The parathyroid glands, small structures located in the neck, play a key role in maintaining the body’s calcium balance. This balance is fundamental for various bodily functions, including nerve signaling, muscle contraction, and bone health. When these glands are absent or non-functional, the body’s ability to regulate calcium is significantly impacted. Living without these glands requires understanding their function and the necessary medical management.
Role of Parathyroid Glands
The parathyroid glands are typically four pea-sized glands situated near the thyroid gland. They produce parathyroid hormone (PTH), which is a crucial regulator of calcium, phosphorus, and vitamin D levels in the bloodstream. Maintaining precise calcium levels is important for the proper functioning of muscles and nerves.
PTH acts on several parts of the body to maintain calcium balance. It stimulates the release of calcium from bones into the bloodstream and signals the kidneys to reabsorb calcium. Additionally, PTH promotes the kidneys to convert inactive vitamin D into its active form, which is essential for the intestines to absorb calcium from food. This intricate system ensures that calcium levels remain stable, supporting bone strength and vital physiological processes.
Reasons for Parathyroid Absence
Individuals may not have functioning parathyroid glands for several reasons. The most frequent cause is inadvertent damage or removal during neck surgery, particularly thyroid surgery, accounting for approximately 75% of cases. This condition is known as iatrogenic hypoparathyroidism.
Less common causes include congenital conditions, such as DiGeorge syndrome, where individuals are born without them. Autoimmune diseases, where the body’s immune system mistakenly attacks the parathyroid glands, can also lead to impaired function. Extensive radiation therapy to the head or neck area can also damage the glands.
Living Without Parathyroid Glands
Living without parathyroid glands is possible, but it requires continuous medical oversight and management. Lacking these glands leads to hypoparathyroidism, characterized by insufficient parathyroid hormone production. This hormonal deficiency results in abnormally low blood calcium (hypocalcemia) and often elevated phosphorus levels.
Low blood calcium can manifest in various symptoms due to its impact on nerve and muscle function. Common signs include tingling or numbness, particularly in the lips, fingers, and toes. Muscle cramps and spasms, affecting the hands, feet, or face, are also frequently experienced. In more severe cases, individuals might experience fatigue, confusion, or even seizures. These symptoms stem from the calcium imbalance, not the absence of the glands themselves.
Managing Life Without Parathyroid Glands
Managing life without parathyroid glands focuses on maintaining stable blood calcium and phosphorus levels. This involves lifelong daily supplementation with oral calcium and activated vitamin D, such as calcitriol. Activated vitamin D helps the body absorb calcium from the intestines. Dosages are adjusted based on individual needs to prevent both low and excessively high calcium levels.
Regular blood tests are an essential part of management to monitor calcium, phosphorus, and kidney function, guiding medication adjustments. Dietary considerations also play a role, with recommendations including a high-calcium, low-phosphorus diet. Ongoing medical supervision by an endocrinologist is necessary to manage the condition. Without consistent management, long-term complications can arise, including kidney stones, calcium deposits in the brain, and cataracts.
Advanced Treatment Possibilities
Beyond conventional supplementation, advanced treatment possibilities exist for individuals living without parathyroid glands. Recombinant human parathyroid hormone (rhPTH) replacement therapy is one such development, aiming to replace the missing hormone directly.
Medications like palopegteriparatide (Yorvipath) are examples of available rhPTH analogs that can help raise serum calcium and reduce phosphorus levels, reducing the need for high doses of calcium and vitamin D supplements. Parathyroid tissue transplantation is another area of research. This involves implanting parathyroid tissue, either from the patient’s own body during a prior surgery or from a donor, to restore hormone production.