The Parathyroid Glands
What Causes Hyperparathyroidism?
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Parathyroid Surgery

ENTRUST Center for Thyroid and Parathyroid Surgery Consist of a multidisciplinary team of experts in the field of Head and Neck surgery, General surgery, Thoracic surgery, Endocrinology, Pathology, Cytopathology, Nuclear Medicine and Interventional Radiology.

All are recognized leaders in the community attempting to coordinate care, providing education, early node and cancer detection. The center offers unmatched surgical expertise, using advanced minimally invasive procedures offering faster recovery, less pain and smaller incision.

Staff Faculty

Head and Neck Surgery
General Surgery/Cardiothoracic Surgeon
  • Brian Palafox, M.D.
  • Herbert Rettinger, M.D.
  • Moran, Rowen, and Dorsey, Inc.
  • St. Joseph Hospital Imaging and Radiology
Interventional Radiologist
  • Vascular Interventional Specialist of Orange County - St. Joseph Hospital
  • Orange County Pathology Medical Group
Speech Pathology
  • Dee Parker, Ph.D., CCC-SLP

Procedures Performed


Thyroid nodule detection
Thyroid fine needle aspiration biopsy
Endoscopic assisted and minimally invasive thyroid surgery
Partial thyroidectomy
Total thyroidectomy
Completion thyroidectomy
Thyroidectomy for Grave’s disease & Hyperthyroidism
Thyroidectomy for large goiters
Excision of substernal goiters
Central, mediastinal and later lymph node dissection
Post-operative scan reduction therapy
Radioactive thyroid remnant ablation
Tracheal resection and reconstruction


Minimally invasive endoscopic assisted parathyroid surgery
Intra-operative parathyroid hormone assessment
Parathyroid localization scans
Metabolic bone disease consultation for osteoporosis
Parathyroid location
Sestamibi scanning


Early voice rehabilitation
Vocal cord medialization surgery
Intra-operative recurrent laryngeal nerve monitoring

The Parathyroid Glands

The parathyroid glands are most often found behind the thyroid gland in the neck. The exact locations Parathyroid surgery at Entrust Medical Groupvary with each person. The parathyroid glands control the level of calcium in the blood. They do this by making parathyroid hormone (PTH). This is a chemical messenger that tells the body how to control calcium.

Understanding The Parathyroid Glands

The parathyroid glands are usually no bigger than grains of rice. Their main job is to keep the level of calcium in the blood within a certain range. Keeping a normal level of calcium helps the muscles and nerves work properly and also keeps bones strong. When there is a problem with the parathyroid glands, the blood calcium level may get too high. This has affects throughout the body.

How These Glands Work

When the blood calcium level is low, the glands make more PTH. This tells the body to increase the amount of calcium in the blood. To increase the blood calcium level, the body may absorb more calcium from food in the intestines; it may also take calcium from the bones. When the blood calcium level is high, the glands make less PTH. This tells the body to decrease the amount of calcium in the blood. To decrease the blood calcium level, calcium is filtered out of the body by the kidneys.

A Problem With The Parathyroid Glands

The parathyroid glands are four tiny glands located in the neck. These glands control the level of calcium in the blood, the most common problem that affects the parathyroid glands is called hyperparathyroidism. This occurs when one or more of the gland is too active, causing a high blood calcium level. Hyperparathyroidism can lead to serious health problems throughout the body, but it can be treated.

When You Have Hyperparathyroidism

With hyperparathyroidism, one or more of the parathyroid glands becomes larger. It then makes too much PTH. As a result, the body continues to increase the level of calcium in the blood. This causes a condition called hypercalcemia (an above-normal level of blood calcium). Hypercalcemia can lead to a number of problems throughout the body. These are listed below.

  • Enlarged parathyroid gland

  • Nervous system problems. A high blood calcium level can make you feel tired, depressed, or irritable. You may also have problems with concentration or memory.

