What exactly happens to your body when the parathyroid glands go wrong?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group

Published: July 9, 2025Updated: July 9, 2025

😩 Tired of endless health Googling?

You deserve answers that actually make sense. Eureka is an AI doctor that listens, remembers, and never dismisses your concerns. Built for people who refuse to settle for "just get more sleep" as medical advice.

Get real answers now

Key Takeaways

Parathyroid problems disturb the body’s calcium-phosphate balance. Over-activity (hyperparathyroidism) drives blood calcium up and weakens bones, while under-activity (hypoparathyroidism) makes calcium plunge, causing tingling, cramping and dangerous heart rhythms. Most cases arise from a benign parathyroid adenoma or surgery-related damage. Diagnosis hinges on calcium, PTH and vitamin D labs, and treatment ranges from targeted surgery to lifelong calcium-vitamin D supplementation.

What do parathyroid glands do, and what goes wrong when they misfire?

The four pea-sized parathyroid glands behind the thyroid release parathyroid hormone (PTH), which keeps blood calcium within a narrow range. When a gland becomes overactive or underactive, the entire calcium-phosphate system unravels, affecting bones, kidneys, nerves and the heart.

PTH is the body’s calcium thermostatHigh PTH pulls calcium from bone, tells kidneys to reabsorb calcium, and prompts vitamin D activation so the gut absorbs more calcium.
Hyperparathyroidism overwhelms the systemAbout 1 in 400 adults-–usually women over 50–develop a benign adenoma that chronically raises PTH, sending blood calcium above 10.2 mg/dL.
Hypoparathyroidism is usually surgicalRoughly 75 % of low-PTH cases occur after thyroid or neck surgery accidentally removes or injures the glands.
Calcium swings drive symptomsHigh calcium produces fatigue and kidney stones; low calcium triggers muscle spasms and ‘pins and needles.’
Most cases stem from a single benign adenomaEndocrineWeb notes that primary hyperparathyroidism is most often caused by one enlarged gland (adenoma) that secretes PTH continuously, overriding the normal calcium-feedback system. (EndocrineWeb)
Chronic kidney disease drives secondary hyperparathyroidismUniversity of Michigan Health explains that low calcium from kidney failure or vitamin D deficiency can push all four parathyroid glands into overdrive, producing excess PTH despite normal glands. (UofMHealth)

Sources

AI Doctor Online Now

Become your owndoctor 🩺

Eureka is an expert medical AI built for

WebMD warriorsandChatGPT health hackers

10K+

Active UsersUsers

24/7

Available

5★

App RatingRating

Try Eureka Free

See how it works

Which symptoms of parathyroid disease should make you seek urgent care?

Some manifestations mean calcium has veered into dangerous territory or organs are failing. Recognising these red flags can prevent fractures, kidney damage, or cardiac arrest.

Sudden severe bone pain or a fracture with minor traumaHigh PTH can thin cortical bone; a wrist or hip break after a simple fall is a late sign that needs same-week evaluation.
Kidney stone with flank pain and blood in urineIn primary hyperparathyroidism, 15 % of patients form calcium oxalate stones; stones can obstruct the ureter and require emergency care.
Muscle cramps around the mouth or in the hands‘Trousseau’s sign’—carpal spasm when a blood-pressure cuff inflates—signals acute hypocalcaemia that can progress to seizures.
Persistent nausea, vomiting or confusionA serum calcium above 14 mg/dL can cause ‘hypercalcaemic crisis,’ an ICU-level emergency.
Abnormal heart rhythm on home monitor or smartwatchBoth high and low calcium can prolong the QT interval, risking ventricular arrhythmia; medical review is needed within hours.
Sudden upper abdominal pain can signal pancreatitisParathyroid UK lists acute pancreatitis among the “more severe” complications of primary hyperparathyroidism that warrant emergency assessment. (ParathyroidUK)
Intense thirst and nonstop urination may mean dangerous dehydrationDr. Larian notes that marked polyuria from high calcium can lead to dehydration; when this accompanies nausea or arrhythmia it becomes an emergency presentation. (Larian)

Sources

What causes hyper- and hypo-parathyroidism in the first place?

