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Primary hyperparathyroidism is an endocrine disorder in which the parathyroid glands in the neck produce too much parathyroid hormone (PTH).
See also:
Alternative NamesParathyroid-related hypercalcemia; Hyperparathyroidism - primary
Causes, incidence, and risk factorsThe parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. They produce parathyroid hormone, which controls calcium, phosphorus, and vitamin D levels within the blood and bone.
When calcium levels are too low, the body responds by increasing production of parathyroid hormone. This increase in parathyroid hormone causes more calcium to be taken from the bone and more calcium to be reabsorbed by the intestines and kidney. When the calcium level returns to normal, parathyroid hormone production slows down.
Primary hyperparathyroidism is caused by swelling of one or more of the parathyroid glands. This leads to the release of too much parathyroid hormone, which raises the level of calcium in the blood. The term "hyperparathyroidism" generally refers to primary hyperparathyroidism.
Rarely, the disease is caused by parathyroid cancer.
The disease is most common in people over 60, but can also be seen in younger adults. Hyperparathyroidism in childhood is very unusual.
Women are more likely to be affected than men. Radiation to the head and neck increases your risk.
Symptoms- Decreased height
- Depression
- Fatigue
- Fractures
- Increased urination
- Kidney stones
- Loss of appetite
- Muscle weakness and pain
- Nausea
- Personality changes
- Upper abdominal pain
- Stupor and possibly coma
Blood tests will be done to check for increased levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, and lower levels of phosphorus.
Bone x-rays and a bone mineral density test can help detect bone loss, fractures, or bone softening.
X-rays, ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.
TreatmentTreatment depends upon the severity and cause of the condition.
If you have mildly increased calcium levels due to primary hyperparathyroidism and no symptoms, you may just need regular check ups with your doctor.
However, you need treatment if:
- Your kidneys do not work correctly
- You have calcium loss from your bones
- Kidney stones develop
If treatment is needed, it may include:
- Drinking more fluids to prevent the formation of kidney stones
- Movement and exercise
- Avoiding thiazide-type diuretics ("water pills")
- Using estrogen therapy (for postmenopausal women)
If symptoms are present or your calcium level is very high, surgery may be needed to remove the parathyroid gland that is overproducing the hormone. Surgery is also recommended for patients less than 50 years of age.
Treatment for severe symptoms may also include:
- Fluids given through a vein (IV)
- Medications such as bisphosphonates and calcitonin, which bring down calcium levels quickly
The outlook is good for those with mild symptoms. Most cases of primary hyperparathyroidism are mild.
ComplicationsComplications may include:
- Bone damage
- Increased risk of fractures
- Pancreatitis
- Pseudogout
- Urinary tract infection due to kidney stones and blockage
Call for an appointment with your health care provider if you have symptoms of hyperparathyroidism.
ReferencesWysolmerski JJ. Insogna KL. The Parathyroid Glands, Hypercalcemia, and Hypocalcemia. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008: chap. 266.
Bringhurst FR, Demay MB, Kronenberg HM. Disorders of Mineral Metabolism. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008: chap. 27.
AACE/AAES Task Force on Primary Hyperparathyroidism. The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract. 2005 Jan-Feb;11(1):49-54.
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What has the author Leslie N Pyrah written?
Leslie N. Pyrah has written: 'Primary hyperparathyroidism' -- subject(s): Hyperparathyroidism
What is Primary hyperparathyroidism?
Primary hyperparathyroidism occurs as a malfunction of one of the four parathyroid glands which are located in the neck, behind the thyroid gland, usually as a result of a benign tumor, called adenoma.
What is hyperparathyroidism?
Primary hyperparathyroidism occurs as a malfunction of one of the four parathyroid glands which are located in the neck, behind the thyroid gland, usually as a result of a benign tumor, called adenoma.
Is there a relationship between spinal stenosis and primary hyperparathyroidism?
Because the symptoms of HPT vary widely from person to person, spinal stenosis can't be ruled in or out as a sypmptom of Hyperparathyroidism. That said, if you have been diagnosed with HPT, get the offending parathyroid gland(s) removed as that is the only "cure" for HPT.
What causes primary hyperparathyroidism?
