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Parathyroid Disease

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Your body needs calcium to be healthy. But too much or too little of a good thing isn’t good.

Parathyroid disease happens when your parathyroid glands either work overtime making too much parathyroid hormone (PTH), or they don’t make enough. Too much PTH (hyperparathyroidism) tells your body to release more calcium than it needs. And that can lead to things like osteoporosis, kidney stones and heart disease. Not enough PTH (hypoparathyroidism) and your body doesn’t get the calcium it needs to be healthy.

Cleveland Clinic specialists can recognize the signs of overactive or underactive parathyroid glands before they get out of hand and start causing problems. We’ll work with you to create a treatment plan that will get your calcium levels back to where they need to be.

Why Choose Cleveland Clinic for Parathyroid Disease Care?

Collaborative care:

Your care team will be led by endocrinologists and endocrine surgeons (hormone experts). They’ll work closely with nephrologists (kidney experts), radiologists, pathologists and other providers to design the right treatment plan for you.

Minimally invasive options:

Our fellowship-trained surgeons specialize in minimally invasive parathyroidectomies. This surgery will remove one or more of your four parathyroid glands through a tiny incision (cut). You’ll likely recover quickly and have less scarring.

Demonstrated expertise:

We do hundreds of parathyroid surgeries each year. This experience helps us deliver excellent outcomes. Meet our team.

Specialized knowledge:

Our healthcare providers know what it takes to treat both types of parathyroid disease. We also offer treatment if you’ve had an unsuccessful surgery in the past.

Comprehensive treatment:

We’ll craft a treatment plan for you that includes caring for any other conditions you have. Our experts know how to treat complications of parathyroid disease, like osteopenia, osteoporosis, kidney stones and kidney disease and other conditions.

Convenient care:

Whether you live near or far, we try to make the best use of the time you spend on testing, treatments and follow-up appointments. If you need to see more than one specialist, we can often schedule several appointments on the same date to make things more convenient for you.

Virtual visits:

When you’re not feeling well, you might not be up to travelling to your appointment. Virtual visits let you meet with your provider from the comfort of your home. All you need is an internet connection, a smartphone, laptop or tablet.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Diagnosing Parathyroid Disease at Cleveland Clinic

Often in the early stages of parathyroid disease, you won’t have any symptoms. Your provider may discover you have the condition during a routine exam and bloodwork. If you do have symptoms, they’ll vary depending on the type of parathyroid disease you have.

Hyperparathyroidism

This is the most common type of parathyroid disease. It’s when your parathyroid glands make too much PTH, causing the calcium levels in your blood to rise (hypercalcemia).

You may not have symptoms, but if you do, you might have achy joints and weak muscles, be really tired, have trouble concentrating or lose your appetite. If your condition is worse, you might have bone pain, feel sick to your stomach and be thirstier than usual.

If you have symptoms like these, your provider may do:

Blood tests to check your Vitamin D level.
Bone density test.
Ultrasound to check for kidney stones.
24-hour urine (pee) test.
Blood tests to see how well your kidneys are working.

Want to find out your risk of hyperparathyroidism? Try our risk assessment tool.

Hypoparathyroidism

This type of parathyroid disease doesn’t happen as often. It’s when your parathyroid glands don’t make enough PTH, causing the calcium levels in your blood to be really low (hypocalcemia).

This condition usually progresses slowly and symptoms (if you have them) can be mild. You might have tingling in your lips, fingers and toes, muscle cramps or spasms, brittle nails or dry, scaly skin.

If you have any of these symptoms, your provider may do:

Blood tests to check for PTH, phosphorous and magnesium.
Calcium blood test.
24-hour urine (pee) test.

They may also do these tests to check for more serious side effects of hypoparathyroidism:

Electrocardiogram (ECG or EKG) to check your heart rhythm.
CT scan to see if you have calcium deposits in your brain.

Once we look at all your test results and find out which type of parathyroid disease you have and how severe it is, we’ll work with you to design a custom treatment plan.

Meet Our Parathyroid Disease Team

We work as a team at Cleveland Clinic to give you the most comprehensive and compassionate care. If you have parathyroid disease, your team will be led by an endocrinologist and endocrine surgeon. Other members of your team may include:

Providers Who Treat Parathyroid Disease

Locations

Our healthcare providers see patients at convenient locations in Ohio, Florida and London.

Parathyroid Disease Treatment at Cleveland Clinic

Treating your parathyroid disease will depend on what type of disease you have, how bad it is and how healthy you are otherwise.

Treating hyperparathyroidism

If you don’t have symptoms (or they’re very mild) and your calcium levels are only slightly higher than they should be, your provider may suggest just keeping an eye on your condition to see if it gets worse. They’ll regularly check your blood calcium levels, blood pressure, bone density and how well your kidneys are working. They may also give you medications to control the amount of calcium in your blood.

If things change, or if you have more severe symptoms, your provider may recommend minimally invasive surgery (parathyroidectomy) to remove part or all of your overactive parathyroid glands. Surgery is the only cure for hyperparathyroidism, and when done by experts, it’s often very successful.

It’s important to note that many of the symptoms for hyperparathyroidism can also point to parathyroid cancer. That’s why, if you’re having any of these symptoms, it’s important to see your provider as soon as possible to figure out exactly what’s going on.

Re-operative parathyroid surgery

Parathyroid glands are small and can hide in places in your neck where they don’t belong. This can make them hard to find and remove. An inexperienced surgeon may not remove the right gland. Or they may take out only one gland when there’s more than one causing problems. If this happens, the procedure won’t be successful.

If you had parathyroid surgery that didn’t work, we can help. Our surgeons have a proven track record of success for this complex operation. And they’re experts in re-operative parathyroid surgery. They do these complicated procedures all the time and with the best possible results.

Treating hypoparathyroidism

Minimizing your symptoms (if you have any) and getting your calcium levels back up to a healthy level is the goal of treating your underactive parathyroid gland. Your provider may recommend:

Taking calcium carbonate and vitamin D supplements.
Eating foods high in calcium and low in phosphorous.
Getting PTH injections (shots).

Taking the Next Step

You probably don’t think much about your parathyroid glands. Maybe you didn’t even know you had them. But when they go rogue and your body starts getting too much calcium or not enough, problems can start. When that happens, our experts know what to do to put your system back on track. We’ll figure out exactly what’s going on and get your calcium levels where they need to be.