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We all normally have four parathyroid glands located in our necks, which produce Parathyroid Hormone (PTH) to control the amount of calcium in our blood, nervous system and bones. If a tumor develops on these glands, it is called parathyroid disease, or hyperparathyroidism. These tumors can cause the glands to produce more hormone than needed (hyper means excessive), resulting in unhealthy, elevated levels of blood calcium, as well as a loss of needed calcium in the bones (osteoporosis) and the potential formation of kidney stones.
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In most patients – approximately 80 percent – a tumor forms in the gland. This tumor is called a parathyroid adenoma and causes over-production of hormone. The remaining 20 percent may be caused by external factors, such as renal failure or other conditions. Parathyroid disease may rarely be caused by genetic mutations shared within families.
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Parathyroid cancer is extremely rare – about 1 in 2 million. Most parathyroid tumors are benign, or non-cancerous. However, some patients have developed other cancers after having been diagnosed with hyperparathyroidism leading some to speculate on whether or not tumors of the parathyroid can lead to other cancers. At this time, however, there is no evidence to link hyperparathyroidism with development of other cancers. More research has to be done in this area.
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Calcium is essential in maintaining many important body functions. We all know that calcium is important in maintaining strong, health bones and teeth. But it’s also vital to our heart, nervous system and kidneys. When working properly, our parathyroid glands produce just the right amount of PTH to keep the perfect balance of calcium in our bones, blood and nervous system. If too much is produced, due to a tumor in the parathyroid gland, we call this hyperparathyroidism, or parathyroid disease.
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Unfortunately, the symptoms of parathyroid disease can be somewhat vague or even general. Some patients complain of fatigue, memory loss, irritability, leg or bone pain, headaches, constipation, kidney stones and higher blood pressure.
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Generally, women over the age of 45 are more likely to develop an overactive parathyroid, but it occurs in both men and women of all ages.
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The diagnosis is made by measuring blood calcium, blood parathyroid hormone and, sometimes, urine calcium levels. The diagnosis cannot be made by radiologic studies. Many times, the location of the parathyroid tumor can be identified by using an ultrasound, a nuclear medicine scan “parathyroid” scan, or a CT scan. Not finding a parathyroid tumor on scans/ultrasound does not mean a person does not have hyperparathyroidism.
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The only treatment for an overactive parathyroid gland is surgical removal. Most of our patients at Vanderbilt go home just hours after a minimally invasive parathyroid procedure. The procedure requires only a small incision over the base of the neck.