{"id":15,"date":"2018-01-30T20:50:52","date_gmt":"2018-01-31T01:50:52","guid":{"rendered":"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/hyperparathyroidism\/"},"modified":"2026-05-21T13:22:59","modified_gmt":"2026-05-21T17:22:59","slug":"hyperparathyroidism","status":"publish","type":"page","link":"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/hyperparathyroidism\/","title":{"rendered":"Hyperparathyroidism"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":null,"protected":false},"author":2,"featured_media":0,"parent":7,"menu_order":5,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-15","page","type-page","status-publish","hentry"],"acf":{"layers":[{"acf_fc_layout":"layer_content_sidebar","layer_label":"","layer_headline":"","layer_intro":"","layer_content":"<h2>About Parathyroid Disease and Hyperparathyroidism; Hypercalcemia<\/h2>\n<p>Hyperparathyroidism is a hormonal problem that can develop at any age, but occurs most commonly in postmenopausal women (2% of older women and 1% of older men). It develops because of excessive secretion of parathyroid hormone (PTH), an important factor in calcium metabolism. It can lead to high PTH levels and calcium levels in the blood, and a wide range of symptoms.<br \/>\n<figure id=\"attachment_1330\" aria-describedby=\"caption-attachment-1330\" style=\"width: 360px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/parathyroid-glands.jpg\" alt=\"parathyroid glands - location on the thyroid\" width=\"100%\" height=\"auto\" class=\"size-full wp-image-1330\" srcset=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/parathyroid-glands.jpg 800w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/parathyroid-glands-300x191.jpg 300w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/parathyroid-glands-768x489.jpg 768w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/parathyroid-glands-100x64.jpg 100w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-1330\" class=\"wp-caption-text\">There are two pairs of parathyroid glands located along the thyroid gland lobes in the neck<\/figcaption><\/figure><\/p>\n<h2 class=\"h3\">What is the Parathyroid Gland and its function?<\/h2>\n<p>Most people are born with four parathyroid glands located behind the thyroid at the lowwer part of the neck. These glands produce PTH in the bloodstream which controls calcium levels, raising levels when they are too low. It&#8217;s impact can affect bones, intestine, and the kidneys. A normal parathyroid range is between 9.0 and 10.1. If the level of parathyroid hormone is too high, the result is hyperparathyroidism.<\/p>\n<h3>Primary Hyperparathyroidism<\/h3>\n<p>When an abnormal parathyroid gland \u2018goes rogue\u2019 and stops responding to normal signals from the body, it tells the body unnecessarily that it needs more calcium. Calcium is then leached from the bones (a cause of <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/osteoporosis\/\">osteoporosis<\/a>) and intestines to compensate, and can be deposited in the kidneys, which leads to kidney stones. A build-up of too much calcium in the bloodstream can be either asymptomatic or can lead to a variety of problems.<\/p>\n<p>Some patients with a parathyroid tumor have normocalcemic hyperparathyroidism where the calcium level is normal but the PTH is high. Other patients may have high calcium but high-normal or normal PTH levels. Assuming that there are no other causes of high calcium or high PTH, these patients should have their primary hyperparathyroidism treated. The cause of overactive parathyroids in 1% of patients is inheritance of a gene abnormality from one parent. The cause of a parathyroid tumor in the other 99% of patients is usually unknown, although radiation therapy to the face or neck can be a factor in causing a single parathyroid tumor.