Parathyroid



parathyroidThe parathyroid glands are located at the front and base of the neck at the 4 corners of the thyroid gland. The glands produce parathyroid hormone (PTH), which regulates calcium balance in the body by increasing absorption of calcium in the intestines, re-absorption in the kidneys and release of calcium from our bones into the blood stream. It controls the production of the active form of Vitamin D (Vit D3) in the kidney, which is what helps absorption of calcium in the intestines.

 

As blood flows through the parathyroid glands, the amount of calcium and Vitamin D in the blood is checked by the parathyroid glands; if the amount of calcium or Vitamin D is low the gland produces PTH, and if the amount of calcium is high the gland stops producing PTH. Through this mechanism, there is minute-to-minute control of the level of calcium in the blood. The concentration of calcium in the blood is so important to normal functioning of the body, which is why there are four parathyroid glands, even though one gland would be enough to do the job.

 

Hyperparathyroidism (HPT)

 

Hyperparathyroidism is a condition in which the parathyroid gland makes more of the PTH than it needs to, causing an imbalance in the amount of calcium in the body. This can lead to problems with the bones, muscles, nervous system, and kidneys.

 

In primary hyperparathyroidism, increased secretion of PTH occurs because one or more of the glands have become enlarged and since the parathyroid glands have only one function (to produce PTH), these enlarged glands continue to produce large amounts of PTH without regard to the amount of calcium in the blood. More then 90% of the cases are caused by enlargement of one gland, called a parathyroid Adenoma. In approximately 5-10% of cases there are abnormalities in more then one gland. Sometimes this is because two or three glands are enlarged (Multiple Adenoma), and at others times it’s because all four glands are abnormal, called Parathyroid Hyperplasia Treatment for all the mentioned conditions is surgery.

 

Secondary hyperparathyroidism happens as a consequence of low vitamin D levels, either due to kidney failure or dietary deficiency. All four glands increase their activity and secrete more PTH so as to increase the vitamin D levels. The treatment of secondary hyperparathyroidism is to correct the chemical imbalance. If untreated, over time all of the parathyroid glands start to work independently without being controlled by the level of calcium in the blood (this is called Tertiary hyperparathyroidism). The PTH levels continually rise and cause problems. Treatment for this condition is surgery.

 

Parathyroid cancer is very rare, and most parathyroid tumors are benign. Less than one percent of people with hyperparathyroidism are diagnosed with a malignant parathyroid tumor.

 

Surgical Options

 

If you require surgical intervention for you thyroid/parathyroid disease and you have been referred to our office, you have the advantage of two surgical approaches.  The traditional neck incision verses a new technique called Minimally Invasive Thyroidectomy.  At your first office visit you surgeon will be able to determine if you are a candidate for MIT. There are a few medical conditions and thyroid tumor characteristics that would prevent a patient from being eligible to have MIT.

The most important advantage of MIT is a lot less pain after surgery, and therefore minimal use of pain medications. The reason for the less pain is that the technique is, exactly as the title states, less invasive and thus a lot less traumatic to the tissue. Although the small incision size seems to be a great advantage, and it is, it represents how minimal the trauma to the normal tissue of the neck is in MIT. When the tissue is traumatized less, there is going to be less pain and a lot faster recovery, as well as a much shorter hospital stay. Our patients who have a total thyroidectomy done, usually stay overnight, and some even go home the same day. Patients who have a hemi-thyroidectomy go home on the same day. The blood loss during MIT is usually minimal and we do not use drains.

 

Due to the ease of the surgery, limited pain and fast recovery, our patients are extremely happy with their results.

 

 

 

 

 

 

 

 

First Surgical Office Locations

Oakland Office
365 Hawthorne Ave, #101
Oakland, Ca 94609
Ph# 510-465-5523
Fax# 510-832-6061

Berkeley Office
2999 Regent St #700
Berkeley, Ca 94705
Ph# 510-486-0818
Fax# 510-486-0819

Hayward Office
27001 Calaroga Ave, #4
Hayward, Ca 94544
Ph# 510-732-5731
Fax# 510-732-5739

Chinatown Office
388 9th St #218B
Oakland, Ca 94607
Ph# 510-839-0298 
Fax# 510-839-4389

Bariatrics Office (Summit South)
3100 Summit St, #2600
Oakland, Ca 94609
Ph# 510-869-8972
Fax# 510-869-6989


Comprehensive Cancer Center
2001 Dwight Way
Berkeley, CA 94704
Ph# 510-204-1634
Fax# 510-204-5749