When most people think about hormones, they think of the thyroid, insulin, or testosterone. But there’s another small but powerful set of glands that play a critical role in your health: the parathyroid glands.

These four tiny glands, located behind the thyroid, regulate calcium balance in the body—a mineral essential not only for strong bones, but for healthy nerve function, muscle contractions, and even heart rhythm. When parathyroid function is disrupted, it can lead to calcium-related disorders, bone loss, kidney stones, and other serious issues.

As a board-certified endocrinologist with nearly 25 years of experience, I specialize in evaluating and managing disorders of the parathyroid glands, osteoporosis, and abnormal calcium metabolism. My practice offers comprehensive diagnostic testing and personalized care plans, including options through both traditional endocrinology and functional medicine pathways.

What Are the Parathyroid Glands and What Do They Do?

The parathyroid glands secrete a hormone called parathyroid hormone (PTH), which helps maintain stable calcium levels in the blood. When calcium levels drop too low, PTH is released to:

• Pull calcium from the bones into the bloodstream
• Increase calcium absorption from food via the intestines (with the help of vitamin D)
• Reduce calcium excretion through the kidneys

This system is tightly regulated, but sometimes it becomes unbalanced, and that’s where parathyroid disease begins.

Primary vs. Secondary Hyperparathyroidism

There are two main types of overactive parathyroid function:

Primary Hyperparathyroidism

In primary hyperparathyroidism, one or more of the parathyroid glands become overactive and secrete too much PTH, even when calcium levels are already normal or high. This leads to elevated blood calcium (hypercalcemia) and ongoing calcium loss from bones, increasing the risk of:

• Osteoporosis and fractures
• Kidney stones
• Fatigue and brain fog
• Abdominal pain or digestive issues
• Depression or irritability

Most cases are caused by a benign tumor (adenoma) in one of the glands. Diagnosis is made through a combination of blood tests (calcium, PTH, vitamin D) and sometimes imaging studies.

Secondary Hyperparathyroidism

Secondary hyperparathyroidism occurs when the parathyroid glands are reacting appropriately, but to a chronic imbalance. Most often, it happens in the setting of:

• Vitamin D deficiency
• Chronic kidney disease
• Calcium malabsorption or low dietary calcium

In this case, the glands are trying to compensate for low calcium or low vitamin D by producing more PTH. Although this may initially help stabilize calcium, long-term overproduction of PTH can lead to bone weakening and worsening health outcomes.

Understanding whether a patient has primary or secondary hyperparathyroidism is crucial, as the treatment approach differs significantly.

Osteoporosis and Calcium Disorders

Many patients with parathyroid issues also struggle with bone loss and osteoporosis, as PTH directly affects bone remodeling. But osteoporosis can also result from:

• Postmenopausal estrogen decline
• Testosterone deficiency
• Chronic steroid use
• Nutritional deficiencies
• Sedentary lifestyle
• Other hormone imbalances

I evaluate and treat osteoporosis using a combination of:

• Bone mineral density testing (DEXA scans)
• Comprehensive lab testing, including vitamin D, calcium, PTH, and markers of bone turnover
• Lifestyle and nutritional assessment
• Pharmacologic therapies, when appropriate
• Functional strategies to support bone health naturally

In patients with abnormal calcium levels, fatigue, bone pain, or kidney stones, I also assess for rare calcium-related disorders such as:

• Hypoparathyroidism (too little PTH)
• Familial hypocalciuric hypercalcemia (FHH)
• Calcium-sensing receptor abnormalities
• Vitamin D excess or resistance

How I Approach These Conditions

As a specialist in both traditional endocrinology and functional medicine, I offer two levels of care depending on your needs and preferences.

In my traditional endocrinology practice, I perform a full workup using blood tests, urine calcium assessments, imaging when indicated, and treatment plans based on current medical guidelines. I routinely coordinate care with surgeons when parathyroid surgery is needed, and I continue long-term follow-up to monitor bone density and lab markers.

For patients seeking a more holistic and in-depth approach, my functional endocrinology model allows for:

• Extended appointment times (90 minutes for initial visits; 30 minutes for follow-ups)
• Exploration of root causes, including nutrient absorption, inflammation, diet, and lifestyle
• Tailored recommendations for supplements, stress reduction, gut health, and movement
• A collaborative, individualized care plan that supports both conventional and natural interventions

This functional medicine model is offered on a fee-for-service basis, while my traditional endocrinology services remain available through standard referrals.

Who Should Seek Evaluation?

You may benefit from evaluation if you have:

• Elevated calcium or PTH levels on labs
• Low bone density or a history of fractures
• Recurrent kidney stones
• Fatigue, bone pain, or cognitive fog
• A history of vitamin D deficiency or chronic GI malabsorption
• Concerns about calcium supplements or long-term osteoporosis medication use

Many parathyroid and calcium disorders are underdiagnosed because symptoms can be vague, or blood work is only mildly abnormal. But early diagnosis and treatment can prevent long-term complications.

A Personalized, Expert Approach to Calcium and Bone Health

With nearly a quarter century of experience in endocrine disorders, I bring both clinical expertise and an individualized approach to managing parathyroid disease, osteoporosis, and calcium-related issues. Whether you’re seeking a second opinion, guidance on bone strength, or a deeper dive into unexplained fatigue or mineral imbalances, I would be honored to help.

To schedule an appointment, please call 203-760-5544. I look forward to supporting your journey toward better bone and metabolic health.