Hyperparathyroidism

Specialty of Surgery

What is hyperparathyroidism?

Hyperparathyroidism refers to an excess of parathyroid hormone in the bloodstream. This occurs due to overactivity in one (or more) of the body’s parathyroid glands. There are four parathyroid glands in the body, which are found in the neck and produce parathyroid hormone. This hormone helps to maintain the right balance of calcium in the body and its tissues.

What are the symptoms?

Symptoms of hyperparathyroidism include:

  • Pain in the abdomen
  • Bone and joint pain
  • Nausea
  • Vomiting
  • Losing appetite
  • Frequently needing to pee
  • Kidney stones
  • Osteoporosis, or bones more prone to fracture
  • Fatigue, or feeling tired easily
  • Feeling weak
  • General malaise

Symptoms may be mild, which means they may go unnoticed or it can be hard for a patient to tell that something is wrong. However, hyperparathyroidism is often diagnosed before symptoms occur, through testing for unrelated conditions or at medical check-ups. Symptoms can also be severe – it varies, and depends on the patient.

What causes hyperparathyroidism?

Primary hyperparathyroidism occurs when one or more of the body’s parathyroid glands produce too much parathyroid hormone, thus causing high levels of calcium in the blood. This is called hypercalcaemia, which leads to a variety of health problems.

Secondary hyperparathyroidism is the result of a different condition or disease which causes low levels of calcium to occur in the body. Over time, this results in an increase in parathyroid hormone levels.

How can it be prevented?

Hyperparathyroidism cannot be prevented, but there are certain risk factors for the condition, including radiation treatment for cancer, vitamin D deficiency, being female and having gone through the menopause, and having taken lithium, which is a drug often used in the treatment of bipolar disorder.

What is the treatment?

Hyperparathyroidism is often caught by doctors in routine testing, when elevated levels of calcium are shown in the blood. There are many conditions which cause elevated levels of calcium, however once this is combined with an increase in parathyroid hormone, this leads to a diagnosis of hyperparathyroidism.

The most common treatment is surgery (in the case of primary hyperparathyroidism), which removes the enlarged glands and leaves behind those which are functioning correctly.

Some medications can be used to treat hyperparathyroidism, including hormone replacement therapy which can help the body to retain calcium, especially in women who have gone through the menopause.

In some cases, doctors choose to monitor the condition and recommend no treatment. However, this requires scheduled blood tests to monitor the levels of calcium in the blood, and bone density scans to check if the hyperparathyroidism is affecting the bones.  

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