{"id":3106,"date":"2026-07-30T15:04:25","date_gmt":"2026-07-30T18:04:25","guid":{"rendered":"https:\/\/naturalmedicalpost.com\/blog\/parathyroidectomy-underuse-underused-primary-hyperparathyroidism\/"},"modified":"2026-07-30T15:04:25","modified_gmt":"2026-07-30T18:04:25","slug":"parathyroidectomy-underuse-underused-primary-hyperparathyroidism","status":"publish","type":"post","link":"https:\/\/naturalmedicalpost.com\/blog\/parathyroidectomy-underuse-underused-primary-hyperparathyroidism\/","title":{"rendered":"Parathyroidectomy Underused for Primary Hyperparathyroidism"},"content":{"rendered":"<aside class=\"medical-disclaimer\" style=\"border-left:4px solid #d97706;background:#fef3c7;padding:12px 16px;margin:16px 0;font-size:0.92em;color:#78350f;border-radius:4px\"><strong>&#9888; <\/strong><span>This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making health decisions.<\/span><\/aside>\n<p>A large national cohort study has uncovered a striking gap in the treatment of primary hyperparathyroidism (PHPT): despite clear guideline recommendations, parathyroidectomy\u2014the surgical removal of overactive parathyroid glands\u2014is vastly underused in patients with end-organ damage. Al\u00e9m disso, published in JAMA Surgery, the research by Seib et al. analyzed data from over 43,000 adults and found that only 19.9% of those with end-organ damage underwent surgery. Portanto, the findings raise important questions about adherence to clinical guidelines and optimal management of this common endocrine disorder.<\/p>\n<p>Primary hyperparathyroidism occurs when one or more parathyroid glands become overactive, leading to excessive calcium in the blood. Consequentemente, over time, this can cause complications such as brittle bones, kidney stones, and impaired kidney function\u2014collectively termed end-organ damage. Contudo, current guidelines recommend parathyroidectomy for patients who exhibit such damage, yet the real-world application appears far from universal.<\/p>\n<h2>Key Findings from a National Cohort<\/h2>\n<p>The study examined 43,481 patients with biochemically confirmed primary hyperparathyroidism. Al\u00e9m disso, at diagnosis, 51.3% already showed evidence of end-organ damage, which includes complications like kidney stones, osteoporosis, or reduced kidney function. Em seguida, among those with damage, the median time from diagnosis to surgery was 208 days, yet only 19.9% ultimately had parathyroidectomy during follow-up. Por outro lado, for patients without end-organ damage initially, the situation was also concerning: 32% developed new signs of organ damage over time, and among these, only 19.9% underwent surgery, with a median delay of 154 days after damage detection. Portanto, these numbers highlight a significant underutilization of a potentially curative intervention. No entanto, while the statistics reveal low surgery rates, the baseline characteristics of the patients offer additional insight.<\/p>\n<aside aria-label=\"Low energy even after sleeping well?\" class=\"nbn-cta nbn-cta-hormones-energy\" role=\"complementary\">\n<h3 class=\"nbn-cta__headline\">Low energy even after sleeping well?<\/h3>\n<p class=\"nbn-cta__context\">Hormonal balance and real stamina with support.<\/p>\n<p class=\"nbn-cta__action\"><a class=\"nbn-cta__button\" href=\"https:\/\/backfunnel.com.br\/sfunnel\/16716\/?utm_source=naturalmedical&amp;utm_medium=cta&amp;utm_campaign=hormones-energy&amp;utm_content=mid\" rel=\"noopener noreferrer nofollow sponsored\" target=\"_blank\">Chat on WhatsApp<\/a><\/p>\n<\/aside>\n<h2>Patient Profiles and Risk Factors<\/h2>\n<p>The cohort had a mean serum calcium level of 10.5 mg\/dL and a mean parathyroid hormone (PTH) level of 115.3 pg\/mL at diagnosis. Ademais, patients with end-organ damage tended to be older and had higher PTH levels, while serum calcium levels did not differ significantly between those with and without damage. Al\u00e9m disso, interestingly, severe hypercalcemia\u2014defined as levels above 11.2 mg\/dL\u2014was associated with an increased risk of developing end-organ damage within the first year after diagnosis, though that risk diminished over time. Consequentemente, this suggests that early aggressive monitoring may be warranted for patients with markedly elevated calcium. Contudo, however, the decision to recommend surgery is not always straightforward, as the evidence on its benefits is mixed.