<\/p>\n<div style=\"width: 100%; height: 40px;\"><\/div>\n<p><code><\/p>\n<style>\n.container1 {\nposition: relative!important; overflow: hidden!important; width: 80%!important; padding-top: 48%!important; margin-left:10%;\n}\n.responsive-iframe {\nposition: absolute!important; top: 0!important; left: 0!important; bottom: 0!important; right: 0!important; width: 100%!important; height: 100%!important;\n}\n<\/style>\n<p><\/code><\/p>\n<div class=\"container1\">\n  <iframe class=\"responsive-iframe\" src=\"https:\/\/www.youtube.com\/embed\/FC_ud4cDVpw?rel=0&amp;frameborder=\"0\"><\/iframe>\n<\/div>\n<div style=\"text-align: center; padding-left:10%; padding-right:10%; padding-bottom:80px\" align=\"center\">\n<p style=\"text-align: center;font-size: 14px;line-height: 14px;margin-top: 15px;color: #101010\">Dr. Melanie Goldfarb, Director of Center for Endocrine Tumors and Disorders, and Associate Professor of Surgical Oncology of Saint John&#8217;s Cancer Institute, explains primary hyperarathyroidism in simple terms, how it affects the body, who should be screened, and treatment.<\/p>\n<\/div>\n<\/div>\n<figure id=\"attachment_1118\" aria-describedby=\"caption-attachment-1118\" style=\"width: 440px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2018\/07\/006.jpg\" width=\"100%\" height=\"auto\" alt=\"Dr. Melanie Goldfarb performs ultrasound imaging to assess parathyroid glands\"  class=\"size-full\" \/><figcaption id=\"caption-attachment-1118\" class=\"wp-caption-text\"><span style=\"font-size:12px; text-align:center\">Dr. Melanie Goldfarb performs ultrasound imaging to assess parathyroid glands<\/span><\/figcaption><\/figure>\n<h3>Secondary Hyperparathyroidism<\/h3>\n<p>Secondary hyperparathyroidism occurs when a disease unrelated to the parathyroids causes all of your parathyroid glands to become enlarged and overactive. The most common cause of secondary hyperthyroidism is kidney failure, which can lead to overstimulated parathyroid glands due to lower levels of calcium in the bloodstream.<\/p>\n<p>Prolonged vitamin D deficiency is the second most common of secondary hyperparathyroidism, followed by gastrointestinal malabsorption, such as after a gastric bypass procedure.<\/p>\n<h3>Tertiary Hyperparathyroidism<\/h3>\n<p>Tertiary hyperparathyroidism occurs when secondary hyperparathyroidism develops into primary hyperparathyroidism. For example, a kidney failure patient who has received a kidney transplant is later diagnosed with primary hyperparathyroidism.<\/p>\n<p>Once the clinician has validated tertiary hyperparathyroidism, then the statistics are the same as primary hyperparathyroidism, where most people have a single overactive parathyroid gland. If however, the secondary hyperparathyroidism was never cured and renal insufficiency (advanced loss of kidney function) still exists, then these patients likely have disease in all four of their parathyroid glands.<\/p>\n","layer_is_content_auto_columns":false,"sidebar_position":"right","widgets":false,"layer_icon":"","layer_icon_position":"left","layer_background_color":"","layer_id":""},{"acf_fc_layout":"layer_content_sidebar","layer_label":"","layer_headline":"","layer_intro":"","layer_content":"<h2 style=\"margin-top:-50px\">Signs and Symptoms of Hyperparathyroidism and Hypercalcemia<\/h2>\n<p>Hyperparathyroidism, or hypercalcemia, can be asymptomatic (not having any symptoms), cause mild symptoms, or in rare cases, present severe symptoms.\u00a0The most easily recognized and curable primary hyperparathyroidism\/hypercalcemia symptoms are osteoporosis and kidney stones.<\/p>\n<p style=\"font-weight: bold; font-size:24px;color:#494949\">Common symptoms of high calcium or high PTH:<\/p>\n<figure id=\"attachment_1324\" aria-describedby=\"caption-attachment-1324\" style=\"width: 400px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/concentration-problems-high-PTH-parathyroid.jpg\" alt=\"Concentration problems due to high PTH - Hyperparathyroid - Saint John&#039;s Cancer Institure \" width=\"100%\" height=\"auto\" class=\"size-full wp-image-1324\" srcset=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/concentration-problems-high-PTH-parathyroid.jpg 800w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/concentration-problems-high-PTH-parathyroid-300x212.jpg 300w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/concentration-problems-high-PTH-parathyroid-768x541.jpg 