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Hyperparathyroidism

(Overactive Parathyroid)

Definition

Hyperparathyroidism is when the body makes too much parathyroid hormone (PTH). PTH is made in the parathyroid gland. It helps to balance calcium levels in the blood. High PTH causes too much calcium in the blood. There are three types:

  • Primary
  • Secondary
  • Tertiary

Thyroid and Parathyroid Glands
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Causes

The primary type may be caused by:

  • A noncancerous tumor—most common cause
  • Certain inherited conditions
  • Cancer—rare

The secondary type may be caused by:

  • Low levels of vitamin D
  • Kidney failure or other health problems

The tertiary type is caused by an enlarged parathyroid. It can happen with long term kidney failure.

Risk Factors

This condition is more common in older adults, especially women. Other things that may raise the risk are:

Symptoms

Most people do not have symptoms. Those who do may have:

  • Joint or back pain
  • Digestive problems such as:
  • Headache
  • Thirst
  • Frequent urination
  • Kidney stones
  • Anxiety, depression, or confusion
  • Tiredness or weakness

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

This condition is diagnosed with blood and urine tests. The doctor may also do a scan of the parathyroid gland. Other scans may be done such to check the kidneys and bones.

Treatment

Treatment depends on the cause. Options may be:

  • Surgery to remove tumors
  • Medicine to treat symptoms and keep levels of calcium and vitamin D in the normal range
  • Management of kidney disease, if present

Blood calcium levels may need to be checked on a regular basis. It can help to find problems early. Other tests can also help to look for related problems such as bone density tests.

Prevention

Healthy amounts of calcium and vitamin D may prevent primary hyperparathyroidism in women. A healthy diet can help.

RESOURCES:

Hormone Health Network—Endocrine Society
http://www.hormone.org

The American Association of Endocrine Surgeons
http://endocrinediseases.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Canadian Society of Endocrinology and Metabolism
http://www.endo-metab.ca

REFERENCES:

Hyperparathyroidism. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/hyperparathyroidism. Accessed January 18, 2021.

Primary hyperparathyroidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-hyperparathyroidism. Accessed January 18, 2021.

Secondary hyperparathyroidism. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/secondary-hyperparathyroidismAccessed January 2021.

Tertiary hyperparathyroidism. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/tertiary-hyperparathyroidism. Accessed January 2021.

Walker M, Bilezikian P. Primary hyperparathyroidism: recent advances. Curr Opin Rheumatol . 2018 Jul;30(4):427-439.

Last reviewed March 2020 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 1/18/2021