Hyperparathyroidism

Overview

What is hyperparathyroidism?

You have 4 pea-sized glands behind the thyroid gland at the front of your neck. These glands are called parathyroids. They make a hormone called parathyroid hormone (PTH) that keeps the right levels of calcium and phosphorus in your body. PTH helps you absorb calcium from your food and keeps you from losing too much calcium through your urine.

Hyperparathyroidism occurs when your parathyroid glands make too much PTH and cause you to have too much calcium in the bloodstream.

Symptoms

What are the symptoms of hyperparathyroidism?

Most people who have hyperparathyroidism do not experience any symptoms. Some people may have one or more of the following symptoms:

  • Feeling weak or tired most of the time

  • General aches and pains throughout your body

  • Abdominal pain

  • Frequent heartburn (because the high calcium level in your blood causes your stomach to make too much acid)

  • Nausea

  • Vomiting

  • Loss of appetite

  • 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?

Hyperparathyroidism occurs when your parathyroid glands make too much PTH and cause you to have too much calcium in the bloodstream. A number of things can cause your parathyroid glands to make too much PTH, including a growth on the parathyroid glands, enlargement of 2 or more of the parathyroid glands or medical conditions such as kidney failure and rickets.

Who gets hyperparathyroidism?

Hyperparathyroidism is hereditary (which means it runs in families). More women develop hyperparathyroidism than men, especially women who have gone through menopause. Hyperparathyroidism is also more common in older people. People who have vitamin D deficiency are also at an increased risk of developing hyperparathyroidism, because vitamin D helps your body absorb the calcium in your bloodstream. People who take lithium (typically prescribed to treat bipolar disorder) are also at an increased risk for hyperparathyroidism.

Diagnosis & Tests

How does my doctor know I have hyperparathyroidism?

Hyperparathyroidism is most often suspected when a high level of calcium is found in your blood on a routine blood test, especially since symptoms of hyperparathyroidism are often not present. The test results can help your family doctor make the diagnosis even before any problems start. This is one benefit of having regular blood tests. Further blood testing proves the diagnosis, usually by measuring the amount of PTH in your blood.

A special scan can find any abnormal growth on your parathyroid gland, if that is what is causing your hyperparathyroidism. Regular X-rays look normal until late in the disease, so they aren’t much help in diagnosing hyperparathyroidism. Other causes of increased calcium in the blood, such as some medicines or cancer, must sometimes be considered.

Treatment

How is hyperparathyroidism treated?

If a growth on your parathyroid is causing your hyperparathyroidism, surgery to remove it usually solves the problem. The growth doesn’t typically come back. Most of your symptoms will stop in the first month after surgery. For a short time after surgery, your blood calcium level may be too low. This problem is treated with medicine.

Surgery is usually recommended for people who have hyperparathyroidism and are experiencing moderate to severe symptoms. If you are not experiencing any symptoms or your symptoms are not severe, your doctor may recommend treatment with medicine alone. Medicines can treat some (but not all) of the symptoms of hyperparathyroidism. If you don’t have surgery or need medicines to treat your hyperparathyroidism, tests are still needed from time to time to see if the disease is hurting your kidneys, bones or other body systems. Special machines can check your bone strength. This treatment approach is called watchful waiting.

Most people feel much better after treatment when the discomforts that they have been trying to live with go away.

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

If you have hyperparathyroidism, you should limit your intake of calcium (aim for less than 1,200 mg each day) and vitamin D (aim for less than 600 IU each day). Your doctor can give you additional information about limiting your intake of these nutrients. You should drink plenty of water to help prevent kidney stones. Make sure to get plenty of exercise, which can help build bone strength. Do not smoke, as it increases your risk for a number of conditions, including bone loss.

Complications

What does hyperparathyroidism do to your body?

Normally, the amount of calcium going into your bones matches the amount of calcium passing out of your bones. This means that the amount of calcium in your bones should stay about the same all the time. 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, causing your blood to have too much calcium. Too much calcium in your blood can cause high blood pressure. You might also develop kidney stones, because your kidneys are trying to filter out the extra calcium in your blood. Too much calcium in your kidneys might also make you thirsty or increase your need to urinate.

Untreated hyperparathyroidism in women who are pregnant can cause their babies to be calcium deficient, which is dangerous to the developing fetus.

These complications tend to develop slowly, so you may not notice them at first.

Questions to Ask Your Doctor

  • What is the likely cause of my hyperparathyroidism?

  • What are the results of my blood test(s)? What do these results mean?

  • What is the best treatment option? Will I need surgery?

  • What risks are associated with surgery?

  • Will I need to take medicine? For how long?

  • When can I expect relief from my symptoms?

  • Am I at risk for any long-term health problems?