Hypoparathyroidism is the combination of symptoms due to inadequate parathyroid hormone (PTH) production. Since the four parathyroid glands have complete control over the levels of calcium in the blood and bones, inadequate parathyroid gland function causes the blood calcium levels to decrease dramatically. If untreated with large doses of calcium, the patient can be expected to die within a week because of the failure of all muscles to contract and a complete failure of the musculature and nervous systems.
Hypoparathyroidism is a very rare condition in the general population where it can occur in mild to moderate forms due to genetic problems. However, hypoparathyroidism it is quite common following surgery for thyroid nodules and thyroid cancer due to the surgeon injuring or accidentally removing the parathyroid glands during the thyroid operation. It is estimated that more than 50% of patients undergoing thyroid surgery will have lack of parathyroid function for at least a few weeks, and as many as 5-6% will have hypoparathyroidism for the rest of their life.
More than 95% of patients with hypoparathyroidism have this problem as a complication from thyroid or parathyroid surgery. This is one of the most debilitating complications of any type of surgery performed on any area of the body because the lack of blood calcium affects the entire nervous system and every muscle of the body. And this complication is almost completely avoidable.
Hypoparathyroidism: A Life Altering Complication of Thyroid Surgery
Symptoms of hypoparathyroidism are lifelong and can be quite severe, including weak bones that break easily, kidney stones, excessive urination, stomach pain, weakness, fatigue, depression, anxiety, memory loss, bone and joint pain, nausea and more.
This condition makes people feel poorly often enough that nearly 25% of those suffering say they cannot work and have become unemployed because of this complication. Of those still working, 72% said they had to change jobs because of concentration abilities or other issues related to symptoms. 65% of patients say they miss 2 weeks or more of work per year more than they ever did before. These patients typically require doctor visits every 2-3 months for the rest of their lives, and many require visits to the emergency room every few months for additional calcium given intravenously.
Additionally, patients who had all of their parathyroid glands removed or destroyed during surgery will require high doses of calcium and Vitamin D every day for the rest of their lives. Less than 10% of all patients with hypoparathyroidism say their disease is managed well enough that they never have to go to the emergency room to receive IV calcium. Almost half of patients make one ER visit per year, while 25% make 3 or more ER visits per year. One third of patients with hypoparathyroidism are now required to see an endocrinologist every 1-2 months.
“My wife has been struggling with hypoparathyroidism for years,” says Bill from Atlanta, GA. “She had thyroid surgery for cancer and her parathyroid glands were destroyed. This has made her life miserable. She feels terrible all the time, has to take up to a dozen calcium pills per day, and has to go to the emergency room every 3-5 months to get additional calcium in an IV.”
“Every week, I get multiple notes from patients who now have hypoparathyroidism as a consequence of their surgery,” said Dr. Jim Norman, Founder and CEO of the Norman Parathyroid Center. “It’s heartbreaking. They are suffering with horrible, debilitating symptoms and there is no way to fix it. It all could have been avoided by choosing a more experienced surgeon. My goal is to reach patients before they undergo thyroid or parathyroid surgery and educate them so that they can better advocate for themselves. There is no reason anyone should be suffering from surgeon-induced hypoparathyroidism.”
New Methods Give Hope for Decreasing Hypoparathyroidism Following Thyroid Surgery
The expert thyroid surgeons at the Clayman Thyroid Center at the Hospital for Endocrine Surgery have been using human amniotic membrane to cover all parathyroid glands following thyroid surgery for the past 17 months. “The amniotic membrane contains growth factors and stem cells which promote tissue growth and viability,” states Dr. Clayman. “Since we began using amniotic membrane, our incidence of temporary hypoparathyroidism has decreased from 18% to 3% and it only lasts a week or two instead of a month or two. This is a huge advantage for our patients, and we now we use it in all our thyroid operations.”
For over 20 years, the Norman Parathyroid Center’s surgeons have been the highest-volume parathyroid surgeons in the world, performing nearly 3,800 parathyroid operations annually. Along with the surgeons of the Clayman Thyroid Center and the Carling Adrenal Center, they have recently moved into the new Hospital for Endocrine Surgery where the use of amniotic membrane on all exposed parathyroid glands following thyroid surgery has become standard of care, as well as during parathyroid surgery on any glands that have questionable viability. Aside from surgeon experience, the use of amniotic membrane appears to be the only means to decrease the incidence of this terrible disease.