<\/p>\n<h2>Weighing the Evidence: Benefits and Controversies<\/h2>\n<p>Guidelines endorse parathyroidectomy for PHPT patients with end-organ damage, but real-world data complicate the picture. Por exemplo, one retrospective cohort study found that surgery was linked to a 24% to 63% reduction in fracture risk over a 10-year period, depending on the fracture type\u2014a compelling argument for intervention. No entanto, on the other hand, an observational study involving veterans detected no long-term kidney function benefit from parathyroidectomy, raising doubts about its renal protective effects. Portanto, the divergent findings underscore the need for individualized decision-making and further research.<\/p>\n<h2>Understanding the Study&#8217;s Limitations<\/h2>\n<p>Beyond the clinical outcomes, the study&#8217;s methodology also warrants careful interpretation. Em resumo, the authors acknowledged that the study was limited by its observational design, which cannot establish causality. Ademais, additionally, including chronic kidney disease (CKD) as an outcome may have overestimated the kidney-related morbidity attributable to PHPT, since CKD can arise from many other causes. Dessa forma, these caveats mean that while the low surgery rates are clear, the reasons behind them\u2014and the exact impact on patient health\u2014require more rigorous investigation.<\/p>\n<h2>Closing the Treatment Gap<\/h2>\n<p>Despite these limitations, the findings emphasize the need to bridge the gap between guidelines and practice. Em resumo, the underuse of parathyroidectomy in PHPT with end-organ damage is a multifactorial problem. Por exemplo, it may stem from patient reluctance, lack of access to specialized surgeons, or insufficient awareness among clinicians. Consequentemente, for individuals diagnosed with primary hyperparathyroidism, especially those with signs of organ damage, a discussion with a healthcare professional about the potential benefits and risks of surgery is crucial. Sobretudo, while parathyroidectomy is not without risks, it remains the only definitive treatment for the disease. Assim sendo, as the evidence evolves, clearer protocols and better patient education could help ensure that those who stand to benefit most actually receive surgery. Portanto, the study serves as a call to action for both the medical community and patients to prioritize guideline-adherent management.<\/p>\n<p>In the end, the research underscores that while surgery can offer substantial benefits\u2014such as reduced fracture risk\u2014it is not a one-size-fits-all solution. Al\u00e9m disso, the observational nature of the study and the mixed findings on kidney outcomes highlight the necessity for personalized care. Portanto, patients and physicians should weigh the available evidence, consider individual risk factors, and make informed decisions together.<\/p>\n<aside aria-label=\"Low energy even after sleeping well?\" class=\"nbn-cta nbn-cta-hormones-energy\" role=\"complementary\">\n<h3 class=\"nbn-cta__headline\">Low energy even after sleeping well?<\/h3>\n<p class=\"nbn-cta__context\">Hormonal balance and real stamina with support.<\/p>\n<p class=\"nbn-cta__action\"><a class=\"nbn-cta__button\" href=\"https:\/\/backfunnel.com.br\/sfunnel\/16716\/?utm_source=naturalmedical&amp;utm_medium=cta&amp;utm_campaign=hormones-energy&amp;utm_content=end\" rel=\"noopener noreferrer nofollow sponsored\" target=\"_blank\">Chat on WhatsApp<\/a><\/p>\n<\/aside>\n<section class=\"faq-section\">\n<h2>Frequently Asked Questions<\/h2>\n<h3>What percentage of patients with primary hyperparathyroidism and end-organ damage underwent parathyroidectomy in the national cohort study?<\/h3>\n<p>Only 19.9% underwent parathyroidectomy during follow-up, a median 208 days after diagnosis.<\/p>\n<h3>Among patients without end-organ damage at the time of primary hyperparathyroidism diagnosis, how many developed it later?<\/h3>\n<p>32% had newly documented evidence of end-organ damage during longitudinal follow-up.