Hyperparathyroidism: What to know

Hyperparathyroidism is a disorder in which too much parathyroid hormone is produced in the parathyroid glands. This can cause the levels of calcium in the blood to increase, which can lead to a range of complications without treatment.

Usually , people have four parathyroid glands. Small glands located near the thyroid gland are these. Parathyroid hormone, which is responsible for controlling calcium levels in the body, is released by the parathyroid glands.

This article will take a more detailed look at hyperparathyroidism, including its signs, causes, medications, and potential risk factors.

Types and causes

hyperparathyroidism

Three forms of hyperparathyroidism exist. They are:

Primary hyperparathyroidism

When there is a problem with a parathyroid gland as opposed to an underlying health condition, this type of hyperparathyroidism occurs. The parathyroid glands become overactive in one or more of them, leading to too much parathyroid hormone. This allows the body’s levels of calcium to become too high.

In certain cases, a tumor in one or more of the glands may be responsible for primary hyperthyroidism.

Secondary hyperparathyroidism

Due to a parathyroid gland problem, secondary hyperparathyroidism does not occur. Rather, an underlying disorder, such as kidney disease or low levels of vitamin D, causes the body ‘s calcium levels to decrease. This causes the parathyroid glands to begin producing additional parathyroid hormones.

Tertiary hyperparathyroidism

When an individual has long standing secondary hyperparathyroidism, this form occurs. In people with kidney disorders, this type of hyperparathyroidism usually occurs.

Symptoms of primary and secondary hyperparathyroidism

The symptoms may differ in severity and depend on the type of hyperparathyroidism experienced by a person.

By type, the following sections will look at symptoms.

Primary hyperparathyroidism

Initially, any symptoms are unlikely to arise in people with primary hyperparathyroidism. However, because of the high levels of calcium in the body, they can develop symptoms over time.

These symptoms may include:

Secondary hyperparathyroidism

Secondary hyperparathyroidism may cause bone disease, according to the National Kidney Foundation. This is because high bone turnover is frequently encountered in people with secondary hyperparathyroidism.

When the cells that extract bone function faster than those that build new bone, high bone turnover occurs. This can result in weak and brittle bones, resulting in an increased risk of bone pain and fractures.

The following symptoms can be encountered by a person with secondary hyperparathyroidism as a result of this process:

  • bone irregularities
  • itching of the skin
  • open non-healing wounds

Calciphylaxis may be experienced by some people with secondary hyperparathyroidism.

Calciphylaxis refers to the body’s accumulation of calcium, which can cause chalk-like deposits to form in the skin’s blood vessels. This can narrow the blood vessels and reduce the skin and fatty tissue supply. As a result , blood clots, skin ulcers, infections, and skin necrosis may result.

Diagnosis

Each form of hyperparathyroidism can require distinct tests for a doctor to make a diagnosis because of the variations in the underlying causes.

The sections below will look at diagnosis by type.

Primary hyperparathyroidism

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says physicians can use blood tests to diagnose primary hyperparathyroidism. Blood tests can detect levels of calcium in the blood and parathyroid hormone.

An individual with primary hyperparathyroidism will usually have increased calcium levels or mid-to-high normal levels.

Secondary hyperparathyroidism

In order to diagnose secondary hyperparathyroidism, a doctor can also use blood tests. In order to determine the severity and cause of the disorder, a person with secondary hyperparathyroidism may also require urine and kidney tests.

Additionally, to detect bone softening, bone loss, or fractures, doctors can use a bone density X-ray, also known as a DEXA scan.

When to see a doctor

The result of kidney disease can be secondary hyperparathyroidism. For this reason, if they experience kidney stones, kidney inflammation, or kidney infections, a person should talk to a doctor.

An individual should also try talking to a doctor if they notice any of the following symptoms:

  • difficulty sleeping
  • muscle cramps
  • shortness of breath
  • swollen ankles, feet, or hands

Treatments

Hyperparathyroidism treatment will also depend on which form an individual has.

The sections below will look at treatment options by type.

Primary hyperparathyroidism

Primary hyperparathyroidism treatment can 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.

Secondary hyperparathyroidism

Vitamin D supplements and calcimimetics are also used in treating secondary hyperparathyroidism.

However, to decrease the absorption of dietary phosphate, people might also need phosphate binders. This is because individuals with kidney disorders may have increased phosphate levels in their bodies.

The following foods are good sources if a person needs an increase in their vitamin D intake:

  • salmon
  • trout
  • swordfish
  • mackerel
  • yogurt
  • 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.

Risk factors

At any stage of their life, a person may develop hyperparathyroidism. Certain individuals, however, are at higher 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.

Complications

Various complications may arise from various forms of hyperparathyroidism.

The sections below will look at some possible complications by type.

Primary hyperparathyroidism

The NIDDK states that the following are potential complications of primary hyperparathyroidism:

Secondary hyperparathyroidism

The complications of secondary hyperparathyroidism may include:

  • calciphylaxis
  • bone irregularities
  • fractures
  • immune dysfunction
  • muscle atrophy

Outlook

In certain cases of primary hyperparathyroidism, having undergone surgery can help address the problem. Surgery may help relieve the symptoms and allow a person to proceed as usual with their life.

Due to complications, secondary hyperparathyroidism is likely to have a major negative effect on the quality of life of an individual. The symptoms, however, can improve with medication and become easier to manage.

Summary

When too much parathyroid hormone is released by the parathyroid glands, it can contribute to hyperparathyroidism.

There are two major 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 disorder.

The wellbeing and quality of life of a person may be adversely affected by hyperparathyroidism. However, a person may increase their chance of recovery and decrease their risk of long-term complications with prompt treatment.

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