Your parathyroid is a set of 4 small glands located just behind your thyroid in your neck. Despite the similar name, they do a completely different job. These glands produce parathyroid hormone (PTH), which regulates how much calcium is in your blood.

Calcium does more than build strong bones and teeth. It also helps your muscles contract, your nerves send signals and your heart maintain a steady rhythm. PTH keeps all of that in balance by telling your bones, kidneys and intestines when to release or absorb calcium.

When your parathyroid glands aren't working properly, calcium levels can swing too high or too low — and that's when symptoms start to show up.

Hyperparathyroidism means your parathyroid glands are producing too much PTH, which raises calcium levels in your blood too high. It's the more common of the 2 conditions and is often caused by a benign tumor (adenoma) on one of the glands. 

Hypoparathyroidism is the opposite. Your glands don't produce enough PTH, so calcium levels drop too low. It's less common and is most often caused by damage to the parathyroid glands during neck surgery. It can also have autoimmune or genetic causes.

The good news: Both conditions are treatable. The right approach depends on the underlying cause, your symptoms and your overall health.

Hyperparathyroidism symptoms can be subtle at first. They’re sometimes mistaken for other conditions. Common signs include:

• Abdominal discomfort
• Bone or joint pain
• Constipation
• Depression, anxiety or trouble concentrating
• Fatigue or low energy
• High blood pressure
• Increased thirst and urination
• Kidney stones
• Muscle weakness
• Nausea or vomiting
• Reduced appetite

Some people with mild hyperparathyroidism don't notice symptoms at all. It's often caught through routine bloodwork showing elevated calcium levels.

Hypoparathyroidism causes low calcium levels, which can lead to a different set of symptoms. Common signs include:

• Brain fog or difficulty concentrating
• Depression or anxiety
• Dry skin and brittle nails
• Fatigue
• Hair loss
• Muscle cramps or spasms
• Painful menstrual periods
• Tingling or numbness in your lips, fingers or toes

If you're noticing any of these symptoms, especially tingling, cramping or persistent fatigue, it's worth talking to your doctor.

Your doctor will order a blood test to check your calcium levels and PTH levels, along with vitamin D and kidney function. If calcium is high or low and PTH levels don't match what they should be, that points toward a parathyroid issue.

From there, imaging helps locate the problem. An ultrasound can show the size and shape of your parathyroid glands. A sestamibi scan uses a small amount of radioactive material to light up overactive glands. CT scans or MRIs may also be used to get a more detailed picture.

Once you have a diagnosis, your care team will talk through what it means and what your options look like going forward.

In many cases, yes. Hyperparathyroidism caused by a single overactive gland can often be cured with a minimally invasive parathyroidectomy. That’s a surgery that removes the problem gland. Cure rates for this procedure are high. Most people go home the same day as the surgery.

Hypoparathyroidism is managed rather than cured. But with the right treatment, most people keep their levels stable and live with minimal disruption. Your care team will adjust your plan over time to make sure it's working for you.

Treatment depends on the type and severity of your condition. For hyperparathyroidism, options include: 

• Active monitoring if symptoms are mild and calcium is only slightly elevated
• Medication to manage calcium levels
• Surgery to remove the overactive gland

Minimally invasive parathyroidectomy is the most common surgical approach and offers shorter recovery times and smaller incisions.

For hypoparathyroidism, treatment focuses on restoring calcium balance through supplements, like calcium and vitamin D. Sometimes you need prescription medications that help regulate PTH levels. Lifestyle adjustments, like new eating and movement patterns, can also play a role.

In all cases, regular follow-up appointments and lab work make sure your treatment plan stays on track as your needs change.

Several factors can increase your chances of developing a parathyroid condition. Being female is one of the biggest. Women are about 3 times more likely than men to develop hyperparathyroidism, especially after menopause. Other risk factors include a family history of parathyroid disorders, low vitamin D levels, low calcium intake over time and previous radiation therapy to the neck area.

For hypoparathyroidism, the most common risk factor is having had thyroid or neck surgery. Parathyroid glands can sometimes be damaged during the procedure. In rare cases, autoimmune conditions or inherited genetic factors play a role.