Hyperparathyroidism occurs when the parathyroid glands make too
much parathyroid hormone (PTH). The parathyroid glands are four pea-sized
endocrine glands located in your neck, near or attached to the back of your
thyroid. Endocrine glands secrete hormones necessary for the normal functioning
of the body.
Despite having similar names and being adjacent in your neck, the
parathyroid glands and the thyroid are very different organs. PTH helps
regulate the levels of calcium, vitamin D, and phosphorus in your bones and
Some people with this condition don’t experience any symptoms and
don’t need treatment. Others have mild or severe symptoms that might require
Are the Causes of Hyperparathyroidism?
In hyperparathyroidism, one or more of your parathyroid glands
becomes overactive and makes excess PTH. This could be due to a tumor, gland
enlargement, or other structural problems of the parathyroid glands.
When your calcium levels are too low, your parathyroid glands respond
by increasing the production of PTH. This causes your kidneys and intestines to
absorb a larger amount of calcium. It also removes more calcium from your
bones. PTH production returns to normal when your calcium level goes up again.
Are the Types of Hyperparathyroidism?
There are three types of hyperparathyroidism: primary, secondary,
This type occurs when you have a problem with at least one of
your parathyroid glands. Common causes of parathyroid problems include benign
growths on the gland and enlargement of at least two glands. In rare cases, a cancerous
tumor causes this condition. An increased risk of developing primary
hyperparathyroidism also occurs in people who:
- have certain inherited disorders that affect
several glands throughout the body, such as multiple endocrine neoplasia
- have a long history of calcium and vitamin D
- have been exposed to radiation from cancer
- have taken a drug called lithium, which mainly
treats bipolar disorder
This type occurs when you have an underlying condition that
causes your calcium levels to be abnormally low. Most cases of secondary
hyperparathyroidism are due to chronic kidney failure that results in low
vitamin D and calcium levels.
This type occurs when your parathyroid glands keep making too
much PTH after your calcium levels return to normal. This type usually occurs
in people with kidney problems.
Are the Symptoms of Hyperparathyroidism?
Symptoms can vary from mild to severe, depending on your type of
Some patients don’t have any symptoms. If you do have symptoms,
they can range from mild to severe. Milder symptoms may include:
- body aches
More severe symptoms can include:
- appetite loss
- excessive thirst
- increased urination
- memory problems
- kidney stones
With this type, you may have skeletal abnormalities, such as
fractures, swollen joints, and bone deformities. Other symptoms depend on the
underlying cause, such as chronic kidney failure or severe vitamin D
Is Hyperparathyroidism Diagnosed?
Your primary care provider might suspect that you have
hyperparathyroidism if routine blood tests show high levels of calcium in your
blood. To confirm this diagnosis, your primary care provider will need to
perform other tests.
Additional blood tests can help your primary care provider make a
more accurate diagnosis. Your primary care provider will check your blood for
high PTH levels, high alkaline phosphatase levels, and low levels of
A urine test can help your primary care provider determine how
severe your condition is and whether kidney problems are the cause. Your primary
care provider will check your urine to see how much calcium it contains.
Your primary care provider might take X-rays of your abdomen to
check for kidney abnormalities.
Are the Treatments for Hyperparathyroidism?
You might not need treatment if your kidneys are working fine, if
your calcium levels are only slightly high, or if your bone density is normal.
In this case, your primary care provider might monitor your condition once a
year and check your blood-calcium levels twice a year.
Your primary care provider will also recommend watching how much
calcium and vitamin D you get in your diet. You’ll also need to drink plenty of
water to reduce your risk of kidney stones. You should get regular exercise to
strengthen your bones.
If treatment is necessary, surgery is the commonly used
treatment. Surgical procedures involve removing enlarged parathyroid glands or
tumors on the glands. Complications are rare and include damaged vocal cord
nerves and long-term, low levels of calcium.
which act like calcium in the blood, are another treatment. These drugs can
trick your glands into making less PTH. Primary care providers prescribe these
in some cases if surgery is unsuccessful or not an option.
which keep your bones from losing calcium, can help reduce the risk of
therapy can help bones hold on to calcium. This therapy can treat
postmenopausal women with osteoporosis, although there are risks involved with
prolonged use. These include an increased risk of some cancers and
Treatment involves bringing your PTH level back to normal by
treating the underlying cause. Methods of treatment include taking prescription
vitamin D for severe deficiencies and calcium and vitamin D for chronic kidney
failure. You might also need medication and dialysis if you have chronic kidney
Are the Complications Associated with Hyperparathyroidism?
If you suffer from hyperparathyroidism, you might also have a
condition called osteoporosis which is also sometimes referred to as “thinning”
of the bone. Common symptoms include bone fractures and height loss due to
vertebral body (spinal column) fractures. This can develop when excess PTH
production causes too much calcium loss in your bones, making them weak.
Osteoporosis typically occurs when you have too much calcium in your blood and
not enough calcium in your bones for a prolonged period.
Osteoporosis puts you at a higher risk for bone fractures. Your primary
care provider can check for signs of osteoporosis by taking bone X-rays or
doing a bone mineral density test. This test measures calcium and bone mineral
levels using special X-ray devices.
What Is the Long-Term Outlook?
According to the Cleveland
Clinic, surgery can cure most cases of hyperparathyroidism. If you and your
primary care provider opted to monitor your condition rather than treating it,
making several healthy lifestyle choices can help you fight symptoms. Drink
plenty of water, and get regular exercise. You should also monitor the amount
of calcium and vitamin D you consume.