Primary Hyperparathyroidism

What is primary hyperparathyroidism?

Primary hyperparathyroidism is a metabolic disorder in which one (or more) of the parathyroid glands produces too much parathyroid hormone, which can result in the loss of bone tissue. According to the National Institute of Diabetes and Digestive and Kidney Diseases, primary hyperparathyroidism affects about 100,000 people in the U.S. each year, and is more prevalent in women than in men.

A function of the parathyroid hormone is to keep blood calcium levels from going too low by releasing calcium from bones, conserving calcium that would be excreted by the kidneys, and increasing calcium absorption from food. When the hormone overacts, the result is a rise in the blood calcium level.

Anatomy of the endocrine system in males and females

When there is a benign tumor in a parathyroid gland, the condition is called a parathyroid adenoma. When more than one parathyroid gland becomes enlarged, the condition is called parathyroid hyperplasia. Both of these conditions are benign (noncancerous).

Too much parathyroid hormone causes too much calcium to be released from bone.

What causes primary hyperparathyroidism?

In some cases, no cause can be identified. Some known causes include benign (noncancerous) tumors on the parathyroid glands, or enlargement of the glands.

What are the symptoms of primary hyperparathyroidism?

The following are the most common symptoms of primary hyperparathyroidism. However, each individual may experience symptoms differently. Symptoms of too much calcium in the blood may include:

  • Loss of appetite

  • Increased thirst

  • Frequent urination

  • Lethargy and fatigue

  • Muscle weakness

  • Joint pain

  • Constipation

  • Kidney pain (due to the presence of kidney stones)

Other serious symptoms may include:

  • Nausea

  • Vomiting

  • Abdominal pain

  • Memory loss

  • Depression

The symptoms of primary hyperparathyroidism may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is primary hyperparathyroidism diagnosed?

The disorder may not present symptoms or complications, and is sometimes discovered during a routine blood test as part of a physical examination.

A diagnostic procedure for primary hyperparathyroidism may involve a dual X-ray absorptiometry, also called bone densitometry, to determine bone density and to reveal loss of bone tissue. Bone densitometry is also used to continually monitor the disorder.

Treatment for primary hyperparathyroidism

Specific treatment for primary hyperparathyroidism will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Surgery to remove the affected gland may be performed. Treatment may include continual monitoring with bone densitometry to reveal loss of bone tissue, and to determine if surgery may be a necessary treatment.