What Happens When You Have Hyperparathyroidism?

The parathyroid glands are four pea-sized glands located in the neck near the thyroid gland. They produce parathyroid hormone, which helps to control the calcium and phosphorous levels in the body. They are located on the outside borders of the thyroid glands.

The parathyroid glands raise blood calcium levels by:

• Causing bone to release calcium in the blood
• Aiding the intestines to absorb calcium from the diet
• Helping the kidneys to store calcium and return it to the blood instead of excreting it in the urine

Primary hyperparathyroidism is a type of hyperparathyroidism that starts in at least one of the parathyroid glands. It occurs due to one of the following reasons:

• Benign tumor
• Cancer of one of the glands
• Two or more of the glands being overactive

Secondary hyperparathyroidism is a type of hyperparathyroidism that occurs due to low calcium levels in the blood, triggered by certain medical conditions. Secondary hyperparathyroidism may occur due to:

• Low calcium levels in the blood due to chronic kidney disease or some other conditions
• Low levels of Vitamin D that balances the amount of calcium in the blood
• Paraneoplastic syndrome (an accompanying disease because of cancers of other organs) may also be present with elevated PTH levels.

About 100,000 people in the United States develop hyperparathyroidism each year. Women are more commonly affected than men and the risk increases with age.

Hyperparathyroidism does not manifest any symptoms in the majority of the patients. However, in some, hyperparathyroidism may exhibit the following symptoms:

• Joint pain
• Muscle weakness
• Fatigue
• Depression
• Trouble concentrating
• Loss of appetite
• Increased need for sleep

In severe cases of hyperparathyroidism, the patient may experience:

• Nausea and vomiting
• Confusion
• Increased thirst and need to urinate
• Constipation
• Pain on one side of the lower abdomen
• Kidney failure symptoms

The physician may order blood tests to check the level of calcium and PTH in the blood. After diagnosis, the physician may conduct the following tests to assess the complications:

• Bone densitometry: It uses a small dose of ionizing radiation to look for reduced bone mineral density.
• Kidney ultrasound: It may be useful to check for kidney stones.
• Imaging tests, such as MRI or CT scan, may be helpful to check for broken bones
• 25-hydroxy-vitamin D blood test to assess the level of Vitamin D

Treatment options include:

• Surgery: It involves removal of the either one or more overactive glands.
• Medication: Cinacalcet is approved for the treatment of primary as well as secondary hyperparathyroidism.
• Dietary supplements: Calcium and Vitamin D supplements need to be consumed lifelong.
• Identify and treat the cancer-causing paraneoplastic syndrome, if any.
• Regular monitoring involves physical examination from time to time, blood tests, and bone density measurements.