Parathyroid glands are small, pea-sized glands located behind the thyroid gland at the bottom of the neck. Though tiny, these glands play role in your overall health. If the parathyroid glands become overreactive and release too much parathyroid hormone, your body may not properly regulate calcium, potentially leading to other health serious conditions such as osteoporosis, kidney stones and cardiovascular disease.
Knowing the signs and symptoms of hyperparathyroidism is important for early diagnosis so that you and your doctor can develop a treatment plan before complications may arise.
What Is Hyperparathyroidism?
Most people have four parathyroid glands. The parathyroid glands produce parathyroid hormone. This hormone plays an important role in regulating how much calcium is in the blood. When the parathyroid gland makes too much parathyroid hormone (PTH), the amount of calcium in the blood goes up. Some of the calcium is drawn out of the bones, leading to an increased risk of osteoporosis. Also, in cases of hyperparathyroidism, too much calcium in the kidneys and urine can lead to kidney stones.
Primary, Secondary and Tertiary Hyperparathyroidism
There are three main types of hyperparathyroidism. Primary hyperparathyroidism occurs when at least one parathyroid gland doesn't function correctly and produces high levels of parathyroid hormone. This usually is caused by a benign, noncancerous tumor, called an adenoma, on at least one parathyroid gland. Primary hyperparathyroidism can also be caused by enlargement, or hyperplasia, of more than one parathyroid gland. Parathyroid cancer is extremely rare but also can cause primary hyperparathyroidism.
Secondary hyperparathyroidism is caused by another health condition that prompts the parathyroid glands to overreact and release parathyroid hormone. Secondary hyperparathyroidism can be seen in patients with calcium and / or vitamin D deficiency, as well as in patients with chronic kidney disease.
Tertiary hyperparathyroidism can develop in patients who have had long-term secondary hyperparathyroidism. This is a rare condition that can affect patients with severe chronic kidney disease.
Hyperparathyroidism Symptoms
Patients experiencing mild hyperparathyroidism may not have any symptoms. Those with symptoms may experience problems that affect the digestive system, nervous system, urinary system and musculoskeletal system. Symptoms include:
- Weakness, including weak bones and muscle weakness
- Bone and joint pain
- Fatigue
- Loss of appetite
- Constipation
- Difficulty concentrating
- Confusion
- Mild depression
- Kidney stones
Risk Factors of Hyperparathyroidism
Women are more likely than men to develop hyperparathyroidism, and risk increases with age. It is more common in post-menopausal women.
Hyperparathyroidism can also be hereditary. In rare cases, radiation treatment to the head or neck area can lead to hyperparathyroidism.
Vitamin D deficiency, low levels of calcium and kidney disease are the most common risk factors for secondary hyperparathyroidism.
Diagnosing and Treating Hyperparathyroidism
Diagnosing and treating hyperparathyroidism is vital to try to prevent long-term complications, such as osteoporosis, kidney disease and cardiovascular disease, including high blood pressure. A blood test can check calcium levels and parathyroid hormone levels. Primary hyperparathyroidism may be diagnosed if the blood calcium and parathyroid hormone levels are both high. Blood tests also can rule out other health problems that may be causing symptoms of hyperparathyroidism.
A urine test can see how well the kidneys are functioning and how well they are removing calcium.
Scans of the neck (including a parathyroid ultrasound, a parathyroid sestamibi scan, or a neck CT) and a bone mineral density test may also be used to help diagnose primary hyperparathyroidism and develop a treatment plan.
The best, most effective way to treat primary hyperparathyroidism in patients who have symptoms is surgery to remove the affected gland. Doing so gives patients the greatest chance of lowering their risk of developing osteoporosis and kidney stones and is considered extremely successful in curing hyperparathyroidism.
Patients who don't have symptoms of primary hyperparathyroidism or have only mild cases may not need surgery. Instead, we may monitor their bone density, kidney function and blood calcium levels. Regular monitoring, called watchful waiting, can help us see if the condition is worsening or remaining stable. Your doctor can discuss whether calcium and Vitamin D supplements would be helpful. Drinking plenty of water to reduce the risk of kidney stones, and exercising to increase bone strength, also can slow the progression of hyperparathyroidism related complications.
Though not as effective as surgery, some medications can help with primary hyperparathyroidism.
Treatment of secondary hyperparathyroidism depends on the cause of the condition.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, approximately 100,000 people develop primary hyperparathyroidism in the United States each year, and it is one of the most common hormonal disorders. Fortunately, surgery can cure nearly all cases of primary hyperparathyroidism. If you have symptoms, talk to your physician for an appropriate, accurate diagnosis and to develop a treatment plan that is right for you.