Definition

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 kidney failure or a vitamin D deficiency
  • Tertiary—also occurs in patients with long-standing kidney failure and dialysis
  • Thyroid and Parathyroid Glands: Posterior (Back) View

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    Causes

    Primary hyperparathyroidism may be caused by:

        
  • Noncancerous tumor in the parathyroid gland—most common cause
  • Familial hyperparathyroidism
  • Multiple endocrine neoplasia (MEN)
  • Parathyroid cancer—rare
  • 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 hormone
  • Enlargement of the parathyroid gland is the main risk factor for tertiary hyperparathyroidism.

    Risk Factors

    Hyperparathyroidism is more common in women, especially after menopause . It is also more common in people older than 50 years of age. Other factors that may increase your chance of developing hyperparathyroidism include:

        
  • Multiple endocrine neoplasia
  • Having specific genetic factors that increase your risk
  • Radiation therapy to the head or neck during childhood
  • Symptoms

    The level of calcium in the blood will determine the symptoms. Symptoms commonly seen with primary hyperparathyroidism include:

        
  • Constipation
  • Nausea
  • Vomiting
  • Abdominal pain
  • Headache
  • Loss of appetite
  • Thirst
  • Frequent and sometimes painful urination due to kidney stones
  • Fatigue
  • Muscle weakness
  • Joint pain
  • Memory loss
  • Heartburn
  • Back pain
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.

    Your bodily fluids may be tested. This can be done with:

        
  • Blood tests
  • Urine tests
  • Images may be taken of your bodily structures. This can be done with:

        
  • Ultrasound
  • 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
  • Abdominal x-ray
  • Treatment

    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
  • Hyperparthyroidism due to a vitamin D deficiency may be treated with medications
  • Treating underlying causes
  • Medication to manage possible side effects
  • Monitoring of Blood Calcium Levels

    Your doctor may 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.

    Prevention

    Adequate calcium and vitamin D intake may play a role in preventing hyperparathyroidism in women. Try to get recommended levels of calcium through dietary choices and supplements.