Parathyroid Glands
The parathyroid glands are four tiny glands (only a few millimeters in size) located behind the thyroid gland in the neck region. They were named for their anatomical proximity to the thyroid gland.
Their primary function is to regulate calcium and phosphorus levels in the blood. They produce and secrete the parathyroid hormone (PTH), which increases blood calcium levels through three main mechanisms:
- Mobilizing calcium from the bones
- Promoting its absorption from the intestine by activating vitamin D
- Reducing its excretion by the kidneys
Calcium balance is of vital importance for the body. This essential element is fundamental to the human body.
Through their function, the parathyroid glands ensure the stability of calcium levels, something crucial for the normal function of the nervous and muscular systems, as well as for maintaining healthy bones.
As part of a routine blood check-up, it is important to always include a simple serum calcium test. The incidental finding of an elevated calcium level, even one that is near the upper limit of normal, should prompt the physician to request a more comprehensive evaluation.
Thus, when a parathyroid disorder is suspected, the initial laboratory assessment typically includes measurements of Parathyroid Hormone (PTH), Calcium, Phosphorus, Magnesium, Albumin, Vitamin D, as well as a 24-hour Urine Calcium test.
Due to their very small size, in the vast majority of cases normal parathyroid glands cannot be visualized on imaging.
Only when a pathological lesion develops in one or more of the parathyroid glands does medical imaging aim to detect them, using examinations such as ultrasound, scintigraphy, MRI, 4D CT, choline PET, and others.
If the patient’s primary physician does not suspect the condition early enough to investigate further, then in most cases of parathyroid disease:
- The patient will not present with any specific or obvious symptoms.
- A routine preventive ultrasound will not clearly visualize a mildly enlarged parathyroid gland.
- A mildly elevated or borderline calcium level in the blood is often not properly evaluated and, unfortunately, may be overlooked.
- Coexisting conditions such as osteoporosis, kidney stones, etc., may be underestimated and not correctly associated with a parathyroid disorder.
As a result, this is a diagnosis that frequently escapes detection in medical practice.
Once the condition is identified, often with delay, it clearly requires prompt management. Each day that elevated parathyroid hormone levels circulate in the bloodstream, they progressively damage the body across various organ systems.
The most common disorder of the parathyroid glands is hyperparathyroidism, in which the normal regulation of calcium and phosphorus levels in the blood is disrupted.
In hyperparathyroidism, one or more glands become overactive and secrete excessive amounts of Parathyroid Hormone (PTH), leading to elevated blood calcium levels. It is usually caused by a parathyroid adenoma, less commonly by glandular hyperplasia, and rarely by malignancy. In many cases, it causes no noticeable symptoms and is discovered incidentally through blood tests. When symptoms do occur, they may include fatigue, muscle weakness, bone pain, kidney stones, or osteoporosis. Treatment typically involves surgical removal of the affected gland.
Parathyroid dysfunction is a subtle and often underdiagnosed condition that may affect your health for a long time without obvious signs. If you have elevated or borderline calcium levels, unexplained fatigue, bone or muscle discomfort, kidney stones, or osteoporosis, do not ignore them.
Schedule an appointment for a specialized evaluation so that your parathyroid function can be thoroughly investigated and you can receive the appropriate guidance and treatment. Early diagnosis can prevent serious complications and significantly improve your quality of life.