What are the parathyroid glands?

The parathyroid glands control the balance of calcium in your blood by making parathyroid hormone (PTH).

Most people have four parathyroid glands, which are in your neck usually behind the thyroid gland. One or more of your parathyroid glands has become overactive, causing an increase in the level of calcium in your blood.

The most common symptom is bone pain.

What are the benefits of surgery?

Your symptoms should improve. You should have less risk of permanent damage to your bones, kidneys or heart.

Are there any alternatives to surgery?

Sometimes you can have medication to reduce your calcium levels until you have surgery.

You can also have this medication if you have other medical problems that mean surgery would be too dangerous for you.

What will happen if I decide not to have the operation or the operation is delayed?

If your overactive gland is caused by cancer, there is a risk that it will spread to other parts of your body.

Your doctor will continue to monitor you and may offer you medication.

The level of calcium in your blood may continue to increase and cause damage to your bones, kidneys or heart.

If you experience any of the following symptoms, contact your healthcare team.

• nausea
• vomiting
• constipation
• feeling very thirsty
• reduced appetite
• extreme fatigue
• lethargy
• tummy pain
• feeling unwell
• chest pain
• difficulty breathing
• muscle aches or cramps

If you choose to have the parathyroidectomy and your doctor suspects the cause may be cancer, it will not be delayed.

What does the operation involve?

The operation is usually performed under a general anaesthetic but sometimes it may be possible to use a local anaesthetic.

The operation usually takes about an hour. Your surgeon will make a cut on your neck in the line of one of your skin creases.

They will remove any enlarged glands.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and in rare cases can even cause death.

General complications of any operation

• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Bleeding during or after the operation. Bleeding in your wound can be serious if it leads to swelling in your windpipe (trachea). You may need another operation to stop the bleeding and remove the blood.
• Change in your voice.
• Breathing difficulties. You may need a tracheostomy to place a breathing tube in your windpipe.
• Drop in calcium levels in your blood. If all of your parathyroid glands need to be removed, you will need to take supplements for the rest of your life.
• Failure of the operation.
• Removing part of your thyroid gland. Rarely, the parathyroid gland may be inside the thyroid gland.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You may be able to go home the same day. However, your doctor may recommend that you stay in hospital a little longer.

You should be able to return to work and normal activities after about 2 weeks, depending on how much surgery you need and your type of work.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery and can return to normal activities.

A normal gland that was not removed may become overactive many years later and you may need another operation.

Summary

Parathyroid glands can become overactive, causing an increase in the level of calcium in your blood. Surgery to remove any affected glands is the only reliable way to prevent long-term problems.

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