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OVERVIEW

What is hyperparathyroidism?

Hyperparathyroidism occurs in your parathyroid glands. These are the 4 pea-sized glands behind the thyroid gland at the front of your neck. The glands make a hormone called parathyroid hormone (PTH). The hormone manages the levels of calcium, vitamin D, and phosphorus in your body. PTH helps you absorb calcium from your food and keeps you from losing too much calcium through your urine.

People who have hyperparathyroidism produce too much PTH. This causes them to have too much calcium in their bloodstream and not enough in their bones. In general, hyperparathyroidism affects the health of your bones and kidneys but has the potential to affect your overall health.

SYMPTOMS

What are the symptoms of hyperparathyroidism?

Hyperparathyroidism does not always produce early symptoms. Some people may have one or more of the following symptoms:

• Feeling weak or tired most of the time
• General aches and pains
• Stomach pain
• Frequent heartburn (because the high calcium level in your blood causes your stomach to make too much acid)
• Nausea
• Vomiting
• Loss of appetite
• Constipation
• Bone and joint pain
• An increase in bone fractures or breaks
• Confusion and memory loss
• Kidney stones
• Excessive urination
• High blood pressure

CAUSES & RISK FACTORS

What causes hyperparathyroidism?

A number of things can cause your parathyroid glands to make too much PTH. These include

• A benign (non-cancerous) growth on the parathyroid glands known as an adenoma
• Enlargement of 2 or more of the parathyroid glands
• A medical condition such as kidney failure or rickets
• A rare inherited condition of the parathyroid gland

Hyperparathyroidism can be hereditary, which means it runs in families. More women have hyperparathyroidism than men. It is more likely to occur in older adults and women who have gone through menopause.  People who lack vitamin D are also at an increased risk. This is because vitamin D helps your body absorb the calcium in your bloodstream. In rare instances, people exposed to chronic lithium therapy (typically prescribed to treat bipolar disorder) also are at an increased risk.

DIAGNOSIS & TESTS

Most cases of hyperparathyroidism are found during routine blood tests. This is because most people do not have or recognize symptoms. When a healthcare provider does a blood test, they will check your calcium level. If it is high, they will look at the amount of PTH in your blood.

Once they confirm the diagnosis, they may run more tests. These can help find the cause of the condition. A CT scan or ultrasound checks for growths on your parathyroid glands. Those test in different body areas also can check for calcium deposits in your kidneys and urinary tract. Other causes of increased calcium, such as some medicines or cancer, must be considered as well.

PREVENTION

Can hyperparathyroidism be prevented or avoided?

You cannot prevent or avoid hyperparathyroidism.

TREATMENT

How is hyperparathyroidism treated?

Treatment for hyperparathyroidism depends on the cause. If you have a growth on your parathyroid gland, you likely will need surgery. Once the growth is removed, it shouldn’t come back. Your symptoms should stop in the first month after surgery. Your blood calcium level may be too low at first. This can be treated with medicine. Surgery also may be recommended for people who have moderate to severe symptoms. The surgeon will remove the glands that are overactive.

If you have minor or no symptoms, medicine may be the best form of treatment. Medicines can treat some but not all of the symptoms of hyperparathyroidism.

If a medical condition is causing your hyperparathyroidism, treatment is aimed at treating the underlying cause.

Living with hyperparathyroidism

Most people feel much better after treatment when the discomforts that they have been trying to live with go away. Your healthcare provider may want to continue routine testing. A blood test checks your calcium and PTH levels. A bone X-ray or bone mineral density (DXA) test can check for bone loss. Other tests may be done as needed based on the cause.

It is very important to maintain your blood calcium level as much as possible. Normally, the amount of calcium going into your bones matches the amount of calcium passing out of your bones. If you have hyperparathyroidism, more calcium is coming out of your bones than is going back in. When this happens, your bones might hurt, ache or become weak. Weak bones break more easily and heal slower than normal bones.

The calcium from your bones enters your bloodstream and causes too much calcium in your blood. This can lead to high blood pressure. You also can get kidney stones, because your kidneys are trying to filter out the extra calcium in your blood.

If you have hyperparathyroidism, you should not have too much or too little calcium in your diet. Your healthcare provider can give you more information about your intake of these nutrients. You should drink plenty of water to help prevent kidney stones. Regular exercise helps to build bone strength. Do not smoke, as it increases your risk for a number of conditions, including bone loss.