Understanding Primary Hyperparathyroidism

Back view of thyroid showing three normal parathyroids and one enlarged one.

The parathyroid glands are 4 tiny glands in the neck. They make parathyroid hormone (PTH). PTH controls the amount of calcium and phosphorus in your blood. Primary hyperparathyroidism is when there is too much PTH in your blood. It occurs when 1 or more of the glands are too active.

The job of PTH is to tell the body how to control calcium. Too much PTH means the body raises the amount of calcium in the blood. This leads to a problem where there is too much calcium in the blood (hypercalcemia). This can cause serious health problems.


Hyperparathyroidism can occur when a parathyroid gland gets bigger. It can also occur as a complication of other health conditions. These include kidney failure or rickets. In these conditions, calcium is often not high. This is called secondary hyperparathyroidism.

Who’s at risk

The risk factors for this condition include:

  • Being a woman

  • Being older

  • Having parents or siblings with the condition or other endocrine tumors

  • Having certain kidney problems

  • Taking certain medicines

  • Having had radiation treatment in the head or neck


Symptoms can include:

  • Muscle weakness

  • Depression

  • Tiredness

  • Confusion and memory loss

  • Poor memory

  • Nausea and vomiting

  • Belly pain

  • Hard stools (constipation)

  • Stomach ulcers

  • Need to urinate often

  • Kidney stones

  • Joint or bone pain

  • Bone disease (osteopenia or osteoporosis) or having more bone fractures

  • High blood pressure

  • Feeling very thirsty


If this condition is not treated, it can get worse over time. Treatments include:

  • Surgery. This may be done to remove any enlarged parathyroid glands. This lets the blood calcium level go back to normal. You may need to take vitamin D and calcium supplements before and after the surgery. This will reduce the risk of low calcium after the surgery.

  • Medicine. This lowers the amount of PTH made by the overactive glands. 

You and your healthcare provider can talk about your treatment options. Ask any questions you have before you sign the informed consent form for surgery.