Butterfly Thyroid Cancer Trust: The Parathyroid glands and Calcium

Nobody really knows why the parathyroid glands should be placed so close to the thyroid. Perhaps to challenge the dexterity of thyroid surgeons.

Four parathyroids about the size of a pea each, embrace the thyroid. Their small size belies their importance, as many a thyroid patient will testify when the tingles and the cramps set in the day after the thyroid operation.

Luckily, parathyroids are a bit like footballers, they collapse after a gentle push by the opposition, but can recover miraculously with some encouragement.

So, what do the parathyroids do? Their purpose in life is to keep the calcium level in the blood normal.

When they give up, calcium drops and the typical symptoms appear: cramps and tingling, usually in the fingertips, toes and around the lips.

To treat it, we give calcium tablets and a form of vitamin D (alfacalcidol), which control the symptoms very effectively. That is all fine, but this treatment needs regular monitoring, as occasionally the blood calcium level will go too high and that can cause problems to kidneys.

Also if you are like me and hate taking pills you may find it a burden on your daily life, especially when they taste like wombat droppings.

So much happens in the first 12 months after the diagnosis of thyroid cancer, that perhaps it s not a surprise that many thyroid patients carry on taking the calcium pills for ever after without questioning the need to do so.

And questioning the need to carry on taking the pills is one of Sister Margaret Morris’s little hobbies. Margaret is an Endocrine Specialist nurse and member of our team at the Joint Thyroid Cancer Clinic.

In the past 18 months Margaret has taken several of our patients under her wing and with gentle determination has managed to get them off calcium and alfacalcidol altogether or at least reduce the dose substantially. This has not always been easy.

Even small reductions in the dose of the pills can bring back the tingling and the cramps. However perseverance usually will reward you with the freedom of not having to take so many pills.

The sense of achievement and liberation, can be incredible and will bring sparkle in your life (I am sure the founder of the Butterfly Thyroid Cancer Trust will agree to that!).

So get that collapsed Chelsea striker inside you off his backside and back on the pitch. If you are on calcium and / or alfacalcidol since your thyroid operation and you have tried to come off them, you may not have to “keep taking the pills” for ever.

But don’t do it on your own. It needs to be done slowly and with medical and nursing supervision.

Petros Perros
Consultant Endocrinologist
Joint Thyroid Cancer Clinic
Northern Centre for Cancer Care
Newcastle upon Tyne

Futher information about hypoparathyroidism can be obtained by visiting HPTH UK