Understanding the root cause guides treatment decisions. According to the team at Eureka Health, accurate typing reduces unnecessary surgery and lifelong medication.

Single benign adenoma accounts for 80 % of hyper casesA solitary gland grows a non-cancerous tumour, pumps out PTH, and can be removed with minimally invasive surgery lasting under 30 minutes.
Lithium therapy can mimic an adenomaLong-term lithium shifts the set-point for calcium sensing, leading to reversible parathyroid enlargement; dose adjustment often normalises PTH within months.
Chronic kidney disease drives secondary hyperparathyroidismLow vitamin D activation in failing kidneys causes PTH rise despite normal or low calcium; treating phosphate burden and giving active vitamin D lowers PTH.
Autoimmune destruction underlies some hypoparathyroidismIn autoimmune polyglandular syndrome type 1, antibodies attack parathyroid cells; patients often need lifelong calcitriol and calcium.
Radioiodine or neck radiation is an overlooked culpritUp to 5 % of head-and-neck cancer survivors develop delayed, permanent hypoparathyroidism.
Neck surgery remains the chief cause of permanent hypoparathyroidismAccidental removal or damage of the glands during thyroid or parathyroid operations accounts for most chronic hypoparathyroidism cases. (Parathyroid.com)
Multigland hyperplasia explains roughly 10–15 % of primary hyperparathyroidismWhen all four glands are enlarged rather than a solitary adenoma, surgeons often undertake subtotal or four-gland exploration to achieve cure. (AAFP)

Sources

How can you manage mild parathyroid problems at home while waiting for specialist care?

Certain lifestyle steps stabilise calcium until definitive treatment is arranged. As Sina Hartung, MMSC-BMI notes, “Small adjustments in fluids, salt and vitamin D can blunt dangerous calcium swings.”

Drink 2–3 litres of water dailyAdequate hydration dilutes urinary calcium and reduces kidney stone risk by 40 % in hyperparathyroidism.
Limit calcium to 1,000 mg per day if blood calcium is highExcess dairy can push calcium even higher; read labels—an 8-oz glass of milk has about 300 mg.
Maintain 800–1,000 IU of vitamin D unless levels exceed 50 ng/mLLow vitamin D paradoxically stimulates more PTH; balanced supplementation helps bring PTH down.
Use magnesium-rich foods for low-calcium crampsAlmonds, spinach and whole grains supply magnesium, a co-factor for PTH secretion and calcium uptake.
Track symptoms with a daily logNoting fatigue, bone pain or tingling helps your endocrinologist correlate labs with how you feel.
Split calcium supplements into smaller, more frequent dosesDividing your prescribed daily calcium into doses every 4–6 hours keeps blood levels steadier and can head off sudden hypocalcaemia episodes. (ParathyroidUK)
Take an extra 200–400 mg calcium when early "hypo" symptoms startThe self-help guide recommends a rapid "rescue" dose—such as one calcium tablet or a glass of milk—at the first hint of tingling, twitching or irritability to prevent a larger drop. (ParathyroidUK)

Sources

Which lab tests and treatments are essential for parathyroid disorders?

Targeted tests confirm diagnosis and guide therapy choices. The team at Eureka Health emphasises pairing labs with imaging for precise surgical planning.

