Parathyroidectomy

I had some blood work done as a part of a routine physical last year that indicated hypercalcemia (increased calcium in my blood). My doctor ordered some additional blood work to verify the results and narrow down the cause. Life was a little crazy at the time, I wasn't that concerned, and I hate needles so I didn't get around to the follow-up blood work until August of this year. The hypercalcemia was still present as was abnormally high levels of parathyroid hormone (PTH). I don't remember the exact numbers but my PTH levels were around 2.5 times the upper limit of the normal range. My doctor diagnosed me with hyperparathyroidism and referred me to an endocrinologist.

The parathyroids are four tiny, flat, lentil-shaped glands located on the back of the thyroid. Location aside, they are not related to the thyroid. The parathyroids are responsible for regulating calcium and phosphorus in the blood. They release PTH which instructs the body to increase blood calcium concentrations. That increased calcium is pulled from the bones. Nearly all cases of hyperparathyroidism are caused by a benign tumor called an adenoma on one or more of the parathyroid glands.

The endocrinologist ordered more blood work. She used that to confirm a diagnosis of primary hyperparathydroidism. The cure is the surgical removal of the affected parathyroid(s) so she referred me to a surgeon. The surgeon and I had a consultation earlier this month and decided to go ahead with a parathyroidectomy. Surgery is scheduled for next Thursday, September 29th.

They'll make about a one inch cut low on my neck to investigate and remove the offending glands. Because of the location and size of the glands, there aren't any really effective imaging techniques to identify which ones need to go. A pathologist will perform a quick blood assay to make sure my PTH levels go down to normal before the completion of the surgery. They'll be keeping me overnight.

It doesn't seem to be a particularly risky surgery. The likeliest complication will be injury to the recurrent laryngeal nerve. I could end up with a weak, breathy voice that fatigues easily and have some difficulty swallowing. This usually clears up within a couple of months but it could also be persistant. I'll also, of course, end up with neck scar. I sport a pretty good sized scar on my forehead from the last time I had surgery (twenty-something years ago) that I've never minded so I doubt this new scar will bother me.

I'm apprehensive about the pain during recovery but mostly anxious to get cured. Symptoms of hyperparathyroidism (and the hypercalcemia it causes) include high blood pressure, fatigue, anxiety, excessive urination, depression, heat sensitivity, body aches, forgetfulness, excessive thirst, osteoporosis, and kidney stones. Excessive PTH has also been implicated in the promotion of weight gain [1]. Nearly all of those apply to me and they range from mildly annoying to really fucking shitty. My endocrinologist says that most patients who are cured feel like a new person afterward. My surgeon tried to hedge that optimism a bit but did say that I should experience at least some improvement in most of those symptoms. That's good enough for me!



  1. McCarty, M.F and Thomas, C.A. “PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight.” Medical Hypotheses, vol. 61, no.s 5-6, 2003, pp. 535–542.