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Treatment

The treatment of parathyroid disease depends on the type (primary or secondary) and the underlying cause. Getting the right diagnosis is the first step in treatment.

Are there medications to treat primary hyperparathyroidism?

There are no medications that cure primary hyperparathyroidism. The only cure is with an operation to remove the diseased parathyroid glands. There are medications that can decrease calcium and PTH levels, but they are not treating the underlying problem. They can make your levels look better on paper, but not necessarily make you any healthier. Cinacalcet (Sensipar) is a medication that is ...

Cinacalcet (Sensipar) Treatment

Is it safe to wait for surgery? I was diagnosed with primary hyperparathyroidism and told that I need surgery. Unfortunately I cannot get the operation done this month. Is it safe to delay the operation for a few months?

It is fine to delay. This is a disease that causes problems over decades. A delay of months, or even a year, is not likely going to cause any harm. You have likely had this growing for several years already before being diagnosed (this is true for most patients), so a little longer won't significantly harm you. While you are waiting for the operation, the best things to do are: stay hydrated...

Primary HPT Operation Treatment

How is parathyroid disease treated?

For the most common type of parathyroid disease, called primary hyperparathyroidism, the only treatment is an operation. During the operation, one or more diseased parathyroid glands are removed. Primary hyperparathyroidism is characterized by high calcium (generally over 10.0 mg/dl in adults over age 40, slightly higher for younger adults). If you have parathyroid disease with high calcium, th...

Operation Treatment FAQ Popular

Does parathyroid surgery have to be performed for primary hyperparathyroidism if I don't have any symptoms? Can nutrition or natural medicine correct hyperparathyroidism?

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 ...

Operation Primary HPT Treatment

This question is regarding Direct Visualization of all 4 parathyroids versus radioguided parathyroidectomy. When directly visualizing the 4 parathyroids, is it easy to tell a normal gland versus a hyperactive gland? I'm sure it is easy to tell if one is grossly enlarged but if it is going abnormal (producing too much PTH) but not yet enlarged, can that be seen or can it only detected by the radioactivity? If 2 of the glands are abnormal or will become abnormal, do they usually become abnormal at the same time? The reason I ask this question is that I see you worked at the Norman Parathyroid Center who uses the radioguided method while you prefer the direct visualization method. Do you still run a sestamibi scan before each surgery but simply don't take a sample of each gland to test individually for radioactivity? Is it just a difference in your views on sampling via visual and being able to tell by size or texture or other feature rather than radioactivity and consequential exposure for patients? Since 20% have more than one gland hyperactive, I'm wondering how certain the visualization is or if in certain cases you do test. I see your method is different now from what you did at Norman Center and just wondered why you changed.

Thank you for your question. It touches on several important aspects of parathyroid surgery. I was at the Norman Parathyroid Center for six years, and was the Medical Director when I left to start my own practice. In starting my own center, I took a close look at our practices in Florida and critically evaluated each one. For the most part, the operation that I do here is the same as the one I ...

Operative technique Primary HPT Treatment Operation

The local endocrinologist diagnosed me with primary hyperthyroidism. Ultrasound showed a 22 mm thyroid nodule. Should I have a FNA prior to having a surgical evaluation at your center? My calcium is 10.6 mg/dl and PTH 116 pg/ml.

Thyroid nodules are very common, especially as we get older. It is very common for thyroid nodules to be discovered on imaging for parathyroid disease. Do the nodules need to be biopsied prior to parathyroid surgery? It depends. I would want to see more information about the nodule before giving a recommendation. Most thyroid nodules are completely benign; some nodules will contain cancer. ...

Thyroid nodule Primary HPT Diagnosis Operation Treatment

I have both high pth (140) and high calcium (10.4). A Scan of my parathyroid glands showed normal. What should I do to lower these?

Thanks for writing. Your scenario is fairly common. Your labs are classic for primary hyperparathyroidism (high calcium and high PTH), but your parathyroid scans are negative (no parathyroid tumors seen). So what should you do to lower the calcium and PTH? **Short answer: A parathyroid operation.** Long answer: Parathyroid surgery is the only way to cure primary hyperparathyroidism. ...

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