Overview

What Is Hyperparathyroidism?

Hyperparathyroidism occurs when the parathyroid glands, which are located next to the thyroid gland, produce too much parathyroid hormone (PTH), leading to increased calcium in the bloodstream as it is released from bones. Loss of calcium can eventually cause osteoporosis and bone fractures.

Types of hyperparathyroidism

There are two types of hyperparathyroidism, including:

Primary hyperparathyroidism

This condition is caused by adenomas, hyperplasias or carcinomas in the parathyroid glands, or by gene mutations.

Secondary hyperparathyroidism

This occurs when the parathyroid produces excess PTH in response to low blood calcium levels caused by renal failure, vitamin D deficiency or calcium deficiencies caused by the body not receiving or absorbing calcium properly.

Symptoms

Hyperparathyroidism is characterized by whether it is the result of a malfunction in the parathyroid glands themselves or is a response to vitamin deficiencies. Common symptoms include:

  • Joint pain
  • Abdominal pain
  • Fatigue
  • Kidney stones
  • Muscle weakness
  • Excessive urination

Diagnosis

Northwestern Medicine diagnoses hyperparathyroidism using blood tests to determine the presence of elevated levels of calcium in the blood, bone mineral density tests and imaging tests of the kidneys to detect kidney stones and other abnormalities. Ultrasounds may also be conducted before surgery to create images of the parathyroid gland. A sestamibi scan, which uses a radioactive compound injected into the bloodstream, may also be performed to detect an overactive parathyroid.

Treatment

Treatment depends on whether the hyperparathyroidism is primary or secondary.

Primary hyperparathyroidism is typically treated by removing parathyroid glands that are enlarged or contain a tumor; if all four glands are affected, your surgeon may only remove three glands and part of the fourth to leave as much parathyroid function as possible.

Patients may have to use calcium and vitamin D supplements to counteract decreased calcium levels after the surgery.

Medications such as calcimimetics to trick the parathyroid gland into producing less calcium, hormone replacement therapy for women with osteoporosis and bisphosphonates to prevent calcium loss from bones may be prescribed in addition to surgery, or for patients with secondary hyperparathyroidism.

Your physician may also recommend lifestyle changes such as monitoring your calcium intake, drinking water to prevent kidney stones, regular exercise and quitting smoking to help prevent bone loss.

The Endocrinology and Metabolism Program at Northwestern Memorial Hospital provides comprehensive diagnosis and treatment of cancers and diseases of the pituitary, thyroid, parathyroid, and adrenal glands. Specialized services are provided for diagnosis and treatment of diabetes, thyroid cancer, Polycystic Ovarian Syndrome (PCOS) and osteoporosis.