768w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/concentration-problems-high-PTH-parathyroid-100x71.jpg 100w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-1324\" class=\"wp-caption-text\">High PTH may reveal as a problem with concentration and fatigue &#8211; Saint John&#8217;s Cancer Institute<\/figcaption><\/figure>\n<h3>Nervous system<\/h3>\n<ul style=\"line-height:16px\">\n<li>Mood swings<\/li>\n<li>Depression<\/li>\n<li>Forgetfulness<\/li>\n<li>Irritable<\/li>\n<li>Concentration problems<\/li>\n<li>Fatigue<\/li>\n<li>Decreased sexual desire or impotence<\/li>\n<\/ul>\n<h3>Kidney\/Urinary<\/h3>\n<ul style=\"line-height:16px\">\n<li>Kidney Stones<\/li>\n<li>Nocturia (going to the bathroom a lot at night)<\/li>\n<li>Worsening kidney function<\/li>\n<\/ul>\n<h3>Digestive system<\/h3>\n<ul style=\"line-height:16px\">\n \t<figure id=\"attachment_1323\" aria-describedby=\"caption-attachment-1323\" style=\"width: 400px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/joint-and-bone-pain-high-PTH-parathyroid.jpg\" alt=\"Joint and bone pain as a result of high PTH - Saint John's Cancer Institute\" width=\"100% height=\"auto\" class=\"size-full wp-image-1323\" srcset=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/joint-and-bone-pain-high-PTH-parathyroid.jpg 800w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/joint-and-bone-pain-high-PTH-parathyroid-300x202.jpg 300w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/joint-and-bone-pain-high-PTH-parathyroid-768x517.jpg 768w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/joint-and-bone-pain-high-PTH-parathyroid-100x67.jpg 100w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-1323\" class=\"wp-caption-text\">High PTH may result in joint and bone pain &#8211; Saint John&#8217;s Cancer Institute<\/figcaption><\/figure><\/p>\n<li>Stomach or duodenal ulcer<\/li>\n<li>GERD (reflux)<\/li>\n<li>Pancreatitis<\/li>\n<li>Abdominal pain<\/li>\n<li>Constipation<\/li>\n<\/ul>\n<h3>Musculoskeletal<\/h3>\n<ul style=\"line-height:16px\">\n<li>Bone pain<\/li>\n<li>Joint pain<\/li>\n<li>Bone fractures<\/li>\n<li><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/osteoporosis\/\" rel=\"noopener\">Osteoporosis<\/a><\/li>\n<li>Generalized weakness<\/li>\n<\/ul>\n","layer_is_content_auto_columns":false,"sidebar_position":"right","widgets":false,"layer_icon":"","layer_icon_position":"left","layer_background_color":"bg-gray-l","layer_id":""},{"acf_fc_layout":"layer_content_sidebar","layer_label":"","layer_headline":"","layer_intro":"","layer_content":"<h2 style=\"margin-top:-50px\">Diagnosis of Primary, Secondary, and Tertiary Hyperparathyroidism<\/h2>\n<p>Since hyperparthyroidism is a <em>hormonal<\/em> problem, a diagnosis is reached by measuring the hormone levels in the body, such as calcium and PTH.<\/p>\n<p style=\"font-weight: bold; font-size:24px; color:#494949\">Common blood tests for parathyroid disease:<\/p>\n<ul style=\"line-height:16px\">\n<li>Calcium<\/li>\n<li>PTH (parathyroid hormone)<\/li>\n<li>Vitamin D 25-OH and vitamin D 1,25-hydroxy<\/li>\n<li>Creatinine<\/li>\n<\/ul>\n<p>Once a diagnosis of primary hyperparathyroidism has been made and a surgeon has evaluated you for <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2018\/08\/Parathyroid.png\" target=\"_blank\" rel=\"noopener\">parathyroid surgery<\/a>, <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/parathyroid-imaging\/\">parathyroid Imaging<\/a>\u00a0will be performed.  This may include a parathyroid ultrasound, 3D parathyroid CT scan, or less commonly a Sestamibi scan. The endocrine surgeon will perform a parathyroid ultrasound in the office and order additional testing as needed.