Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
WHAT IS A Parathyroidectomy?
The four tiny parathyroid glands rest on the back of the thyroid gland. These glands regulate the body's blood calcium levels. A healthy parathyroid gland is small and mustard in colour, but if you suffer from a parathyroid disease, one of these glands grows to the size of a grape or walnut.
Why do I need a parathyroidectomy?
Hyperparathyroidism develops when either one or more of the parathyroid glands secretes an excess of the parathyroid hormone (PTH). As the levels of PTH increases, the body produces more calcium. A surplus of calcium in the blood is called hypercalcemia and can lead to other problems such as kidney stones, abdominal pain, poor memory, concentration and depression.
Enlarged parathyroid glands, referred to as "hyperplasia," can cause hyperparathyroidism. In other cases, an adenoma or growth forms on one of the parathyroid glands, and because of this, the parathyroid gland becomes overstimulated.
A parathyroidectomy is a type of thyroid surgery needed in cases of adenomas or parathyroid gland enlargement. An adenoma will continue to multiply until the tumour grows to an unimaginable size. As this tumour develops, it secretes an excess of PTH. Overstimulation of PTH draws more calcium from the bones and increases blood calcium levels. High blood calcium levels lead to brittle bones and stimulate the production of kidney stones.
Dr Mitchell orders blood and urine tests, ultrasounds and x-rays to diagnose hyperthyroidism. These tests include:
- Blood tests: Usually, the doctor orders blood tests to detect high levels of calcium or overstimulation of PTH.
- Urine tests: Urine tests determine how well the kidneys function. These tests also reveal the amount of calcium that exits the body.
- Ultrasounds: An ultrasound is a test that utilises sound waves to capture images of the parathyroid glands and nearby tissue to diagnose adenomas or hyperplasia.
- Sestamibi scan: A sestamibi scan is a special type of test to show which of the parathyroid glands are overactive.
- X-rays: Dr Mitchell orders x-rays to check for kidney stones or structural abnormalities.
You must consider parathyroid surgery if there is a tumour present. The thyroid surgeon only removes the affected or enlarged glands. If all the parathyroid glands are overactive, Dr Mitchell will remove three and a half glands, with a small portion of the fourth parathyroid gland remaining intact.
After this minimally invasive procedure, you can return home the same day, or you may choose to stay overnight in the hospital. You may develop a sore throat or experience slight discomfort after the procedure.
The doctor will closely monitor your PTH and calcium levels over the next few months after surgery. Dr Mitchell prescribes calcium supplements to strengthen bones that have been deprived of calcium.
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr Mitchell is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr Mitchell takes no responsibility for any errors or omissions present on this website and is not liable for any consequences that may occur from misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.