What are the parathyroid glands?

Located discreetly behind the thyroid gland, the parathyroid glands can be easily overlooked. However, their role is anything but minor — they secrete a hormone that influences everything from nerve conduction to bone health.

In this article, we cover:

• What are the parathyroid glands and what do they do?
• What hormones do the parathyroid glands produce?
• What can go wrong with the parathyroid glands?
• What are the symptoms of hyperparathyroidism?
• How is hyperparathyroidism diagnosed?
• Hyperparathyroidism treatment
• How to check your hormone health

What are the parathyroid glands and what do they do?
 

The parathyroid glands are four pea-sized glands in your neck. Their name relates to their proximity to the thyroid gland, but apart from being close neighbours, they have little else in common.

The parathyroids are part of the endocrine system of glands that regulate most of the body’s functions and processes.

They regulate the level of calcium in your body, which is vital for strong bones and teeth, and the functioning of the nervous and muscular systems.

What hormones do the parathyroid glands produce?
 

The parathyroid glands produce parathyroid hormone (PTH). By controlling the release of PTH in the bloodstream, the parathyroids regulate the amount of calcium in your blood and bones. PTH also controls levels of vitamin D and phosphorus.

If the parathyroids receive the message that the calcium level in your blood is too low, they respond by releasing more PTH. This causes your kidneys and intestines to absorb calcium. It also triggers the release of calcium from your bones. If the glands detect excess calcium in your blood, they secrete less PTH.

What can go wrong with the parathyroid glands?
 

The most common condition of the parathyroid glands is when they become overactive (hyperparathyroidism). In this condition, one or more of the parathyroid glands produces too much PTH. This leads to excess calcium in the blood and can cause other health problems.

Causes of hyperparathyroidism:

• A non-cancerous tumour (adenoma) on one of the glands
• Enlargement of two or more of the parathyroids (hyperplasia)
• Rarely, a cancerous tumour of the parathyroid gland

Hyperparathyroidism is more common in women than men, and most people who develop it are over 60 [1].

Other risk factors include having certain inherited conditions that affect several glands in the body, such as multiple endocrine neoplasia.

The parathyroid glands can also become underactive (hypoparathyroidism), leading to abnormally low parathyroid hormone levels. However, this condition is rare. It’s usually caused by removal of or accidental damage to the parathyroid glands during thyroid gland surgery.

What are the symptoms of hyperparathyroidism?
 

Hyperparathyroidism affects people differently. Some people may have many symptoms while others have none. They can come on suddenly or develop gradually over several years.

Symptom severity isn’t always related to the level of calcium in the blood. For instance, some people experience severe symptoms with only slightly raised levels, while those with high calcium levels may experience mild or no symptoms.

Many symptoms are non-specific and can be confused with other conditions, especially if they’re mild. Therefore, there’s a risk of missed or delayed diagnosis.

Possible signs of hyperparathyroidism [2]:

• Constipation
• Depression
• Feeling sick and losing your appetite
• Feeling thirsty and frequent urination
• Loss of concentration
• Muscle weakness
• Stomach pain
• Tiredness

If hyperparathyroidism isn’t treated, it can lead to abnormally high levels of calcium in the blood (hypercalcaemia).

Symptoms of hypercalcaemia:

• Being sick (vomiting)
• Bone and joint pain
• Confusion
• Dehydration
• Drowsiness
• High blood pressure (hypertension)
• Irregular heartbeat
• Muscle spasms

If left untreated, hypercalcaemia can cause health complications including:

• Heart problems
• Kidney failure
• Kidney stones
• Osteoporosis and bone fractures
• Pancreatitis (inflammation of the pancreas)
• Stomach ulcers

If you’re experiencing symptoms, it’s important to see your doctor to investigate the causes, so you can take early action.

Cases of hyperparathyroidism are usually diagnosed at an early stage in the UK, and therefore, complications are rare [1].

How is hyperparathyroidism diagnosed?
 

A diagnosis is made by a combination of symptom assessment and blood tests to measure levels of parathyroid hormone and calcium.

It’s important that hyperparathyroidism is diagnosed as early as possible, as without treatment, it can gradually worsen, increasing the likelihood of health complications.

However, in most cases, the condition is mild to moderate and can remain stable for years.
 

How is hyperparathyroidism treated?
 

Hyperparathyroidism is typically treated with surgery to remove the affected parathyroid or tumours on the glands.

Medication such as bisphosphonates may also be given to lower calcium levels. However, these are usually only used as a short-term treatment to stabilise levels before surgery.

In some cases, where calcium levels are only slightly raised, the kidneys are working well, and bone density is within the normal range, a doctor may recommend monitoring hyperparathyroidism instead of surgery.

Can you manage hyperparathyroidism naturally?
 

If you and your doctor have opted to monitor your condition, there are some healthy lifestyle changes that you can make. They’re unlikely to cure hyperparathyroidism (depending on the cause), but they may help manage symptoms and prevent complications. They’re also beneficial for your overall health and wellbeing.

Ways you can manage hyperparathyroidism include:

• Eat a healthy, balanced diet — monitor how much vitamin D and calcium you get in your diet. Although it may seem counterintuitive, restricting your calcium intake isn’t recommended. A lack of dietary calcium is more likely to lead to a loss of calcium from your bones, increasing your risk of osteoporosis [1].
• Drink plenty of fluids — drinking enough fluids (usually water) helps prevent dehydration and reduces your risk of kidney stones.
• Take regular exercise — physical activity, particularly strength training, can help strengthen your bones and may ease symptoms such as joint and muscle pain.
• Don’t smoke — smoking can increase your risk of bone loss, as well as several serious health conditions. If you want to stop, the NHS has plenty of advice on quitting smoking.

How to check your hormone health
 

If you want to check your hormones but are unsure which test is right for you, read our Male Hormone Blood Test Buying Guide or Female Hormone Blood Test Buying Guide.

If you want to know more about your hormone health, check out our Hormone Health Hub.

References

1. NHS (2021) Hyperparathyroidism. Available at: https://www.nhs.uk/conditions/hyperparathyroidism/ [Accessed 28 August 2024].
2. Cleveland Clinic (2024) Hyperparathyroidism. Available at: https://my.clevelandclinic.org/health/diseases/14454-hyperparathyroidism [Accessed 28 August 2024].