Doctor's Notes on Hyperparathyroidism
Hyperparathyroidism is the result of an overproduction of a hormone called parathyroid hormone (or PTH) from the parathyroid glands, which regulate calcium levels in the body. If calcium levels are low, parathyroid hormone levels increase. If calcium is high, PTH levels are reduced.
Symptoms of hyperparathyroidism are due to elevated calcium levels (hypercalcemia) so the symptoms are the same as those of hypercalcemia including high blood pressure (hypertension). Symptoms are often described as "moans, stones, groans, and bones."
- “Moans” symptoms refer to gastrointestinal conditions including abdominal pain, constipation, decreased appetite, nausea, and peptic ulcer disease.
- “Stones” symptoms refer to kidney-related conditions and include flank pain, frequent urination, and kidney stones.
- “Groans” symptoms refer to psychological conditions and include confusion, dementia, depression, and memory loss.
- “Bones” symptoms refer to bone pain and bone-related conditions including bone aches and pains, curving of the spine and loss of height, and fractures.
What is the treatment for primary hypoparathyroidism?
Hyperparathyroidism may occur because of problems in the parathyroid glands (primary hyperparathyroidism) or from another problem in another organ like the kidneys (secondary hyperparathyroidism). Options for treatment include variations of watchful waiting, surgery and medications for both types. For example:
- Watchful waiting – no treatment but regular monitoring of calcium levels, kidneys function well and no kidney stones, bone density within about the standard range and no additional symptoms
- Surgery – most common treatment
- Removal only those parathyroid glands that are enlarged or have a tumor
- If all 4 glands are affected, the surgeon may remove 3 glands and only part of the fourth to leave some functioning tissue
- Medications
- Calcimimetics – cause reduced amount of parathyroid hormone; may include vitamin D
- Bisphosphonates – reduce or stop calcium loss from bones
- Hormone replacement - for post menopausal women with signs of osteoporosis
You and your doctors can decide what plan is best for your condition.
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What Happens When You Have Hyperparathyroidism?
Primary hyperparathyroidism is a disorder that occurs when one or more of the parathyroid glands becomes overactive and secretes excess parathyroid hormone, causing high blood calcium levels (hypercalcemia). In secondary hyperparathyroidism, the parathyroid glands function normally, and are secreting extra hormones in response to low blood calcium levels in the body, caused by other health conditions such as kidney failure.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.