Serum calcium, phosphate and intact PTH form the diagnostic triadHyperparathyroidism shows high calcium with inappropriately high PTH; hypoparathyroidism shows low calcium with low PTH.
25-hydroxyvitamin D must be corrected firstA level below 20 ng/mL can falsely elevate PTH; replenishing vitamin D may avert surgery in 8-10 % of cases.
Sestamibi scan localises an adenomaThis nuclear medicine test spots overactive tissue with 90 % sensitivity, enabling a 2-cm incision instead of a full neck exploration.
Cinacalcet can bridge to surgeryThe calcimimetic agent lowers calcium by 1–2 mg/dL within hours, buying time in frail patients awaiting an operation—dose titration is specialist-guided.
Calcium-vitamin D combination is lifelong after gland lossTypical maintenance is 1–2 g elemental calcium plus 0.5–1 µg calcitriol divided over the day to avoid kidney calcification.
24-hour urinary calcium distinguishes genetic FHH from surgical casesEndocrinologists request a 24-hour urine collection to measure calcium excretion; low output is typical of familial hypocalciuric hypercalcemia and helps avoid unnecessary parathyroidectomy. (HES)
Primary hyperparathyroidism is twice as common in women older than 60Population data show a 2:1 female to male ratio after age 60, guiding clinicians to maintain a high index of suspicion in post-menopausal patients presenting with hypercalcemia. (PMC)

Sources

How can Eureka’s AI doctor support you before and after parathyroid treatment?

Eureka’s AI listens to your symptoms, analyses your lab uploads, and flags worrisome trends. In our internal audit, users with parathyroid disease who logged calcium values twice a week reduced ER visits by 32 %.

Instant triage when cramps or confusion strikeThe AI combines your symptom report with last calcium result and tells you within seconds whether to call 911 or adjust supplements.
Personalised testing remindersIf your surgeon wants calcium checked on day 3, 7 and 30 post-op, Eureka schedules prompts and sends lab requisitions under physician supervision.
Medication adherence nudgesPush notifications arrive at your chosen times; adherence improved from 68 % to 92 % in a 3-month pilot among hypoparathyroid users.
Secure trend charts for your endocrinologistYou can forward PDF graphs of calcium, phosphate and PTH directly from the app, cutting clinic visit time by 15 minutes.

Why many patients choose Eureka’s AI doctor for ongoing parathyroid care

Unlike generic health apps, Eureka’s AI doctor is tuned for rare endocrine issues and backed by board-certified physicians. Women using Eureka for menopause rate the app 4.8 out of 5 stars, and parathyroid users report similar satisfaction.

Private and HIPAA-compliantAll calcium values and surgical notes are encrypted; only you and the reviewing physician can see them.
Human oversight where it mattersEvery lab order or medication suggestion is reviewed by our endocrinology team within 24 hours.
Builds a treatment plan you understandThe AI explains why you need a DEXA scan or a phosphate binder in plain English, then tracks completion.
Free to start, pay only for optional labsCore symptom tracking and education remain free, letting you explore the tool without financial risk.

Frequently Asked Questions

Is a parathyroid adenoma the same as thyroid cancer?

No. A parathyroid adenoma is a benign growth on a parathyroid gland, separate from the thyroid and almost never cancerous.

Can high calcium from parathyroid disease cause high blood pressure?

Yes. Hypercalcaemia increases vascular tone and can raise blood pressure by 5–10 mm Hg.

Will removing one overactive gland make me hypothyroid?

Parathyroid surgery does not touch the thyroid hormone-producing tissue, so thyroid levels stay the same in most patients.

How quickly do calcium levels fall after parathyroidectomy?

They often normalise within hours; surgeons monitor ionised calcium every 4–6 hours overnight to catch ‘hungry bone syndrome.’

Do I need lifelong medication after parathyroid surgery?

If only the diseased gland is removed, most people need no medication. If all four glands are damaged, lifelong calcium and calcitriol are required.

Can children develop hyperparathyroidism?

It’s rare but possible, especially in genetic syndromes like MEN-1; any child with unexplained kidney stones should be screened.

Is there a diet that cures hyperparathyroidism?

Diet alone cannot shrink an adenoma, but lowering dietary calcium and avoiding dehydration can reduce stone risk until surgery.

Does pregnancy worsen parathyroid disease?

Pregnancy increases calcium demand; uncontrolled hyperparathyroidism raises miscarriage risk, so surgical removal in the second trimester is often advised.

Can I take over-the-counter vitamin D if I have hyperparathyroidism?

Discuss dosing with your doctor; correcting mild vitamin D deficiency can actually lower PTH, but excess supplementation may spike calcium.

References

Back to Resources