Primary hyperparathyroidism is a condition where the parathyroid gland becomes overactive and starts to secrete an excessive amount of a hormone that increases the calcium levels in the blood by causing resorption of the bone.
The reasons why this occurs are varied. The most common one is the presence of a non-cancerous tumor in the gland. A cancerous tumor can also be the cause, but studies show that less than 1% of all cases are caused by a malignant growth. Another common reason for primary hyperthyroidism is an enlargement of the parathyroid gland due to normal variation and processes.
The treatment of primary hyperthyroidism can be divided into non-surgical and surgical modalities.
Non-Surgical Treatment For Primary Hyperthyroidism
Only people that are asymptomatic are advised to go in for non-surgical treatment. The doctor will likely do a test for bone density and will keep the patient under regular observation if it is found to be only slightly decreased.
Kidney function, serum calcium levels, and vertebral fractures will also be assessed before a patient is declared asymptomatic.
Patients are required to remain active to stimulate bone density, and to avoid lithium or diuretics that can increase the calcium levels in the blood. They are also put on calcium and Vitamin D supplements to ensure that any excessive loss is being compensated for.
An oral dose of Bisphosphonates or other drugs used to prevent bone resportion may also be prescribed to the patient.
Surgical Treatment Of Primary Hyperparathyroidism
This is the treatment of choice in most cases of primary hyperthyroidism. The procedure involves the identification and removal of one or most of both parathyroid glands in the body. The surgeon will leave behind one or a part of one parathyroid gland so that a normal amount of hormone may continue to be released in the body.
The procedure is relatively safe and can even be performed under local anesthesia as an outpatient procedure. People in their latter decades of life can also undergo this procedure with relative ease.
In some cases, an aberrant/unexpected piece of parathyroid gland tissue may be located elsewhere in the body and thus the serum calcium levels will continue to be high even after the procedure has been performed.
In this case, a second procedure may have to be performed to remove that tissue after it has been detected through the required imaging procedures.
Possible Complication Of Parathyroid Gland Surgery
Even though the surgery to be performed is considered a simple procedure, all surgery comes with risks.
The patient may be required to be put under general anesthesia and that in itself carries the risk of complications. The chance of injury to the remaining parathyroid gland leading to a decrease in its function is also present.
There are many important anatomic structures related to the parathyroid gland that may be injured due to surgeon error.
Advances in surgical techniques and imaging techniques have made this procedure more predictable and less invasive than ever before. It is the clear treatment of choice and should be considered favorable by the patients.
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