<\/p>\n<p style=\"font-weight: bold; font-size:24px;color:#494949\">Other tests may order include:<\/p>\n<figure id=\"attachment_1322\" aria-describedby=\"caption-attachment-1322\" style=\"width: 360px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dexa-bone-scan.jpg\" alt=\"DEXA Bone Scan\" width=\"360\" height=\"auto\" class=\"size-full wp-image-1322\" srcset=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dexa-bone-scan.jpg 398w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dexa-bone-scan-300x213.jpg 300w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dexa-bone-scan-100x71.jpg 100w\" sizes=\"(max-width: 398px) 100vw, 398px\" \/><figcaption id=\"caption-attachment-1322\" class=\"wp-caption-text\">A bone scan may reveal the impact of high PTH<\/figcaption><\/figure>\n<ul style=\"line-height:16px\">\n<li>Bone Scan<\/li>\n<li>24-hour Urinary calcium<\/li>\n<li>Abdominal CT (to look for kidney stones)<\/li>\n<\/ul>\n<p>Many clinicians may not identify parathyroid disease when mildly elevated calcium levels exist (hypercalcemia), inclduing complaints such as fatigue, forgetfulness, problems with concentration, depression\/anxiety, kidney stones or disease, osteoporosis, constipation, stomach ulcers, or sexual dysfunction.<\/p>\n<p>Additionally, primary care physicians may not refer patients for minimally invasive surgical treatment that could cure them of their parathyroid disease if they beleive the parathyroid condition is mild.<\/p>\n","layer_is_content_auto_columns":false,"sidebar_position":"right","widgets":false,"layer_icon":"","layer_icon_position":"left","layer_background_color":"bg-gray-l","layer_id":""},{"acf_fc_layout":"layer_content_sidebar","layer_label":"","layer_headline":"","layer_intro":"","layer_content":"<h2 style=\"margin-top:-50px\">Treatment of Primary, Secondary, and Tertiary Hyperparathyroidism<\/h2>\n<p class=\"p-lg\">The only cure for hyperparathyroidism is parathyroid surgery&#8211;the removal of one or more parathyroid tumors (parathyroidectomy).<\/p>\n<p>During parathyroid surgery, the number of parathyroid glands removed will be determined by measuring parathyroid hormone (PTH) in the blood during the operation. Most <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/parathyroidectomy\/\" target=\"_blank\" rel=\"noopener\">parathyroid surgery<\/a> is minimally invasive (small incision).  <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/parathyroidectomy\/\">Parathyroidectomy<\/a> (parathyroid removal) may be recommended based on your situation and health history.<br \/>\n<figure id=\"attachment_1328\" aria-describedby=\"caption-attachment-1328\" style=\"width: 400px\" class=\"wp-caption alignright\"><img decoding=\"async\" src=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dr-melanie-goldfarb-performs-hyperparathyroid-surgery.jpg\" alt=\"Dr. Melanie Goldfarb performs hyperparathyroid surgery\" width=\"100%\" height=\"auto\" class=\"size-full wp-image-1328\" srcset=\"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dr-melanie-goldfarb-performs-hyperparathyroid-surgery.jpg 800w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dr-melanie-goldfarb-performs-hyperparathyroid-surgery-300x214.jpg 300w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dr-melanie-goldfarb-performs-hyperparathyroid-surgery-768x548.jpg 768w, https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/dr-melanie-goldfarb-performs-hyperparathyroid-surgery-100x71.jpg 100w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-1328\" class=\"wp-caption-text\">Dr. Melanie Goldfarb performs hyperparathyroid surgery &#8211; Saint John&#8217;s Cancer Institute<\/figcaption><\/figure><\/p>\n<h4>Benefits of having parathyroid surgery include:<\/h4>\n<ul style=\"line-height:16px\">\n<li>Improved bone density and decreased risk of bone fractures (stabilization of <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/osteoporosis\/\">osteoporosis<\/a>)<\/li>\n<li>Improved quality of life<\/li>\n<li>Lower risk of kidney stones (up to 90 percent of patients do not develop any new stones)<\/li>\n<li>Decreased risk of premature death<\/li>\n<li>Disappearance or improvement of symptoms<\/li>\n<\/ul>\n<h4>Parathyroid Cancer<\/h4>\n<p>Parathyroid cancer is a rare cause of primary <a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/hyperparathyroidism\/\">hyperparathyroidism<\/a>, which is very difficult to diagnosis before surgery. Typically, patients will have very high calcium and PTH levels. During parathyroid surgery, the parathyroid tumor is usually dense and stuck to the surrounding tissues, as wells as the thyroid gland. Parathyroid cancer survival is generally expected because this type of tumor is very slow-growing. However, because it can recur, patients may need re-operations in the future.