<\/p>\n<h3>What long-term fracture risk reduction has been associated with parathyroidectomy for primary hyperparathyroidism?<\/h3>\n<p>A retrospective cohort study tied parathyroidectomy to a 24%-63% reduction in fracture risk over 10 years, depending on fracture type.<\/p>\n<\/section>\n<section class=\"newsbot-related-posts\">\n<h2>Read Also<\/h2>\n<ul>\n<li><a href=\"https:\/\/naturalmedicalpost.com\/blog\/levothyroxine-recall-glp-1-updates\/\"><strong>Levothyroxine recall, GLP-1 updates, and PMOS prevalence reported<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/naturalmedicalpost.com\/blog\/hawaii-lng-terminal-democrats-reaction\/\"><strong>Hawaii LNG terminal: Democrats\u2019 reaction undocumented amid high oil use<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/naturalmedicalpost.com\/blog\/cheney-utility-tax-renewal-ballot\/\"><strong>Cheney utility tax renewal on ballot for street projects<\/strong><\/a><\/li>\n<\/ul>\n<\/section>\n<h2>Source<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.medpagetoday.com\/endocrinology\/thyroid\/122401\" rel=\"nofollow noopener\" target=\"_blank\">www.medpagetoday.com<\/a><\/li>\n<li><a href=\"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/10.1001\/jamasurg.2026.3051?guestAccessKey=3ebcc46f-c505-440a-834a-e7b1eeb25281&amp;utm_source=for_the_media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_term=072926\" rel=\"nofollow noopener\" target=\"_blank\">JAMA Surgery<\/a> (jamanetwork.com)<\/li>\n<li><a href=\"https:\/\/academic.oup.com\/jbmr\/article\/37\/11\/2293\/7512381\" rel=\"nofollow noopener\" target=\"_blank\">guideline recommendations<\/a> (academic.oup.com)<\/li>\n<li><a href=\"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/10.1001\/jamasurg.2026.3047?guestAccessKey=9c66e802-1499-4f93-b756-6d7edbe7696c&amp;utm_source=for_the_media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_term=072926\" rel=\"nofollow noopener\" target=\"_blank\">accompanying commentary<\/a> (jamanetwork.com)<\/li>\n<li><a href=\"https:\/\/www.acpjournals.org\/doi\/10.7326\/M15-1232\" rel=\"nofollow noopener\" target=\"_blank\">retrospective cohort study<\/a> (www.acpjournals.org)<\/li>\n<li><a href=\"https:\/\/disqus.com\/?ref_noscript\" rel=\"nofollow noopener\" target=\"_blank\">comments powered by Disqus.<\/a> (disqus.com)<\/li>\n<\/ul>\n<section class=\"author-box\" style=\"border:1px solid #e5e7eb;background:#f9fafb;padding:16px 20px;margin:24px 0;border-radius:6px;font-size:0.95em;color:#1f2937\">\n<h3 style=\"margin:0 0 8px 0;font-size:1.05em;color:#111827\">About the author<\/h3>\n<p style=\"margin:0 0 6px 0\"><strong>Natural Medical Post Editorial Team<\/strong> &mdash; <em>Health &amp; Wellness Research Team<\/em><\/p>\n<p style=\"margin:0\">Our editorial team reviews health and wellness topics based on peer-reviewed research and trusted medical sources.<\/p>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>A new study reveals that parathyroidectomy is significantly underused in patients with primary hyperparathyroidism and end-organ damage. Only 19.9% underwent surgery despite guideline recommendations, raising concerns about management practices.<\/p>\n","protected":false},"author":1,"featured_media":3108,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_newsbot_seo_title":"Parathyroidectomy Underused for Primary Hyperparathyroidism","_newsbot_seo_description":"A national cohort study finds parathyroidectomy is underused in primary hyperparathyroidism patients with end-organ damage, with only 19.9% undergoing surgery despite guidelines.","_newsbot_seo_canonical":"https:\/\/naturalmedicalpost.com\/blog\/parathyroidectomy-underuse-underused-primary-hyperparathyroidism","_newsbot_seo_og_image":"https:\/\/assets.medpagetoday.net\/media\/images\/122xxx\/122401.jpg","_newsbot_schema_json":"{\"@context\": \"https:\/\/schema.org\", \"@graph\": [{\"@context\": \"https:\/\/schema.org\", \"@type\": \"NewsArticle\", \"headline\": \"Study: Parathyroidectomy Underuse in Primary Hyperparathyroidism\", \"description\": \"A new study reveals that parathyroidectomy is significantly underused in patients with primary hyperparathyroidism and end-organ damage. 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