What is parathyroidectomy?

Parathyroidectomy is an operation to remove some or all of the parathyroid glands. The parathyroid glands are four small glands in your neck, which help to control the level of calcium in your blood by producing parathyroid hormone (PTH).

Overactive parathyroid glands (hyperparathyroidism) make too much PTH and can lead to high calcium levels, in your blood. This can cause bone problems, kidney stones and other symptoms.

In people with chronic kidney disease (CKD), long-term changes in calcium, phosphate and vitamin D can overstimulate the parathyroid glands (secondary hyperparathyroidism), and over time they may become enlarged and overactive (tertiary hyperparathyroidism).

What does parathyroidectomy involve?

Parathyroidectomy is usually done in hospital under a general anaesthetic, so you’re fully asleep during the operation.

The surgeon makes a small cut in a natural skin crease in the lower front of your neck to reach the parathyroid glands. They examine the glands and remove those that are enlarged or overactive. This may mean that just one gland is removed but sometimes more than one is taken out, and occasionally all four.

The wound is usually closed with dissolvable stitches under the skin and covered with a small dressing. The operation typically takes about one to three hours, depending on how many glands need to be removed.

Sometimes, scans you have before the operation identify one gland that needs to be removed, which may mean you can have a minimally invasive parathyroidectomy, where the gland is taken out through one small cut on your neck.

Who is parathyroidectomy for?

High PTH and calcium levels can lead to problems such as bone fractures, depression, kidney stones and muscle weakness.

Parathyroidectomy may be recommended if your blood tests show very high PTH and calcium levels over a long period, despite other treatment.

If you’ve been on dialysis for a long time, you may eventually need parathyroidectomy.

Is it safe? Are there any alternatives?

Parathyroidectomy is considered when other treatments are not enough to manage calcium levels in your blood, or when you have severe, long-standing hyperparathyroidism.

Parathyroidectomy is a routine operation and most people recover well.

All surgery under general anaesthetic carries some small risks, including bleeding, infection and complications of anaesthesia. Your healthcare team will discuss this with you.

• The nerves that control your voice are very near the parathyroid glands. The surgeon will try to avoid damaging them but if these nerves get bruised, there’s a risk you may have some temporary voice changes. Your voice should go back to normal within a few days or weeks, and you’ll be offered speech and language therapy if it doesn’t.
• You may develop low levels of calcium after the operation so you might need to take vitamin D or calcium supplements for a short period of time, to protect your bone health.
• Sometimes, low calcium is permanent and you’ll need lifelong supplementation. This is more likely if you have had all four glands removed.

Where will the parathyroidectomy take place?

The operation takes place in a hospital operating theatre. You will usually stay on an ear, nose and throat (ENT), endocrine surgery or kidney (renal) ward before and after the operation.

Parathyroidectomy is carried out by a surgeon with experience in thyroid and parathyroid surgery.

What happens before the procedure? 

• The hospital team will assess you before the procedure, checking your general health and medicines, and carrying out blood tests.
• They will give you instructions on eating and drinking before the procedure. You may be encouraged to drink lots of water in the run-up to your operation to help prevent a build-up of calcium deposits in your body. Usually, you’ll usually be asked not to eat for several hours before your operation, although you’ll be able to drink water until up to two hours before. The team will also tell you if you need to stop any of your medications before surgery.
• If you’re on dialysis, your operation will be planned around your dialysis schedule. Your hospital team will advise you about any specific preparation.

What happens during the parathyroidectomy?

• On the day of surgery, you will come to the ward, change into a hospital gown and meet your surgeon, who will answer any questions.
• In the operating theatre, you receive a general anaesthetic so you fall asleep.
• Once you’re asleep, the surgeon may give you a local anaesthetic to numb the nerves controlling pain in your neck, which should help you to feel more comfortable after surgery.
• The surgeon makes a small incision in your lower neck, identifies the parathyroid glands and removes any that are overactive.
• The operation usually takes between one to three hours, depending on how many glands need to be removed.
• You are then taken to the recovery area while you wake up, with close monitoring of your breathing, blood pressure and comfort.

What happens immediately after the procedure?

Back on the ward, you’ll be given pain relief if you need it, and nurses will monitor signs such as your temperature, pulse and blood pressure. Usually, you’ll stay in hospital overnight.

Many people notice a mildly sore throat, a stiff neck or a slightly croaky voice at first, which usually improve over a few days.

What should I expect when I get home?

It’s normal to feel tired and have some neck discomfort or tightness for a week or two. Simple painkillers often help.

You’ll be given advice on looking after the wound and when to have any dressings removed. The hospital team will explain that you should get urgent medical help if the wound shows any signs of infection, or if you have signs of very low calcium levels, such as tingling around the mouth and muscle spasms.

How will I get the results?

Your blood calcium and PTH levels will be monitored in the days and weeks after surgery to see how well the operation has worked.

The removed glands are sent to the laboratory to be examined, and the results are usually discussed with you at a follow-up clinic. Your doctor may adjust your medications and supplements according to the results.

Is there anything else I need to know?

You should arrange time off work and help at home for the first week or so after surgery if needed.

If you have been taking a medication to help control the high levels of parathyroid hormone, you may not need to take it after your operation.

In rare cases, an abnormal parathyroid gland is not in your neck so would continue to produce high levels of PTH. If this is the case, you might need another operation to remove this gland.

Publication date: 02/2026

Review date: 02/2029