<\/p>\n<h3>What to Expect After Parathyroid Surgery<\/h3>\n<div id='em-accordions-0' class='em-panels em-panels--accordions '><nav class='em-panels__nav'><div class='em-panels__controls' role='tablist'><div data-id='controls-accordions-0-panel-do-symptoms-improve-after-parathyroidectomy' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-do-symptoms-improve-after-parathyroidectomy'>Do symptoms improve after parathyroidectomy?<\/div><div data-id='controls-accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery'>Will medication be needed after parathyroid surgery?<\/div><div data-id='controls-accordions-0-panel-what-kind-of-follow-up-do-i-need' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-what-kind-of-follow-up-do-i-need'>What kind of follow-up do I need?<\/div><div data-id='controls-accordions-0-panel-can-hyperparathyroidism-come-back' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-can-hyperparathyroidism-come-back'>Can hyperparathyroidism come back?<\/div><\/div><\/nav><div class='em-panel__container'>\n\t\t\t<div id='controls-accordions-0-panel-do-symptoms-improve-after-parathyroidectomy' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-do-symptoms-improve-after-parathyroidectomy'>Do symptoms improve after parathyroidectomy?<\/div>\n\t\t\t<div id='accordions-0-panel-do-symptoms-improve-after-parathyroidectomy' class='em-panel' role='tabpanel' aria-hidden='true' aria-labelledby='controls-accordions-0-panel-do-symptoms-improve-after-parathyroidectomy'>\n\t\t\t\t<div class='em-panel__content'><\/p>\n<p>There is the potential to resolve or improve all symptoms of parathyroid disease. However, because many symptoms of hyperparathyroidism or hypercalcemia are nonspecific, it is difficult to tell which symptoms are actually caused by the parathyroid tumor and which are unrelated. <\/p>\n<p><\/div>\n\t\t\t<\/div>\n\t\t<\/div><div class='em-panel__container'>\n\t\t\t<div id='controls-accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery'>Will medication be needed after parathyroid surgery?<\/div>\n\t\t\t<div id='accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery' class='em-panel' role='tabpanel' aria-hidden='true' aria-labelledby='controls-accordions-0-panel-will-medication-be-needed-after-parathyroid-surgery'>\n\t\t\t\t<div class='em-panel__content'><\/p>\n<p>Most people will not have to take any medication after parathyroid surgery. There are occasional patients who have very high and sustained calcium levels that may need calcium supplements, which can be acquired over-the-counter.<\/p>\n<p>Patients that have three or 3 \u00bd parathyroid glands removed due to a familial syndrome, or sporadic 4-gland hyperplasia, have a higher risk for temporary calcium and\/or vitamin D displacement.<\/p>\n<p><\/div>\n\t\t\t<\/div>\n\t\t<\/div><div class='em-panel__container'>\n\t\t\t<div id='controls-accordions-0-panel-what-kind-of-follow-up-do-i-need' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-what-kind-of-follow-up-do-i-need'>What kind of follow-up do I need?<\/div>\n\t\t\t<div id='accordions-0-panel-what-kind-of-follow-up-do-i-need' class='em-panel' role='tabpanel' aria-hidden='true' aria-labelledby='controls-accordions-0-panel-what-kind-of-follow-up-do-i-need'>\n\t\t\t\t<div class='em-panel__content'><\/p>\n<p>You will need to return for a post-op visit two to three weeks after your parathyroid surgery, and again about 6 months later, for blood tests. For all patients, we monitor your calcium, parathyroid hormone, and vitamin D levels on a yearly basis.<\/p>\n<p><\/div>\n\t\t\t<\/div>\n\t\t<\/div><div class='em-panel__container'>\n\t\t\t<div id='controls-accordions-0-panel-can-hyperparathyroidism-come-back' class='em-panel__control' role='tab' aria-selected='false' aria-expanded='false' aria-controls='accordions-0-panel-can-hyperparathyroidism-come-back'>Can hyperparathyroidism come back?