15043 Parathyroid Adenoma

Overview

A parathyroid adenoma is a non-cancerous (benign) growth on one of the parathyroid glands. These four small glands in your neck make parathyroid hormone (PTH), which controls how much calcium is in your blood. An adenoma makes the gland produce too much PTH, leading to high calcium levels. This can cause symptoms like tiredness, kidney stones, and bone thinning.

Parathyroid adenomas are the most common reason for primary hyperparathyroidism, which affects around 1 in 1,000 people in the UK. They are more common in people over 50, especially women.

Parathyroid adenomas can affect anyone, but they are most often diagnosed in adults aged 50 to 60. Women are affected about two to three times more often than men.

Symptoms

Common symptoms

• Often no symptoms at all — many people find out by chance from a blood test.
• Tiredness and fatigue
• Feeling weak in the muscles
• Bone and joint pain
• Kidney stones (severe pain in the back or side)
• Increased thirst and needing to pass urine more often
• Low mood or depression
• Poor memory or trouble concentrating
• Stomach discomfort, constipation, or nausea

Causes

Main causes

• The exact cause is not fully understood.
• Most parathyroid adenomas are sporadic — they happen for no known reason.
• Rarely, a gene change (mutation) can make a person more likely to develop one.
• An adenoma is a benign tumour (non-cancerous growth) that makes the gland release too much parathyroid hormone (PTH).

Risk factors

• Adults over the age of 50
• Being female
• A history of radiation therapy to the neck (in rare cases)
• Certain rare inherited conditions, such as multiple endocrine neoplasia (MEN) type 1 or familial isolated hyperparathyroidism

When to see a doctor

See a doctor urgently if:

• If you have severe bone, muscle, or kidney pain, or you are vomiting and cannot keep fluids down, seek urgent medical advice.
• If you feel confused, very drowsy, or have a seizure, call your local emergency number immediately.

Book a routine appointment if:

• Make an appointment with your GP if you have persistent tiredness, thirst, low mood, or any other symptoms listed above that are not going away.
• If you have had kidney stones, mention this to your doctor — you may need a calcium test.

Diagnosis

Doctors usually suspect a parathyroid adenoma after a blood test shows high calcium and high parathyroid hormone (PTH) levels. To confirm the diagnosis, your doctor will arrange further tests.

Tests that may be done

• Blood tests — to check levels of calcium, parathyroid hormone (PTH), vitamin D, and kidney function.
• 24-hour urine collection — to measure how much calcium your body is losing in urine.
• Bone density scan (DEXA) — to check for bone thinning.
• Kidney ultrasound or X-ray — to look for kidney stones.
• Imaging tests to locate the adenoma, such as an ultrasound of the neck, a sestamibi scan, or a CT scan.

What to expect at your appointment

Diagnosis is usually straightforward. Your GP may refer you to an endocrinologist (a hormone specialist) for further tests and treatment planning. Imaging scans help find the exact position of the adenoma before any surgery.

Treatment

The main treatment for a parathyroid adenoma is surgery to remove the abnormal gland. However, not everyone needs surgery straight away. Some people with mild symptoms are monitored with regular blood tests. Your doctor will recommend the best option based on your calcium levels, age, kidney function, and bone health.

Self-care at home

• Stay well hydrated — drink plenty of fluids to help protect your kidneys.
• Stay physically active — weight-bearing exercise can help keep bones strong.
• Avoid very high-calcium supplements unless your doctor advises them.
• Do not take certain medicines (like thiazide diuretics) without your doctor's advice, as they can affect calcium levels.

Medical treatments

Doctors may use medicines to help control calcium levels in the blood, especially if you are not having surgery. These treatments aim to lower calcium and reduce symptoms, but they do not cure the adenoma. Your specialist will discuss which medicine is right for you. Surgery remains the most effective way to stop the overproduction of hormone.

When is surgery considered?

Surgery is usually recommended if you have symptoms such as kidney stones, bone thinning, or very high calcium levels. It is also considered for younger people and those with complications. The operation is called a parathyroidectomy and involves removing the adenoma. It has a very high success rate, and most people go home within a day.

Living with this condition

If you are being monitored without surgery, you will have regular blood tests to check your calcium levels. You may need to see an endocrinologist every few months or once a year. If you have surgery, most people feel better quickly, though calcium levels may need to be checked for a few months afterwards.

Lifestyle tips

• Drink plenty of water throughout the day.
• Do regular weight-bearing exercise like walking or dancing to keep bones strong.
• Eat a balanced diet with enough calcium and vitamin D — but do not take high-dose supplements unless your doctor tells you to.
• Avoid smoking and limit alcohol, as these can weaken bones.

Diet and exercise

Aim for a normal, balanced diet. You usually do not need to restrict calcium from food, but talk to your doctor before taking calcium or vitamin D supplements. Gentle exercise is safe; weight-bearing activities are best for bone health. If you have severe bone pain, start slowly and build up.

Mental health and emotional wellbeing

Living with a parathyroid adenoma can cause anxiety, low mood, and trouble concentrating. These symptoms are real and often improve after treatment. It is important to talk to your doctor if you feel depressed or anxious — there are effective ways to help.

Prevention

There is no proven way to prevent a parathyroid adenoma. Because most cases happen for no known reason, early detection through blood tests is the best strategy to avoid complications.

Screening programmes

Routine screening is not recommended for the general public. However, if you have a family history of a rare inherited condition like MEN, your doctor may advise regular blood tests to check calcium levels.

Complications

If left untreated

• Kidney stones — severe pain and possible kidney damage.
• Osteoporosis — thinning bones that break more easily.
• Heart and blood vessel problems — high calcium can affect blood pressure and heart rhythm.
• Peptic ulcers or pancreatitis (inflammation of the pancreas).
• A condition called hypercalcaemic crisis — very high calcium levels that can be life-threatening.

Long-term outlook

The outlook for parathyroid adenoma is very good. Surgery cures the problem in more than 95% of cases. Even without surgery, regular monitoring and medical care can control symptoms and prevent complications. Most people return to their normal lives after treatment.

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