A parathyroidectomy is the surgical removal of one or more parathyroid glands, tiny glands in the neck that most Australians have never heard of until a doctor mentions them. If you or someone you love has been referred for this operation, it is completely normal to have questions about why it is needed and what recovery involves. This article walks through parathyroidectomy in plain, everyday language, with no assumed medical background.
This information is general only, not personal medical advice, so always speak with your GP or surgeon about your own situation. And if you are ever having a medical emergency, call 000 or go to your nearest emergency department straight away rather than waiting for a routine appointment.
What Do the Parathyroid Glands Do, and How Are They Different From the Thyroid?
Despite the similar name, the parathyroid glands are not the same as the thyroid. Most people have four parathyroid glands, each about the size of a grain of rice, sitting behind or near the thyroid gland at the front of the neck.
Their job is to control the level of calcium in your blood. They do this by releasing a hormone called parathyroid hormone, or PTH, which tells your bones, kidneys and gut how much calcium to release or absorb. Calcium is essential for healthy bones, muscles and nerves.
The thyroid, by contrast, mostly controls metabolism. You can read more via healthdirect’s overview of the parathyroid glands.
Conditions That Can Lead to a Parathyroidectomy
The most common reason for a parathyroidectomy is a condition called hyperparathyroidism, where one or more parathyroid glands become overactive and produce too much PTH. This causes calcium levels in the blood to rise higher than normal, a condition doctors call hypercalcaemia.
In most cases, hyperparathyroidism is caused by a small, non-cancerous growth on one gland. It is rarely linked to cancer. Some people have no symptoms at all, and the condition is picked up during a routine blood test ordered by their GP.
Other people notice symptoms that prompt their GP to investigate further and consider a surgical referral. These can include:
- Ongoing tiredness or low energy that does not improve with rest
- Bone or joint pain, or thinning bones (osteoporosis)
- Kidney stones or changes in kidney function
- Digestive issues such as nausea or constipation
- Difficulty concentrating, or low mood
- Excessive thirst or needing to urinate more often
If your GP suspects hyperparathyroidism, they may organise blood tests and refer you to an endocrinologist or specialist surgeon for further assessment before parathyroidectomy is considered.
How Parathyroidectomy Is Performed
Parathyroidectomy is usually carried out as day surgery or with a short overnight hospital stay, under general anaesthesia, meaning you are fully asleep during the operation. You can read more about anaesthesia and what to expect from the Australian and New Zealand College of Anaesthetists.
Before the operation, imaging scans often help the surgeon locate the overactive gland. During surgery, the surgeon makes a small incision in the neck to remove the affected gland, while trying to preserve the healthy ones.
In some cases, where scans clearly identify a single overactive gland, a more minimally invasive approach with a smaller incision may be possible. Your surgeon will explain which approach is most suitable for you as part of the informed consent process.
Recovery Timeline After Parathyroidectomy
Most people go home the same day or the following day after parathyroidectomy. You can expect some soreness or tightness in your neck, and your voice may sound a little hoarse for a short time while it settles.
Blood tests to check your calcium levels are an important part of post-operative recovery, since calcium can drop temporarily after surgery. Your surgical team will advise if you need calcium or vitamin D supplements.
Many people return to light daily activities within a week or two, though your surgeon will give guidance based on your individual recovery. Follow-up appointments with your GP, which may attract a Medicare rebate, help track your progress after parathyroidectomy.
Risks and Possible Complications
As with any operation, parathyroidectomy carries some risks. These can include bleeding, infection, or a reaction to the anaesthesia, and your surgeon and anaesthetist will discuss these with you beforehand as part of informed consent.
One specific risk relates to a small nerve near the parathyroid glands that helps control the voice box. Temporary hoarseness is relatively common, and permanent changes to the voice are uncommon but possible.
Low calcium levels after surgery, sometimes called hypocalcaemia, can also occur and are usually managed with supplements for a short period. Your surgical team will monitor you closely and explain any warning signs to watch for.
Life After Parathyroidectomy
For many people, calcium levels return to normal fairly quickly after parathyroidectomy, and symptoms such as fatigue or bone pain gradually improve. Your GP will usually arrange follow-up blood tests to confirm things have settled.
It is worth choosing a specialist surgeon accredited by the Royal Australasian College of Surgeons, since accreditation reflects rigorous training standards.
Some people benefit from ongoing support from allied health professionals, such as a dietitian, particularly if bone health or diet needs attention going forward.
Medicare, Private Health Insurance and Choosing a Surgeon
In Australia, seeing a specialist surgeon for a possible parathyroidectomy generally starts with a referral from your GP. This referral is needed to access Medicare rebates for specialist consultations.
If you are treated in the public system, you may be placed on a public hospital elective surgery waitlist, with timing depending on clinical urgency. Going private, with private health insurance, may offer more flexibility, though it is worth checking any applicable waiting periods on your policy.
Before your surgery, a pre-admission clinic appointment and a process called informed financial consent will help you understand any out-of-pocket costs. It is worth asking your surgeon’s rooms for a clear breakdown in advance.
Conclusion
Parathyroidectomy is a well-established procedure for treating overactive parathyroid glands, most often caused by hyperparathyroidism. While every person’s situation is different, the surgery generally involves a short hospital stay, a period of monitoring calcium levels, and a gradual return to normal activities.
If you have been referred for parathyroidectomy, or you think your symptoms might be worth discussing, start with a conversation with your GP about a specialist referral. You can also use surgery.com.au to compare information on specialist surgeons across major Australian cities as you plan your next steps.
FAQs
1. What is a parathyroidectomy?
A parathyroidectomy is a surgical procedure to remove one or more of the parathyroid glands in the neck, usually because one has become overactive and is producing too much parathyroid hormone. This is most commonly due to a condition called hyperparathyroidism.
2. How long does recovery from parathyroidectomy usually take?
Many people return to light daily activities within one to two weeks, though full recovery time varies between individuals. Your surgeon will give you guidance tailored to your own procedure and health.
3. Is parathyroidectomy considered major surgery?
Parathyroidectomy is generally considered a relatively low-risk procedure and is often done as day surgery or with a short hospital stay. Like any operation involving general anaesthesia, it still carries some risks, which your surgical team will discuss with you.
4. Will I need calcium supplements after parathyroidectomy?
Some people need short-term calcium or vitamin D supplements while their levels stabilise after surgery. Your surgical team will monitor your blood tests and let you know if supplements are needed.
5. Does Medicare cover parathyroidectomy in Australia?
Medicare and private health insurance can both contribute towards the cost of parathyroidectomy, depending on your circumstances and whether you are treated in the public or private system. Your surgeon’s rooms can provide informed financial consent so you understand any out-of-pocket costs beforehand.