Parathyroid Q&A is a community of experts and patients dedicated to understanding and treating Parathyroid Disease.

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Questions and Answers

Intraoperative PTH

Some surgeons check PTH levels in the operating room just before and after removing a parathyroid gland. This technique is called intraoperative PTH.

Why don’t you use intraoperative PTH? Another surgeon I saw said that he uses intraoperative PTH (ioPTH) to confirm that the patient is cured. You said that you do not use ioPTH. Why is that?
I prefer to evaluate all four parathyroid glands rather than rely on intraoperative PTH. Here is why: intraoperative PTH is just not that accurate. Here is the thinking behind ioPTH: a surgeon can remove one parathyroid, often one seen on preoperative imaging, test the PTH level in the blood, then wait 5 to 10 minutes and test again, then wait 5 or 10 more minutes and test again. If the PTH dr...
Operation Operative technique Cure rate Intraoperative PTH
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Regarding surgery, many swear by intraoperative PTH while others say no. As a patient it would seem that having a confirmed appropriately lowered PTH while the patient is still in the OR would make more sense than waiting until they are in the recovery room. Can a surgeon really just look at a parathyroid gland and tell it’s abnormal even when it’s just at the beginning stages?
Looking at the parathyroids is currently the best way to evaluate the parathyroids - if you have enough experience with it. Intraoperative PTH does seem logical, but in practice does not work as well as expected. In my experience, viewing all four parathyroid glands is a more accurate and faster way to evaluate the parathyroid glands and ensure a cure. In my residency and endocrine surgery fell...
Intraoperative PTH
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