What is Hyperparathyroidism?

The parathyroid glands are small glands located behind the thyroid. When these glands create too much parathyroid hormone, hyperparathyroidism develops. These hormones are in charge of maintaining a balanced calcium amount in the bloodstream. 

There are two types of hyperparathyroidism. Primary hyperparathyroidism is when the glands are enlarged and overproduce hormones. This is going to elevate the calcium in the bloodstream.

Secondary hyperparathyroidism is usually caused by another condition or disease that causes low calcium levels. The most common conditions are kidney failure and vitamin D deficiency. The low calcium stimulates the parathyroid gland to secrete more hormone so the calcium level can increase. After a while, since the gland is working extra time, it becomes enlarged and leads to hyperparathyroidism. 

For more information about the risk factors of hyperthyroidism visit the Mayo clinic website

What are the symptoms of Hyperparathyroidism?

  • Bone pain
  • Kidney stones
  • Osteoporosis (bone fractures)
  • Fatigue
  • Loss of appetite
  • Nausea
  • Loss of focus 
  • Depression 

How is Hyperparathyroidism diagnosed?

The diagnosis of hyperparathyroidism can be made with routine blood work at your doctor’s office. The doctor looks at your parathyroid hormone (PTH) and other minerals such as calcium and phosphorus. Calcium can also be checked by doing a urine test, which would should the amount of calcium excreted by the kidneys. A high concentration of sodium in urine will be suggestive of overactive parathyroid. Other tests can be ordered and can be seen here

How is Hyperparathyroidism treated?

The treatment of hyperparathyroidism depends on the severity of your symptoms as well as the cause or type of hyperparathyroidism the patient has. If symptoms are mild and the calcium level is just mildly elevated, the medical provider can monitor the blood calcium levels every 6 months to check for changes. It is also recommended to increase the intake of water and keep hydrated as well as maintaining an active lifestyle. Please avoid medications such as thiazide diuretics or lithium since they can elevate the blood calcium levels even more. 

If the patient presents with more severe symptoms or higher calcium levels, removal of the parathyroid glands might be recommended since surgery cures the majority of cases. In this case, your primary medical provider might refer you to an ear, nose, and throat specialist for further treatment. 

For secondary hyperparathyroidism, the cause of the problem should be addressed first. If the cause it’s vitamin D deficiency, then supplementation with vitamin D is recommended. When the cause is something more severe like kidney failure then, the definitive treatment is a kidney transplant. On the other hand, if the underlying condition cannot be fixed, then the goal treatment is medical therapy instead of surgery. For example, patients waiting for a kidney transplant or ineligible to get one, have to be started on medications such as calcimimetics. These medications help to reduce the parathyroid hormones in your bloodstream. Side effect such as nausea and vomiting are common while taking calcimimetics.

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