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Secondary Hyperparathyroidism

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Secondary hyperparathyroidism is caused by a disease outside the parathyroid glands that causes them to grow and make too much parathyroid hormone (PTH). Vitamin D deficiency and kidney failure are the most common causes of secondary hyperparathyroidism. 

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

The goal of treatment for secondary hyperparathyroidism is fixing the vitamin D deficiency or kidney failure. Treatment for vitamin D deficiency involves raising the vitamin D levels to the normal range. For patients with secondary hyperparathyroidism from kidney failure, the only treatment is a kidney transplant. Until then, the best treatment is medical therapy.

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

  • Medical Therapy 

    Medical therapy options may include phosphate binders and vitamin D supplements (like calcitriol and calcimimetics), which lower the PTH levels by about 50 percent on average.

  • Surgery

    Because medical therapy doesn't work for up to 25 percent of patients, surgery is sometimes necessary to treat problems such as weakened bones, severe itching, high PTH levels and high calcium and phosphorus levels that can't be lowered with dialysis.

  • Four-Gland Excision Auto-Transplantation

    Parathyroid auto-transplantation involves removing all four parathyroid glands and taking part of one gland and placing it into your forearm muscle. This offers easy access in the future if it becomes overactive. It takes time for the transplanted gland to develop a blood supply and start producing PTH, so you'll need to take calcium and vitamin D supplements, and occasionally intravenous calcium, until the gland functions normally.

  • PTH-Guided Parathyroidectomy 

    In this surgery, the surgeon removes enough parathyroid tissue to bring the PTH levels to between 200 and 300.

  • Subtotal Parathyroidectomy 

    This surgery involves removing part of the parathyroid glands, leaving some functioning tissue.


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) 

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

  • 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
  • CompCare (Comprehensive Behavioral Care)
  • 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 Vista Medicare HMO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • 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
  • Global Health Claims Services
  • 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 HUMx
  • 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
  • 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