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HYPERPARATHYROIDISM

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HYPERPARATHYROIDISM

Hyperparathyroidism is a condition characterized by excess parathyroid in the bloodstream due to overactivity of one or more of the parathyroid glands.

  • There are four parathyroid glands in the body. They are about the size of a grain of rice and are located in the neck
  • The parathyroid glands produce parathyroid hormone (PTH), which helps keep the amount of calcium in the blood and in tissues that depend on calcium for functioning at the right level
  • There are two types of hyperparathyroidism, primary and secondary
  • In primary hyperparathyroidism, one or more of the parathyroid glands spontaneously produce an excessive amount of PTH, causing the level of calcium in the blood to rise. This can result in a variety of health problems
  • In secondary hyperparathyroidism, an underlying condition causes low levels of calcium in the body and over time, increased parathyroid hormone level occurs. This happens because the low calcium levels prompt the body to release excessive PTH in an attempt to keep it normal and compensate for the loss
  • Older women, usually between the ages of 50 and 60 are the most likely to have hyperparathyroidism.

CAUSES

Primary hyperparathyroidism occurs because of problems with one or more of the parathyroid glands. This may include:

  • A noncancerous growth (parathyroid adenoma). This account for 80% of all cases of primary hyperparathyroidism
  • A cancerous growth (parathyroid cancer). This is a rare cause of primary hyperparathyroidism
  • Enlargement of at least two parathyroid glands

Secondary hyperparathyroidism is a result of another medical condition. This may include:

  • Severe calcium deficiency
  • Chronic kidney failure
  • Severe vitamin D deficiency

An increased risk of developing the condition occurs in people who:

  • Have had prolonged, severe calcium or vitamin D deficiency
  • Have taken lithium, a drug most often used in treating bipolar disorder
  • Have been exposed to radiation from cancer treatment
  • Have inherited certain disorders that affect several glands throughout the body, such as multiple endocrine neoplasia

SYMPTOMS

In many cases, people who have the condition do not have any symptoms. However, when symptoms occur, they may include:

  • Joint pains
  • Fatigue
  • Thinning bone (osteoporosis)
  • Excessive urination
  • Abdominal pain
  • Depression
  • Kidney stones
  • Loss of appetite
  • Nausea or vomiting
  • Muscle weakness
  • Cognitive impairments

DIAGNOSIS AND TREATMENT

If a routine blood test shows a high level of calcium in your blood, hyperparathyroidism might be suspected.

To confirm this diagnosis, the doctor will need to perform other tests, such as:

  • Additional blood tests to make a more accurate diagnosis
  • Urine tests to help determine the severity of your condition
  • Bone mineral density test to measure the amount of calcium and other bone minerals packed into a segment of bone
  • Imaging tests such as X-ray of the abdomen, kidney ultrasound to look for kidney stones

TREATMENT

The doctor may recommend no treatment and regular monitoring if:

  • Your calcium levels are slightly elevated
  • Your kidneys are functioning normally, and no kidney stones are present
  • Your bone density is normal or just slightly below normal
  • You have no other symptoms that may improve with treatment

Periodically scheduled tests are recommended for this treatment option. This aims to help monitor your blood-calcium levels and bone density.

Medications including calcimimetics, bisphosphonates, or hormone replacement therapy for women who have gone through menopause and has symptoms of osteoporosis.

Surgery is the most common treatment for primary hyperparathyroidism and provides 95% chances of cure. During surgery, a surgeon will remove only those glands that have a tumor or are enlarged.