  • Muscle problems. A high blood calcium level can affect the muscles, causing muscle pain and weakness.

  • Kidney problems. As extras calcium passes through the kidneys, you may have frequent urination. And, you’re more likely to develop kidney stones and kidney disease.

  • Digestive problems. The intestines absorb calcium to be used by the body. A high blood calcium level can cause abdominal pain, nausea, vomiting, and constipation. Over time, you may even develop stomach ulcers or pancreatitis.

  • Bone and joint problems. To increase blood calcium, calcium may be taken from the bones. This can cause bone pain and may fractures and bone disease more likely.


What Causes Hyperparathyroidism?

Hyperparathyroidism most often occurs when one parathyroid gland becomes enlarged, this is almost always because of benign (non-cancerous) growth called an adenoma. In some cases, more than one parathyroid gland becomes enlarged.

Risk Factors For Hyperparathyroidism

Anyone can get hyperparathyroidism. It is more common in women than men. The chance of developing hyperparathyroidism also increases with age. Some factors make the problem more likely, these are known as risk factors. Risk factors for hyperparathyroidism include:

  • Having parents or siblings with hyperparathyroidism
  • Getting too little vitamin d in the diet
  • Having certain kidney problems.
  • Taking certain medications
  • Having had radiation to the head or neck.

Symptoms Of Hyperparathyroidism

Most peoples with hyperparathyroidism don’t know they have it; this is because symptoms of this problem can be very mild or are very similar to those of other health problems, and hyperparathyroidism can cause any of the symptoms below:

  • Muscle weakness
  • Depression
  • Hard stools (constipation)
  • Stomach ulcers
  • Tiredness
  • Needing to urinate often
  • Poor memory
  • Kidney stones
  • Nausea and vomiting
  • Joint or bone pain
  • Pain in the stomach area (or abdomen)
  • Bone disease (osteopenia or osteoporosis)
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Your Evaluation

To learn more about your condition, your doctor will evaluate you. A thorough medical history is taken and you are examined. Some tests may also be done. This evaluation gives your doctor information needed to plan your surgery.

Medical History and Physical Exam

During the medical history, you’ll be asked about your risk factors and symptoms. Be sure to describe any symptoms you have, even if they seem minor. Also mention other medical problems you have or have had in the past. You may be asked about the foods you eat and medications you take. During the physical exam, your doctor will check your head and neck. Other parts of the body may also be examined to rule out other conditions.

Diagnostic Tests

Certain tests are done to check for hyperparathyroidism and the risk of related health problems, such as kidney and bone disease. Test may include:

Blood tests. Samples of blood are drawn from a vein. These are checked for high levels of calcium and PTH. The levels of vitamin D, magnesium, alkaline phosphatase, and phosphorus may also be checked.

Urine tests. Samples of urine are taken over a 24-hour period. These are checked for high levels of calcium and problems with the kidneys.

Bone density study. Scans of the hip, lower back, or forearm are taken. This test measures the amount of calcium in the bones to check bone health.

Imaging Tests. Imaging tests may be done to help the doctor find the parathyroid glands and see which are enlarged. Each test is usually performed by a doctor, or a trained technologist. In some cases, enlarged parathyroid glands can’t be seen on imaging tests.

A sestamibi scan. is used to find any enlarged parathyroid glands. The test can take up to 3 to 4 hours. During the test, a safe radioactive fluid is injected into the veins. This fluid helps make enlarged parathyroid glands show up clearly when a special camera is used.

An ultrasound. can also be used to find enlarged parathyroid glands. Normal glands are to small to be seen, but enlarged parathyroid glands will usually be visible. During this quick test, harmless sound waves are used to form pictures of the parathyroid glands. The pictures are then viewed on a computer screen.

A CT. (computed tomography) scan combines x-rays and computer processing technology to form pictures. An MRI (magnetic resonance imaging) scan uses magnets and radio waves to form pictures. These tests are done less often, but they can also be used to locate enlarged parathyroid glands.

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