10 Most Common Thyroid and Parathryoid Myths

  1. One of the most serious misconceptions associated with primary hyperparathyroidism is that high calcium levels can be ignored and not treated. Many times patients believe that since they have no specific symptoms associated with hypercalcemia, that the problem can be “observed”. The fact is that and elevated calcium level test is never normal and demands a complete evaluation. Complete evaluation of elevated calcium levels includes a parathyroid hormone assay and in most cases the diagnosis can be extremely precise. If indeed the diagnosis of primary hyperparathyroidism is made, the consensus among all endocrinologists is that treatment is indicated. The fact is that if a patient has primary hyperparathyroidism, that the only available treatment would be surgical removal of the abnormal gland. If a patient is otherwise healthy and there is no contraindication to surgical removal, there would be no benefit in delaying treatment. Spontaneous regression of parathyroid adenomas does not occur.
  2. A second common myth associated with parathyroid disease is that it may be treated medically. There is no medical treatment indicated for primary hyperparathyroidism.
  3. A third myth associated with parathyroid disease is that it is a disease of women and older women only. This is untrue. Primary hyperparathyroidism occurs in male and female patients of all ages.
  4. A fourth myth associated with parathyroid diagnosis and treatment is that a negative imaging scan implies the absence of parathyroid disease. This is in fact not true. The diagnosis of primary hyperparathyroidism is made based on elevated parathyroid hormone levels. A negative scan only implies that multiple gland may be involved as opposed to one single gland with selective uptake.
  5. Another myth associated with parathyroid disease and parathyroid surgery is that radio-guided techniques can alone differentiate between an adenoma and hyperplasia. This is in fact not true and only a combination of clinical experience, pathological experience, intraoperative use of parathyroid hormone levels and good clinical judgment can help differentiate these to processes.
  6. Another myth associated with parathyroid surgery is that minimally invasive and smaller incisions always result in noticeable scars. In fact, minimally invasive technology combined with cosmetic closure now results in nearly invisible scarring.  In addition, Assisted Robotic Technology avoids any incision on the neck.
  7. It is a misconception that many patients have no symptoms due to diseases of the parathyroid. High calcium levels from primary hyperparathyroidism causes symptoms and effects on the body in 95% of patients. These symptoms are often vague. They can include a general feeling of fatigue. They affect the mood or cause depression. They have often vague symptoms on every organ system. The elimination of these symptoms occurs with the treatment and removal of the parathyroid adenoma. It is at this point that the patients often realize that indeed they did have symptoms.
  8. Another myth is that symptoms of parathyroid disease do not correlate with the level of calcium in the blood. The truth is, many patients with only mild elevation will have significant symptoms.
  9. It is a myth that fluctuations in parathyroid hormone levels and calcium levels may indicate resolution of disease. In fact, fluctuation of parathyroid hormone levels and calcium levels is common and therefore is not an indication that the disease has arrested.
  10. The 10th myth is: since primary hyperparathyroidism always removes calcium from the bones, it will always lead to eventual osteopenia and osteoporosis. Medications that are used for treating osteoporosis are only effective with control of parathyroid hormone levels back to normal. The use of drugs for osteoporosis is not indicated as a substitute for control of primary hyperparathyroidism.