Parathyroid treatments are used to treat the disorders that have something to do with the way your body regulates your calcium levels. One of the most common disorders of the parathyroid glands is hyperparathyroidism, which is an increase in the synthesis and secretion of parathyroid hormone or PTH. An increase of PTH will cause resorption of bone, leading to bone weakness.
Hypoparathyroidism may not be as common as hyperparathyroidism but it bears watching as well. Hypoparathyroidism is the opposite of hyperparathyroidism. In hypoparathyroidism, there is inadequate secretion of PTH by the parathyroid glands, leading to tingling sensations in the extremities, muscle spasms, and loss of consciousness.
Parathyroid Glands and Parathyroid Hormone
On average, a person has four parathyroid glands — two on the posterior left lobe of the thyroid gland and another two on the posterior right lobe — although five or six glands are not uncommon. The parathyroid glands are composed mainly of chief cells, which synthesize and secrete parathyroid hormone or PTH. These cells are highly specialized to synthesize, process, and secrete the peptide hormone that is PTH.
Ionized plasma calcium is the major regulator of parathyroid hormone secretion, although vitamin D plays a role as well. Both serve to inhibit the synthesis and/or secretion of parathyroid hormone.
Parathyroid hormone is responsible for raising the plasma concentrations of calcium by increasing resorption of this mineral from the bone. Parathyroid hormone also serves to promote the reabsorption of calcium in the kidneys with consequent loss of phosphate ions through the urine.
Medications for Parathyroid Disorders
Although a majority of patients with parathyroid disorders undergo surgery or parathyroidectomy, a few will find it unnecessary for their conditions. These few people who may not qualify for parathyroid surgery include patients with hypoparathyroidism or inadequate parathyroid hormone secretion and other hyperparathyroid patients who may not qualify for surgery, such as those not displaying the symptoms. For such cases, the doctor may recommend treatments to prevent the symptoms from showing or supplement the deficiency of the hormone.
The medications for hyperparathyroidism do not cure the disorder but merely reduce its severity. These medications are ideal for patients with mild or asymptomatic hyperparathyroidism.
Calcimetrics. These are medications that inhibit the parathyroid glands from secreting too much parathyroid hormone. It has only been recently approved by the Food and Drug Administration as a treatment for primary hyperparathyroidism due to parathyroid cancer and secondary hyperparathyroidism occurring with renal failure. These medications may not be appropriate for patients with liver disease.
Biphosphonates. In pharmacology, these are drugs that are used to prevent loss of bone mass and treat osteoporosis and other similar diseases. In cases of hyperparathyroidism, PTH stimulates the osteoclasts to pump calcium and phosphates from the bone and into the extracellular fluid. These medications inhibit the digestion of bone by osteoclasts and promote cell suicide or apoptosis in osteoclasts. However, they may not be commendable for pregnant patients and patients with kidney problems.
Estrogen and Progestin. Of the parathyroid treatments, this is the only one that employs the use of hormones which help reduce bone loss in postmenopausal women. They are generally not recommended due to their association with breast cancer, heart disease, and stroke.
