What Is Hyperparathyroidism?

Hyperparathyroidism is a condition in which one or more of the parathyroid glands become overactive and release too much parathyroid hormone (PTH). This hormone plays a key role in regulating calcium levels in the blood. When PTH is too high, calcium levels rise, which can lead to various health problems, especially affecting the bones and kidneys.

There are two main types:

• Primary hyperparathyroidism – caused by a problem with the parathyroid glands themselves
• Secondary hyperparathyroidism – caused by other medical conditions that lead to low calcium, prompting the glands to produce more PTH

What Causes Hyperparathyroidism?

Primary hyperparathyroidism is often caused by:

• A benign tumor (adenoma) on one of the parathyroid glands
• Enlargement of the parathyroid glands (hyperplasia)
• Rarely, parathyroid cancer

Secondary hyperparathyroidism is typically caused by:

• Chronic kidney disease
• Vitamin D deficiency
• Calcium deficiency

What Are the Symptoms?

Symptoms may vary depending on the severity of the condition. Some people have no symptoms at all (especially in early stages), while others may experience:

• Fatigue or weakness
• Bone pain or fractures
• Kidney stones
• Abdominal pain
• Nausea or vomiting
• Frequent urination
• Depression or mood changes
• Memory problems or confusion
• Muscle weakness

How Is It Diagnosed?

Hyperparathyroidism is usually diagnosed with blood and urine tests. These may include:

• Blood calcium levels (often elevated)
• Parathyroid hormone (PTH) levels (also elevated)
• Vitamin D levels
• Urine calcium test
• Bone density scan (DEXA) to check for bone loss
• Imaging tests (ultrasound, sestamibi scan) to locate abnormal parathyroid glands

What Is the Treatment?

Treatment depends on the type, cause, and severity of the condition:

For primary hyperparathyroidism:

• Surgery to remove the overactive gland(s) is often the most effective treatment
• Monitoring may be recommended if symptoms are mild and calcium levels are only slightly elevated

For secondary hyperparathyroidism:

• Treating the underlying cause (e.g., kidney disease, vitamin D deficiency)
• Vitamin D and calcium supplements
• Phosphate binders
• Medications such as calcimimetics (e.g., cinacalcet) to reduce PTH levels

Are There Any Complications?

If untreated, hyperparathyroidism can lead to:

• Osteoporosis and bone fractures
• Kidney stones
• Kidney damage
• Calcium deposits in organs
• Heart and nervous system complications

What Is the Outlook?

With proper treatment, the outlook is usually good. Surgery often cures primary hyperparathyroidism, and secondary forms can be managed with medications and lifestyle changes. Regular follow-up is important to monitor calcium levels and bone health.

Can Hyperparathyroidism Be Prevented?

There is no guaranteed way to prevent hyperparathyroidism, but you can reduce your risk by:

• Getting enough vitamin D and calcium
• Managing chronic kidney disease properly
• Having regular check-ups if you are at risk, especially if you have a family history or other risk factors