The thyroid gland straddles your windpipe in the lower part of your neck. It is butterfly-shaped, with two lobes connected by a thin strand of tissue. The thyroid makes the hormone thyroxine. On the four corners of the thyroid gland are the four small parathyroid glands, each about the size of a sesame, which produce parathyroid hormone. Problems with these glands often involve over- or under-production of the hormones.
Most people who show up at their doctor’s office with symptoms of hyperparathyroidism are chronically ill with symptoms arising from the kidneys or the skeleton. Rarely, however, they arrive acutely ill with urgent symptoms that sometimes prove fatal. The terms acute hyperparathyroidism and hyperparathyroid crisis describe a simple episode of life-threatening high levels of calcium in blood, causing symptoms such as nausea and vomiting, weakness, and mental changes.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Cimetidine, Pamidronate
Hyperthyroidism is overactivity of the thyroid gland, resulting in the production of too much of the hormone thyroxine. The gland is normally controlled by thyroid-stimulating hormone (TSH), which is made in the pituitary gland. In hyperthyroidism, something has gone wrong with the control mechanism. Despite normal or low levels of TSH, the thyroid gland itself produces large quantities of thyroxine. Why this happens is not well understood, but it speeds up all chemical reactions in the body affecting physical and mental processes.
Commonly Prescribed (On-Label) Drugs: Methimazole, Potassium Iodide, Propylthiouracil
Off-Label Prescription Drug Breakthrough Option: Propranolol
Hyperparathyroidism occurs when excessive amounts of parathyroid hormone (PTH) are produced. PTH helps control bone growth by regulating calcium and phosphorus balance in the body. In primary hyperparathyroidism, the glands secrete too much PTH because one or more of them have become enlarged. This may affect the skeletal, gastrointestinal, renal (kidney), muscular, and central nervous system.
It is most likely to occur in those over 60 but younger adults can develop the disorder.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Cimetidine, Pamidronate
The production of excessive amounts of parathyroid hormone (PTH) by the parathyroid gland produces hyperparathyroidism. The parathyroid glands help control bone growth because PTH regulates calcium and phosphorus balance in the body. When this occurs in response to low blood calcium caused by another disorder, it is called secondary hyperparathyroidism. The most common causes are: disorders of vitamin D (such as osteomalacia and vitamin D deficiency or malabsorption); children or the elderly with little sun exposure; those with disorders of phosphate metabolism (due to malnutrition, malabsorption, kidney disease, cancer); calcium deficiency.
Commonly Prescribed (On-Label) Drugs: Cinacalcet, Paricalcitol
Off-Label Prescription Drug Breakthrough Option: Pamidronate
Thyroid crisis, also known as thyroid storm or thyrotoxic crisis, is a medical emergency. It usually occurs in patients with poorly controlled or unrecognized hyperthyroidism. It may be precipitated by some other illness, such as an infection, surgery, uncontrolled diabetes, trauma (such as an automobile accident), or eclampsia or labor in a pregnant woman. Thyroid storm is rare, characterized by hypertension, hyperthermia, and abnormalities in multiple organs of the body.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Methimazole, Propranolol
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