Hyperparathyroidism is when the body makes too much parathyroid hormone (PTH). The parathyroid glands make PTH which help to keep calcium levels in balance.
Hyperparathyroidism may be: Primary—a benign tumor of the parathyroid gland that makes too much PTH (most common form)
Secondary—occurs in patients with long-standing
Tertiary—also occurs in patients with very long-standing
kidney failure and dialysis
Thyroid and Parathyroid Glands: Posterior (Back) View
Copyright © Nucleus Medical Media, Inc.
Primary hyperparathyroidism may be caused by: Noncancerous tumor in the parathyroid gland (most common cause)Parathyroid cancer (very rare)Familial hyperparathyroidismMultiple endocrine neoplasia (MEN)
Secondary hyperparathyroidism may be caused by: Vitamin D deficiency (due to inadequate dietary intake, lack of sunlight exposure, or malabsorption condition like celiac disease)Kidney failure or other medical problems that make the body resistant to the action of the parathyroid hormoneEnlargement of the parathyroid glands—common cause
Enlargement of the parathyroid gland is the main risk factor for tertiary hyperparathyroidism.
Hyperparathyroidism is more common in women, especially after
Other factors that may increase your chance of developing hyperparathyroidism include:
Age: older than 50 yearsMultiple endocrine neoplasiaHaving specific genetic factors that increase your riskRadiation therapy
to head or neck during childhood
The level of calcium in the blood will determine the symptoms. Symptoms commonly seen with primary hyperparathyroidism include: ConstipationNauseaVomitingAbdominal painHeadacheLoss of appetiteThirstFrequent and sometimes painful urination due to kidney stonesLethargyFatigueMuscle weaknessJoint painMemory lossDepressionHeartburnBack pain
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
To measure calcium levels your doctor may ask for: Blood tests—to measure calcium, phosphorus, magnesium, alkaline phosphatase, vitamin D, and PTH, kidney and liver function testsUrine test—a 24-hour urine collection to measure calcium excretion and kidney function (very important test)
Images of the parathyroid gland may be taken with:
—a test that uses sound waves, not radiation, to detect a large parathyroid tumor (adenoma)
Technetium 99m sestamibi scan—a nuclear medicine test that uses safe nuclear molecules to make pictures of the parathyroid glands to help locate a single parathyroid adenoma in primary hyperparathyroidism
Other tests may be done to look for other problems hyperparathyroid may cause: Bone density test
—a test to measure bone loss and risk of fractures
—a test that uses radiation to take a picture of the structures inside the body; can show
caused by high calcium levels
Treatment will be based on the type of hyperparathyroidism. Options may include the following: If a growth is causing the problems, surgery may be done to remove the growth. This can often result in a growth.
Hyperaparthyroidism due to a vitamin D deficiency may be treated with:
—for treating secondary hyperparathyroidism due to vitamin D deficiency.
(the most active vitamin D metabolite)—helps to reduce PTH production in secondary hyperparathyroidism in chronic kidney failure
—helps to lower PTH blood levels for secondary and tertiary hyperparathyroidism in chronic kidney disease
or parathyroid cancer
Treating underlying causesMedication to manage possible side effects
Your doctor may simply choose to regularly check your blood calcium levels and monitor you for possible complications. This may include regular bone density tests every 1-2 years.
Adequate calcium intake may play a role in preventing hyperparathyroidism in women. Try to get recommended levels of calcium through dietary choices and supplements.
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: Paik J, Curhan G, Taylor E. Calcium intake and risk of primary hyperparathyroidism in women: prospective cohort study.
Last reviewed June 2013 by Kim Carmichael, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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