Every year, about 100,000 people in the U.S. are diagnosed with hyperparathyroidism (HPT), and 58,700 experience hypoparathyroidism, two conditions that affect the parathyroid glands. Knowing what kind of doctor treats parathyroid disease is important, as neglecting treatment can result in severe health issues such as osteoporosis, kidney stones, and neurological problems.
If you’re showing signs of parathyroid disease, knowing which healthcare professionals are qualified to diagnose and treat it is vital for getting the appropriate care.
Types of Parathyroid Diseases
Your parathyroid glands are small, pea-sized endocrine glands in your neck behind the thyroid gland. Most people have four parathyroid glands, though the number can vary.
These glands help regulate the body’s calcium and phosphorus levels by producing and secreting parathyroid hormone (PTH). This controls the amount of calcium in the blood and bones. Properly functioning parathyroid glands are essential for various bodily functions, including nerve signaling, muscle contraction, and blood clotting.
When one or more of your parathyroid glands become damaged, compromised, or infected, it can result in one of two diseases:
Hyperparathyroidism is a disorder resulting in an overproduction of PTH. In primary hyperparathyroidism, this excess PTH is due to issues within the parathyroid glands, often caused by a benign tumor or gland enlargement. This leads to high calcium levels in the blood, potentially causing bone weakness, kidney stones, and fatigue.
Secondary hyperparathyroidism occurs when another condition, like kidney disease, causes low calcium levels, prompting the parathyroid glands to overcompensate by producing more PTH, which can exacerbate bone and kidney problems.
Symptoms of hyperparathyroidism can include fatigue, muscle weakness, joint pain, increased thirst and urination, kidney stones, osteoporosis, depression, memory issues, and gastrointestinal problems. However, you may not experience any noticeable symptoms, especially if you are in the early stages of the disease.
Hypoparathyroidism is a rare condition characterized by insufficient production of PTH. When PTH levels are too low, calcium levels in the blood decrease (hypocalcemia), and phosphorus levels may increase.
This imbalance can lead to various symptoms, including muscle spasms or cramps, numbness or tingling in the lips, toes, and fingertips, and, in severe cases, seizures or cardiac arrhythmias.
This condition can arise from various factors, such as parathyroid gland damage or removal during thyroid surgery, autoimmune disorders, or genetic influences.
Diagnosing Parathyroid Diseases
The symptoms of parathyroid diseases can often appear similar to other conditions caused by hormonal disruptions, like thyroid disease, diabetes, or Addison’s disease. Your doctor will perform a blood test and imaging tests to diagnose your condition.
Diagnosing parathyroid diseases primarily requires blood tests that measure calcium and PTH levels.
The PTH test measures PTH in the blood, where elevated levels, particularly alongside high calcium, suggest hyperparathyroidism. Additionally, vitamin D levels are tested, as deficiencies are common in parathyroid disorders and kidney function tests are conducted to evaluate the impact of these disorders on the kidneys.
While blood tests are the primary method used to diagnose your condition, imaging tests are essential for identifying abnormal structures in and around the parathyroid glands and evaluating the effects of parathyroid diseases on other organs.
You’ll be given a neck ultrasound, which uses sound waves to detect gland enlargement or tumors. A sestamibi scan involves injecting a radioactive substance to highlight overactive glands, while CT scans or MRIs offer detailed neck and chest images, identifying abnormal glands.
Bone density tests may be prescribed to assess the impact of hyperparathyroidism on bone health, particularly if you are at a high risk for osteoporosis.
What Kind of Doctor Treats Parathyroid Disease?
If you experience worrisome symptoms, you may initially consult your primary healthcare provider (general practitioner). However, they will likely refer you to a specialist for a comprehensive diagnosis and treatment plan. Healthcare professionals who specialize in the treatment of parathyroid diseases include:
Endocrinologists are your primary point of care for parathyroid disease. These medical specialists focus on the endocrine system, which includes the parathyroid glands. They will oversee treatment plans, including medication, surgery, lifestyle adjustments, and ongoing monitoring of calcium and hormone levels.
Otolaryngologists, also known as ENT (Ear, Nose, and Throat) specialists, often collaborate with your primary healthcare team to treat parathyroid diseases, especially when you need surgical intervention. They are trained in head and neck surgeries, including procedures to remove parathyroid tumors or abnormal glands.
When addressing parathyroid diseases, you may require the expertise of a general surgeon or a specialized endocrine surgeon. When surgery is the recommended treatment, especially for primary hyperparathyroidism with severe or complicated symptoms, a surgeon performs procedures like parathyroidectomy (the removal of parathyroid glands).
Their goal is to minimize complications and safeguard the surrounding structures during the surgery.
Treatment of Parathyroid Diseases
The type and severity of the condition determine the choice of treatment for parathyroid disease. Your healthcare team is likely to propose several common treatment options, which may include:
Treatment for Hyperparathyroidism
In cases where surgery isn’t an immediate option or for mild cases of hyperparathyroidism, your doctor may prescribe medication to manage the condition.
Some common medications recommended for hyperparathyroidism include bisphosphonates like alendronate (Fosamax) and risedronate (Actonel) to help prevent bone loss by inhibiting bone resorption, and calcimimetics, such as cinacalcet (Sensipar), to lower blood calcium levels by reducing PTH production.
If you are postmenopausal, you may need to undergo hormone replacement therapy (estrogen) to increase your bone density and reduce the osteoporosis risk. You may also need supplemental vitamin D to decrease PTH levels.
Treatment for Hypoparathyroidism
Postmenopausal individuals might be advised to undergo hormone replacement therapy, typically involving estrogen, to enhance bone density and lower the risk of osteoporosis. Additionally, supplemental vitamin D may be recommended to reduce PTH levels.
The primary objective of treating hypoparathyroidism is to restore normal calcium and phosphorus levels in the body. This usually entails using calcium supplements to elevate blood calcium levels and active forms of vitamin D, like calcitriol to improve calcium absorption and lower phosphorus levels. In certain instances, magnesium supplements may also be necessary.
Recently, PTH replacement therapy using synthetic parathyroid hormone, such as teriparatide, has been introduced for chronic management. However, while undergoing treatment, it is essential to regularly monitor your calcium and phosphorus levels so your doctor can adjust your treatment and prevent complications like kidney stones or calcium deposits in the body.
Find the Right Doctor for Parathyroid Disease Treatment
Caught early, parathyroid disease is simple to manage. But you need the right kind of doctor to treat parathyroid disease to get the best health outcomes.
At Associated Endocrinologists, our team of physicians, all Board Certified in Endocrinology and Metabolism, have experience in a range of diagnostic methods, from neck ultrasounds to nuclear medicine and radio imaging. If you are experiencing symptoms of parathyroid disease, contact us today to book your appointment.