A family history of parathyroid or endocrine disease.
- Chronic kidney disease.
- Previous thyroid or neck surgery.
Understanding what causes parathyroid disease can help in recognising issues early and seeking timely medical advice.
If you have concerns about your calcium levels or a possible parathyroid issue, consult with Mr Kanzara via his Top Doctors profile.