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Primary Hyperparathyroidism 

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Primary Hyperparathyroidism 

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Primary hyperparathyroidism (PHP) is a condition that occurs when one or more of your parathyroid glands make too much parathyroid hormone (PTH). A high PTH level can lead to kidney stones or weakened bones, and may also contribute to heart disease and high blood pressure. In most instances, PHP is caused by a single hyperactive gland, but it can be caused by two or more hyperactive glands. 

Doctors diagnose parathyroid disease and parathyroid cancer by measuring hormone levels, imaging and, tumor biopsy by a pathologist (our cellular experts). Our main goal is to get a correct diagnosis of your condition — often at the genetic level so we can identify the best treatments.

Why Choose Us?

Only center in South Florida with a specialty endocrine testing center. Our specialized testing centers improves diagnosis accuracy, leading to more precise treatments and better results. Located at the University of Miami Miller School of Medicine, the center is staffed by specialized nurses and technical assistants who perform complex hormone tests.

Advanced radiation oncology tools. We are one of only five medical centers in the country with ViewRay™ — MRI-guided radiation therapy. Our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). These tools lead to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.


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Treatments

  • Surgery 

    A surgeon will remove only those glands that are enlarged or have a tumor (adenoma). The parathyroid glands are very close to your voice box, airway, and vocal cord nerves. Sylvester head and neck surgical oncologists have expertise in voice and vocal nerve preservation in people with parathyroid.

  • Focused Parathyroidectomy 

    This technique allows your surgeon to test which parathyroid gland is over-secreting parathyroid hormone and remove only that gland through a tiny incision. The procedure, called the Miami Criterion, was developed by a Sylvester Comprehensive Cancer Center surgeon, and it’s used worldwide.

  • Bilateral Neck Exploration 

    This technique allows your surgeon to see both sides of your neck and all four parathyroid glands. It helps determine which parathyroid gland (or glands) need to be removed, based on their size, color and texture.

  • Medical Therapy for Primary Hyperparathyroidism 

    Medical therapies, which may be used as an alternative to surgery, focus on treating the symptoms of the disease rather than curing it. Types of medical therapies include hormone therapies and medicines that lower blood calcium and prevent calcium loss from bones. Another alternative to surgery may be frequent testing to check your parathyroid hormone and calcium levels.

  • Calcium Regulation Treatments 

    Calcimimetic medicines, such as cinacalcet, lower the amount of parathyroid hormone your body makes — they don’t cure the disease. Cinacalcet is FDA approved to treat hyperparathyroidism caused by chronic kidney disease or parathyroid cancer. It may also be prescribed if surgery doesn’t cure the condition or you’re not a good candidate for surgery.

  • Hormone Replacement 

    For women who've gone through menopause and have signs of osteoporosis, hormone replacement therapy may help bones retain calcium.

  • Osteoporosis Medicines 

    Bisphosphonates are medicines that prevent calcium loss from bones and may lessen osteoporosis caused by hyperparathyroidism.

Tests

  • Ultrasound Exam of the Neck

    Ultrasound uses high-energy sound waves, which bounce off internal tissues or organs to form a picture (sonogram).

  • Sestamibi Scan 

    This is a type of radionuclide scan used to find an overactive parathyroid gland. A very small amount of a radioactive substance (technetium 99) is injected into your vein, and it travels through your bloodstream to the parathyroid glands. The radioactive substance will collect in an overactive gland and show up brightly on a special camera that detects radioactivity.

  • Single Photon Emission Computed Tomography (SPECT) Scan 

    This procedure creates a 3-D picture using a special camera linked to a computer. You receive an injection of a small amount of a radioactive substance. As the substance travels through your bloodstream, the camera rotates around your neck and takes pictures. Blood flow and metabolism are higher in areas affected by cancer, which show up brighter in the pictures.

  • High-Resolution CT Scan (4-D CT Scan) 

    This test looks for abnormal parathyroid glands. It has a 95 percent accuracy rate for identifying abnormal parathyroid glands — far superior to a standard CT scan. You receive a contrast dye as an injection, which travels through your bloodstream and into your parathyroid glands. The health of your glands is determined by their size and how quickly the dye washes in and out of your glands.

  • Magnetic Resonance Imaging (MRI)

    In cases where ultrasound, sestamibi, and high-resolution CT scans are negative or in re-operative parathyroid surgery, MRI may occasionally be used.

  • Parathyroid Fine-Needle Biopsy 

    This procedure takes a sample of a nodule that may be a sign of an abnormal parathyroid gland. It also measures your parathyroid hormone levels. It's done using a small needle guided by ultrasound imaging. 

  • Miami Criterion 

    If imaging doesn’t show which parathyroid gland is involved, your doctor may use this surgical technique to narrow it down. The Miami Criterion, which was pioneered at UHealth, allows surgeons to test which parathyroid gland is over-secreting parathyroid hormone and remove only that gland (or glands) through a tiny incision.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • Doctor's Healthcare Plan
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Community Care (FCC)
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care