<\/div>\n\t\t\t<div id='accordions-0-panel-can-hyperparathyroidism-come-back' class='em-panel' role='tabpanel' aria-hidden='true' aria-labelledby='controls-accordions-0-panel-can-hyperparathyroidism-come-back'>\n\t\t\t\t<div class='em-panel__content'><\/p>\n<p>It is rare, but published recurrence rates at 10 years after successful parathyroid surgery are in the range of three to five percent. This is why we monitor your blood tests on a yearly basis.<\/p>\n<p><\/div>\n\t\t\t<\/div>\n\t\t<\/div><\/div>\n","layer_is_content_auto_columns":false,"sidebar_position":"right","widgets":false,"layer_icon":"","layer_icon_position":"left","layer_background_color":"bg-gray-l","layer_id":""},{"acf_fc_layout":"layer_two_column","layer_label":"","layer_headline":"","layer_intro":"","layer_content_left":"<p style=\"font-size: 36px; line-height: 40px; font-weight: bold; color: #fff!important; padding-bottom: 10px;\">If you have questions regarding Parathyroid and Hyperthyroidism, please call today. <a href=\"https:\/\/www.saintjohnscancer.org\/contact-us\/?center=Endocrine%20and%20Tumor%20Disorders\"><u>Request an appointment<\/u><\/a><\/p>\n","layer_content_right":"<p style=\"font-size: 56px; font-weight: bold; text-align: center; padding-top:30px\"><a href=\"tel:310-829-8751\">310-829-8751<\/a><\/p>\n","layer_icon":"","layer_icon_position":"left","layer_background_color":"bg-orange","layer_id":""},{"acf_fc_layout":"layer_content_image","layer_label":"","layer_headline":"","layer_content":"<h3>Melanie Goldfarb, M.D., M.Sc., FACS, FACE<\/h3>\n<p><strong>Director, Center for Endocrine Tumors and Disorders<\/strong><br \/>\n<strong>Medical Director for Cancer Survivorship<\/strong><\/p>\n<p>Dr. Melanie Goldfarb is a fellowship-trained endocrine surgeon and Director of the Center for Endocrine Tumors and Disorders. Her expertise is minimally invasive surgery for thyroid cancer and disorders, hyperparathyroidism, and adrenal tumors, including pheochromocytoma, Cushings, Conns, and adrenal cancer.<\/p>\n<ul>\n<li><a href=\"https:\/\/www.saintjohnscancer.org\/contact-us\/?center=Endocrine%20and%20Tumor%20Disorders\">Request an appointment<\/a><\/li>\n<li><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/meet-our-team\/people\/melanie-goldfarb\/\">Learn more about Dr. Melanie Goldfarb<\/a><\/li>\n<li><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/meet-our-team\/\">Meet the Endocrine Team<\/a><\/li>\n<li><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/thyroid-radiofrequency-ablation\/\">Thyroid Nodules: Learn about Thyroid Radiofrequency Ablation (RFA) for benign thyroid nodules<\/a><\/li>\n<\/ul>\n","layer_link":"","layer_img":1318,"layer_img_position":"left","layer_img_size":"cover","layer_img_is_fade":true,"layer_background_color":"","layer_id":""},{"acf_fc_layout":"layer_featured_blog_items","layer_label":"","layer_headline":"Latest Endocrine News From Our Blog","layer_intro":"","layer_featuredblog_col_width":"quarters","layer_featuredblog_pullbycat":"blog","layer_featuredblog_selectblogcat":["endocrine"],"layer_featuredblog_selectblogauth":[],"layer_featuredblog_more_link":{"title":"Read More Endocrine Articles","url":"https:\/\/www.saintjohnscancer.org\/blog\/category\/endocrine\/","target":""},"layer_background_color":"bg-gray-l","layer_id":""},{"acf_fc_layout":"layer_two_column","layer_label":"","layer_headline":"Additional Resources","layer_intro":"","layer_content_left":"<p><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/parathyroid-imaging\/\">Parathyroid Imaging<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/parathyroidectomy\/\">Parathyroid Surgery<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/osteoporosis\/\">Osteoporosis<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/children-and-adolescents\/\">Children, Adolescent and Young Adult (AYA) with Thyroid Nodules and Cancer<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/thyroid-ultrasound\/\">Thyroid