Hyperparathyroidism is a condition wherein the parathyroid glands create too much parathyroid hormone. This can cause the levels of calcium in the blood to rise, which, without treatment, can lead to a number of problems.
People typically have four parathyroid glands. These are small glands located near the thyroid gland. The parathyroid glands release parathyroid hormone, which is responsible for regulating the levels of calcium in the body.
This article will look at hyperparathyroidism in more detail, including its symptoms, causes, treatments, and possible risk factors.
There are three types of hyperparathyroidism. These are:
This type of hyperparathyroidism occurs when there is an issue with a parathyroid gland as opposed to an underlying health condition. One or more of the parathyroid glands become overactive, leading to too much parathyroid hormone. This causes calcium levels in the body to become too high.
In some cases, the cause of primary hyperthyroidism may be a tumor on one or more of the glands.
Secondary hyperparathyroidism does not occur due to an issue with a parathyroid gland. Instead, an underlying condition — such as kidney disease or low vitamin D levels — causes calcium levels in the body to decrease. This triggers the parathyroid glands to start releasing extra parathyroid hormone.
This type occurs when a person has long standing secondary hyperparathyroidism. This type of hyperparathyroidism typically occurs in people with kidney problems.
The symptoms can vary in severity and depend on the type of hyperparathyroidism a person is experiencing.
The following sections will look at symptoms by type.
Initially, people with primary hyperparathyroidism are unlikely to have any symptoms. However, over time, they may experience symptoms due to the high levels of calcium in the body.
These symptoms may include:
According to the National Kidney Foundation, secondary hyperparathyroidism can cause bone disease. This is because people with secondary hyperparathyroidism often experience high bone turnover.
High bone turnover occurs when the cells that remove bone work quicker than those that build new bone. This can cause bones to become weak and brittle, leading to an increased risk of bone pain and fractures.
As a result of this process, a person with secondary hyperparathyroidism may experience the following symptoms:
Some people with secondary hyperparathyroidism may experience calciphylaxis.
Calciphylaxis refers to a buildup of calcium in the body, which can cause chalk-like deposits to form in the blood vessels of the skin. This may narrow the blood vessels and reduce supply to the skin and fatty tissue. As a result, it can lead to blood clots, skin ulcers, infection, and skin necrosis.
Due to the differences in the underlying causes, each type of hyperparathyroidism may require different tests for a doctor to make a diagnosis.
The sections below will look at diagnosis by type.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) state that doctors will diagnose primary hyperparathyroidism using blood tests. Blood tests can detect blood calcium and parathyroid hormone levels.
Normally, a person with primary hyperparathyroidism will have raised levels or mid-to-high normal levels of calcium.
A doctor may also use blood tests to diagnose secondary hyperparathyroidism. A person with secondary hyperparathyroidism may also require urine and kidney tests to assess the severity and cause of the condition.
Secondary hyperparathyroidism may be the result of kidney disease. For this reason, a person should speak to a doctor if they experience kidney stones, kidney inflammation, or kidney infections.
A person should also consider speaking to a doctor if they notice any of the following symptoms:
- difficulty sleeping
- muscle cramps
- shortness of breath
- swollen ankles, feet, or hands
The treatment for hyperparathyroidism will also depend on which type a person has.
The sections below will look at treatment options by type.
Treatment of primary hyperparathyroidism may include:
- Surgery: If the cause of primary hyperparathyroidism is a tumor, a surgeon may remove this. Alternatively, if the cause is the glands becoming enlarged, the surgeon may remove these.
- Calcimimetics: This type of drug reduces levels of calcium and parathyroid hormone. Doctors usually reserve this option for people who are not good surgical candidates.
- Vitamin D supplements: Often, people with primary hyperparathyroidism present with vitamin D deficiency. In these cases, doctors may prescribe supplements to help increase a person’s levels of vitamin D.
- Bisphosphonates: Bisphosphonates are a type of drug that reduces bone loss and increases bone mineral density.
Treatment of secondary hyperparathyroidism also involves vitamin D supplements and calcimimetics.
However, people may also require phosphate binders to reduce the absorption of dietary phosphate. This is because people with kidney problems may have increased levels of phosphate in their bodies.
If a person requires an increase in their vitamin D intake, the following foods are good sources:
- whole milk
A person with hyperparathyroidism should also consider:
- Drinking plenty of fluids: This can help reduce the risk of developing kidney stones.
- Exercising regularly: This may help with bone strength.
- Stopping or reducing smoking: Smoking can decrease bone mass. This may cause further problems with a person’s bones.
A person can develop hyperparathyroidism at any stage of their life. However, certain groups are at greater risk of developing it.
Some risk factors include:
- Gender: Some evidence suggests that women are three times more likely to develop this condition than men.
- Nutritional deficiencies: Vitamin D or calcium deficiencies may result in secondary hyperparathyroidism.
- Certain medications: Some drugs may affect calcium levels. For example, lithium — which can help treat bipolar disorder — can cause elevated levels of calcium in the blood and result in primary hyperparathyroidism.
- Radiation therapy: People receiving radiation therapy to treat neck cancer may go on to develop primary hyperparathyroidism.
- Age: Although people of any age can experience primary hyperparathyroidism, it appears to be most common between the ages of 50 and 60 years.
The different types of hyperparathyroidism can lead to different complications.
The sections below will look at some possible complications by type.
The NIDDK note that the possible complications of primary hyperparathyroidism may include:
The complications of secondary hyperparathyroidism may include:
- bone irregularities
- immune dysfunction
- muscle atrophy
In most cases of primary hyperparathyroidism, undergoing surgery can help address the problem. Surgery can help ease the symptoms and allow a person to continue with their life as normal.
Secondary hyperparathyroidism is likely to have a significant negative impact on a person’s quality of life due to complications. However, with treatment, the symptoms can improve and become easier to manage.
When the parathyroid glands create too much parathyroid hormone, it may lead to hyperparathyroidism.
There are two main types of hyperparathyroidism: primary and secondary.
The cause of primary hyperparathyroidism is an issue with the parathyroid glands. The cause of secondary hyperparathyroidism is an underlying condition.
Hyperparathyroidism can negatively affect a person’s health and quality of life. However, with prompt treatment, a person can improve their chance of recovery and reduce their risk of long-term complications.