Parathyroid Disorders: The Hidden Threat to Bone and Organ Health

Parathyroid problems masquerade as common problems of many other organs, misleading many medical specialists.

- DR P.S. VENKATESH RAO

The parathyroid glands are endocrine organs that secrete the parathyroid hormone (PTH), parathormone, or parathyrin. The parathyroid glands were the last human organ identified in 1880 by Ivar Sandström, a Swedish medical student. The parathyroid glands were first discovered in the Indian rhinoceros by Richard Owen in 1852; hence, the single-horned Indian rhino (not the double-horned African rhino) is the mascot of endocrine surgery worldwide. Studies of parathyroid hormone levels by Roger Guillemin, Andrew Schally, and Rosalyn Sussman Yalow led to the development of laboratory immunoassays and a Nobel Prize, less than 50 years ago in 1977.

We have four tiny parathyroid glands, only a few millimeters in size, located behind the thyroid gland in the neck, in variable locations. Parathyroid glands share blood supply and drainage with the thyroid. PTH increases serum calcium levels and is counteracted by calcitonin produced by the thyroid gland. PTH with vitamin D plays a crucial role in maintaining bone health by regulating calcium and phosphate levels in the blood, and within the bones through its actions on the absorption of calcium from the gut, deposition and removal of calcium from the bones, and disposal

Vitamin D is produced in the skin and obtained from diet, and initially activated in the liver to calcidiol, and further activated to calcitriol in the kidney, facilitated by PTH. Hyperparathyroidism (surplus PTH) and hypoparathyroidism (deficient PTH) cause alterations in blood calcium levels and bone strength. Calcium plays a crucial role in regulating heart rhythm, and both high and low calcium levels can disrupt the heart's electrical signals, potentially leading to irregular heartbeats (arrhythmias). World Hypopara Day is observed annually on June 1st to raise awareness about parathyroid diseases and the importance of early detection and treatment.