A common result of hyperparathyroidism is hypercalcemia, or an abnormally high level of calcium in the blood. Additionally, some, but not all patients who have this disease will also have an above-normal level of PTH or parathyroid hormone, as well as a low vitamin D level. The reason for a low vitamin D level in patients with hyperparathyroidism is a protective measure by the body. The primary purpose of vitamin D is to allow the intestines to absorb calcium. When the body detects higher than normal calcium, it restricts the amount of vitamin D that is produced by the skin.
What causes high calcium in blood?
High calcium in the blood is called hypercalceamia. It can have various causes but Primary hyperparathyroidism and malignancy account for about 90% of cases of hypercalcaemia
What do you do about hyperparathyroidism if you can not get in to see an endocrinologist?
The cure for primary hyperparathyroidism is surgery. There are no other effective treatments. Additionally, you don't necessarily need to see an endocrinologist to be diagnosed with this condition. Most primary care physicians aren't well-educated on this condition and don't diagnose it properly. Request Calcium, PTH and Vitamin D level blood tests from your doctor. Then have them check in another eight weeks. If calcium levels are high, I recommend you visit the link below and read in great detail, then forward to your doctor. DO NOT allow hyperparathyroidism to go untreated. It won't get better on its own. It will only get worse.
What is the cause of primary hyperparathyroidism?
The etiology of hyperparathyroidism is increased production of the parathyroid hormone. The levels of calcium and phosphorus are governed by the secretion pf PTH, parathyroid hormone, which regulates body temperature.
Can you have normal calcium and high pth level?
Yes, it is possible to have normal calcium levels while having high parathyroid hormone (PTH) levels. This condition is often seen in cases of secondary hyperparathyroidism, where the body produces excess PTH in response to low calcium levels or vitamin D deficiency, despite total calcium levels being within the normal range. Additionally, certain conditions like primary hyperparathyroidism can occasionally present with normal calcium levels due to compensatory mechanisms. Always consult with a healthcare professional for proper evaluation and diagnosis.
How can hypoparathyroidism be prevented?
There is much dispute about ways to prevent hyperparathyroidism. The actual cause of the disease is absolutely and unequivoicably unknown. This is important to know before reading the following information. Also, your best resource for becoming educated on hyperparathyroidism is www.parathyroid.com as linked below. I know this because I was personally misdiagnosed for more than 20 years until I found that website.TreatmentNutritional TherapyLimiting intake of soft drinks can help to prevent hyperparathyroidism. Soda drinks contain high levels of phosphorus. High phosphorus intake can cause hypocalcemia that leads to secondary hyperparathyroidism. In patients with hyperparathyroidism, forcing fluids and reducing intake of calcium-rich foods can help decrease calcium levels prior to surgery or if surgery is not necessary. These patients should not take any supplements that contain calcium without a doctor's approval.Allopathic TreatmentHyperparathyroidism cases will usually be referred to an endocrinologist, who is a physician specializing in hormonal problems, or a nephrologist, who specializes in kidney and mineral disorders.Patients with mild cases of hyperparathyroidism may not need immediate treatment if they have only slight elevations in blood calcium level and normal kidneys and bones. These patients should be regularly checked, probably as often as every six months, by physical examination and measurement of kidney function and calcium levels. A bone densitometry-a test to diagnose and monitor osteoporosis or thinning of bones-measurement should be performed every one or two years. After several years with no worsened symptoms, the length of time between tests may be increased.Patients with more advanced hyperparathyroidism usually will have all or half of the affected parathyroid gland or glands surgically removed. This surgery is relatively safe and effective. The primary risks are those associated with general anesthesia. There are some instances in which the surgery can be performed with the patient under regional, or cervical (neck) block, anesthesia. Often such studies as ultrasonography-a test with high-frequency sound waves (ultrasound) that are bounced off tissues and echoes are converted to pictures called sonograms-prior to surgery help pinpoint the affected areas.Treatment of secondary hyperparathyroidism involves removing or treating the underlying cause. In 2004, a new drug therapy was shown to lower parathyroid levels and improve calcium and phosphorus function in patients receiving dialysis (a blood-purifying treatment often performed on people with kidney diseases) who had uncontrolled secondary hyperparathyroidism. The drug, called cinacalcet, was approved by the U.S. Food and Drug Administration for people who have chronic kidney disease with secondary hyperparathyroidism.Source: http://www.answers.com/hyperparathyroidism?gwp=11&ver=2.3.0.609&method=3The link below has the most recent, reliable, and accurate information on hyperparathyroidism.
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