Babak Larian, MD, FACS, is known around the world for his parathyroid expertise and frequently has patients fly in from out of town for consultations and surgery at the CENTER for Advanced Parathyroid Surgery.
The parathyroid glands are located at the front and base of the neck at the 4 corners of the thyroid gland. These glands produce parathyroid hormone, 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 bloodstream. It also controls the production of vitamin D 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 very active and constantly working parathyroid glands. If the amount of calcium or Vitamin D is low the gland produces parathyroid hormone, and if the amount of calcium is high the gland stops producing the hormones. Through this mechanism, there is minute-to-minute control of the level of calcium in the blood.
In some cases, the parathyroid gland makes more parathyroid hormone than it needs to, causing an imbalance in the amount of calcium in the body. This condition is known as hyperparathyroidism, and it can lead to problems with the bones, muscles, nervous system, and kidneys.
In primary hyperparathyroidism, increased secretion of parathyroid hormone occurs because one or more of the glands have become enlarged. Since the parathyroid glands only have one job, to produce parathyroid hormone, these enlarged glands continue to produce large amounts of the hormone without regard to the amount of calcium in the blood. There are several different conditions related to the disease, but they all require surgery.
Secondary hyperparathyroidism happens as a consequence of low vitamin D levels, either due to kidney failure or dietary deficiency. The treatment of secondary hyperparathyroidism is to correct the chemical imbalance. If left untreated, 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, and the treatment for this condition is surgery.
Next, parathyroid tumors
Clinical Chief of the Division of Otolaryngology at Cedars-Sinai
Assistant Clinical Professor of Surgery at UCLA
By Babak Larian, MD FACS Privacy Notice © 2013 Babak Larian, MD FACS. All Rights Reserved.
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