The only known cure for primary hyperparathyroidism (pHPT) is an operation: parathyroidectomy. It’s natural to wonder whether this needs to be done, though, if you aren’t experiencing any ill effects from the condition. Many patients with pHPT report symptoms like fatigue, brain fog, low energy, body aches, and insomnia. But a few patients say that they feel just fine. These patients often ask me if they really need to treat something that is not causing a problem. And if they do need to treat it, they would prefer something less invasive than an operation.

There are two separate issues here. First, does parathyroid disease need to be treated if you don’t have any symptoms? The answer here is fairly straightforward. We know that untreated parathyroid disease can lead to significant health effects in the long-term, including kidney disease, osteoporosis (and bone fractures), hypertension, and cardiac arrhythmias. We can prevent these issues by curing the parathyroid disease. Even if you feel fine right now, you don’t want to put yourself at risk in the future.

The second question is: Is there a non-surgical treatment for parathyroid disease? Nutrition and lifestyle are important for maintaining health, but unfortunately they cannot be used to treat primary hyperparathyroidism. We have medications that can treat symptoms, but do not have any medications that will cure the disease. Parathyroid surgery remains the only cure.

Some people will still choose to avoid or delay surgery, and for those patients, here is what I recommend: 1. Maintain a healthy diet. This is important for everyone! You do not need to avoid calcium-containing foods entirely. You can have a moderate amount of calcium in your diet. 2. Do not take Vitamin D or calcium supplements. pHPT causes “low Vitamin D” - you do not want to treat this prior to parathyroid surgery, since Vitamin D supplementation can further raise your calcium. 3. Exercise regularly. This is another one that is very important for everyone. Regular exercise is good for your brain, heart, and bones, so it may mitigate some of the negative health effects of parathyroid disease. 4. Read about parathyroid disease and connect with other parathyroid patients online. The more you know about the condition, the better you will be able to advocate for your own health.