What is hyperparathyroidism?
Hyperparathyroidism occurs in your parathyroid glands. These are the 4 pea-sized glands behind your 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 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 (the high calcium level in your blood can cause 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
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 your parathyroid glands known as an adenoma
- Enlargement of 2 or more of the parathyroid glands
- A medical condition, such as kidney failure or rickets
- Radiation to your neck or head
- A rare inherited condition of the parathyroid gland
Hyperparathyroidism also 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 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.
How is hyperparathyroidism diagnosed?
Most cases of hyperparathyroidism are found during routine blood tests. This is because most people do not have or recognize symptoms. When the doctor 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 the doctor confirms 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.
Can hyperparathyroidism be prevented or avoided?
You cannot prevent or avoid hyperparathyroidism.
Hyperparathyroidism treatment
Treatment for hyperparathyroidism depends on the cause. If you have a growth on your parathyroid gland, you likely will need surgery. Once the doctor removes the growth, 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 doctor 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 the cause, treatment is aimed at managing the underlying condition.
Talk to your doctor about treatment options if you are pregnant. You do not want your baby to be calcium deficient. This is very harmful to their development.
Living with hyperparathyroidism
Most people feel much better after treatment once the symptoms have gone away. Your doctor will 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. This can lead to decreased bone mass. 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. Aim for about 800-1,000 mg each day. You also should limit your intake of vitamin D to less than 600 IU each day. Your doctor can give you more information about your intake of these nutrients. Drink plenty of water to help prevent kidney stones. Regular exercise helps to build bone strength. Do not smoke. It increases your risk for certain problems, including bone loss.
Questions to ask your doctor
- What is the likely cause of my hyperparathyroidism?
- What are the results of my blood test, and what do they mean?
- What is the best treatment option? Will I need surgery?
- What are the benefits and risks of surgery?
- Will I need to take medicine? If so, for how long?
- When can I expect relief from my symptoms?
- Are there any lifestyle changes I can make to help the condition?
- Am I at risk for any long-term health problems?
- If I take lithium, should I stop without talking to my doctor first?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