Ultrasound<\/a><\/p>\n","layer_content_right":"<p><a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/diagnosis-and-treatment\/thyroid-biopsy-and-molecular-testing\/\">Thyroid Biopsy and Molecular Testing<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/\">Endocrine Conditions We Treat<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/patient-resources\/\">Patient Resources<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/research-and-clinical-trials\/\">Endocrine Tumor and Bone Research and Clinical Trials<\/a><br \/>\n<a href=\"https:\/\/www.saintjohnscancer.org\/endocrine\/testimonials\/\">Testimonials<\/a><\/p>\n","layer_icon":"","layer_icon_position":"left","layer_background_color":"bg-tertiary","layer_id":""}],"int_alt_page_title":"Parathyroid Disease and Hyperparathyroidism; Hypercalcemia","int_page_description":"","int_masthead_image":{"ID":1319,"id":1319,"title":"hyperthyroid-header","filename":"hyperthyroid-header.jpg","filesize":99323,"url":"https:\/\/www.saintjohnscancer.org\/endocrine\/wp-content\/uploads\/sites\/3\/2022\/01\/hyperthyroid-header.jpg","link":"https:\/\/www.saintjohnscancer.org\/endocrine\/conditions\/hyperparathyroidism\/hyperthyroid-header\/","alt":"","author":"62","description":"","caption":"","name":"hyperthyroid-header","status":"inherit","uploaded_to":15,"date":"2022-01-24 19:31:11","modified":"2022-01-24 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The most easily recognized and curable primary hyperparathyroidism \/ hypercalcemia symptoms are osteoporosis and kidney stones.\"\r\n\t\t\t\t}\r\n\t\t\t},{\r\n\t\t\t\"@type\": \"Question\",\r\n\t\t\t\"name\": \"How is Hyperparathyroidism diagnosed?\",\r\n\t\t\t\"acceptedAnswer\": {\r\n\t\t\t\t\"@type\": \"Answer\",\r\n\t\t\t\t\"text\": \"Since hyperparthyroidism is a hormonal problem, a diagnosis is made by measuring the hormone (ie, calcium and PTH) levels in your body.\"\r\n\t\t\t\t}\r\n\t\t\t},{\r\n\t\t\t\"@type\": \"Question\",\r\n\t\t\t\"name\": \"How is Hyperparathyroidism treated?\",\r\n\t\t\t\"acceptedAnswer\": {\r\n\t\t\t\t\"@type\": \"Answer\",\r\n\t\t\t\t\"text\": \"The only cure for hyperparathyroidism is parathyroid surgery by surgical removal of one or more parathyroid tumors (parathyroidectomy). During parathyroid surgery, the number of parathyroid glands removed will be determined by measuring parathyroid hormone (PTH) in the blood during the operation.\"\r\n                }\t\t\t\t\r\n\t\t\t},{\r\n\t\t\t\"@type\": \"Question\",\r\n\t\t\t\"name\": \"Do symptoms improve after parathyroidectomy?\",\r\n\t\t\t\"acceptedAnswer\": {\r\n\t\t\t\t\"@type\": \"Answer\",\r\n\t\t\t\t\"text\": \"There is the potential to fix and\/or improve all symptoms of parathyroid disease. However, because many symptoms of hyperparathyroidism or hypercalcemia are vague and nonspecific, it is difficult to tell which symptoms are actually caused by the parathyroid tumor and which are unrelated.\"\r\n\t\t\t\t}\t\t\t\r\n\t\t\t},{\r\n\t\t\t\"@type\": \"Question\",\r\n\t\t\t\"name\": \"Will medication be needed after parathyroid surgery?\",\r\n\t\t\t\"acceptedAnswer\": {\r\n\t\t\t\t\"@type\": \"Answer\",\r\n\t\t\t\t\"text\": \"Most people will not have to take any medication after parathyroid surgery. There are occasional patients who have very high calcium levels for a long time before they undergo parathyroid tumor removal that will need temporary over the counter calcium supplementation.Patients that have three or 3 \u00bd parathyroid glands removed due to a familial syndrome or sporadic 4-gland hyperplasia have a higher risk for temporary calcium and\/or vitamin D replacement.\"\r\n\t\t\t\t}\t\t\t\r\n\t\t\t},{\r\n\t\t\t\"@type\": \"Question\",\r\n\t\t\t\"name\": \"What kind of follow-up do I need?\",\r\n\t\t\t\"acceptedAnswer\": {\r\n\t\t\t\t\"@type\": \"Answer\",\r\n\t\t\t\t\"text\": \"You will return for a post-op visit two to three weeks after your parathyroid surgery and again about 6 months later if you live locally; everyone will have repeat blood tests at this time. 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