If you are hesitating about moving forward with minimally invasive surgery then please read a bit further.
If you are not able to have surgery, then, at a minimum you should be followed closely by an experienced endocrinologist. An endocrinologist is a physician who specializes in the medical treatment of hormonal diseases. But, be cautious because the majority of people would be far better off with removal of the abnormal parathyroid.
A recent 2005 position paper by The American Association of Clinical Endocrinologists advises:
“...we believe that operative management should be considered and recommended for all asymptomatic patients with primary hyperparathyroidism who have a reasonable life expectancy and suitable operative and anesthesia risk factors.”
In short, experts familiar with following this disease now strongly advocate surgery rather than a “watchful waiting approach” in most situations. It is rare that someone should just “live with the problem” or “keep an eye on it”.
One reason for this recommendation is that many mild symptoms (apathy, mood swings, sleep disorders, irritability, fatigue, lack of mental sharpness, and depression) decrease or resolve after parathyroid surgery. This improvement happens even in people with very mild blood calcium elevations.
If one opts for a “watchful approach” rather than minimally invasive surgery, then unfortunately symptoms will persist. Although not life-threatening they may affect overall quality of life for many. Of course the main reason to consider surgery is to avoid the very serious symptoms and consequences of parathyroid disease.
Progressive silent bone weakening can lead to fractures. Medication is of very little use generally. Successful minimally invasive radioguided parathyroid surgery reverses accelerated bone mineral loss as well as the risk of bad fractures. Untreated high blood calcium and parathyroid disease can also increase the risk of cardiovascular disease and kidney stones. Research shows that this in turn puts people with parathyroid disease at risk overall for premature death. After successful parathyroid surgery, this risk of premature death is no longer seen. While there are very appropriate instances where surgery is not recommended these are very rare.
Generally the best way to deal with parathyroid disease is minimally invasive radioguided parathyroid removal.