The parathyroid glands are tiny glands located in the neck along with the thyroid gland. Although small, these glands are essential in regulating calcium distribution throughout the body. Patients with hyperparathyroidism have an overactive parathyroid gland, which results in elevated levels of parathyroid hormone. Hyperparathyroidism is a common cause of a condition known as hypercalcemia, which is characterized by excess levels of calcium in the bloodstream. Severe cases of hyperparathyroidism may require surgery.
Types of Hyperparathyroidism
Hyperparathyroidism is normally classified as primary or secondary.
This is the most common form of hyperparathyroidism and accounts for approximately 85 percent of cases. It occurs when there is a problem with the growth or functioning of the parathyroid gland.
This form of the condition occurs as the result of another health condition. It is common for patients with kidney failure to develop hyperparathyroidism. Secondary hyperparathyroidism is also associated with multiple endocrine neoplasia, which is a group of disorders affecting the various hormone-producing glands.
Signs and Symptoms of Hyperparathyroidism
Patients often do not develop symptoms until after the excessive calcium production and lack of calcium absorption into the bones has caused damage to various organs and tissues. The high levels of calcium in the blood and urine may cause kidney stones and abdominal pain. Other common symptoms include
- Excessive fatigue and weakness
- Unexplained excessive urination
- Loss of appetite
- Nausea and vomiting
- Frequent fractures and signs of osteoporosis related to decreased bone density
- Memory lapses
How is Hyperparathyroidism Diagnosed?
Since a number of conditions can cause elevated blood calcium levels, diagnosing hyperparathyroidism often involves a process of elimination. A blood test may be performed to confirm the diagnosis. The results will typically show elevated calcium and parathyroid hormone. Additional tests may include imaging tests of the kidneys, urinalysis, and bone mineral density scans.
How is Hyperparathyroidism Treated?
The appropriate treatment for hyperparathyroidism varies based on the severity of the condition and how it is affecting the patient. Mild cases may only require observation and monitoring through regular blood and urine tests. Patients may be encouraged to have periodic bone density scans to ensure that bone strength is not being adversely affected.
Most patients with primary hyperparathyroidism eventually require a surgical procedure known as a parathyroidectomy. This procedure involves removing one of the overactive parathyroid glands in the hopes that blood calcium and parathyroid hormone levels will return to normal. In rare cases, all four of the parathyroid glands are determined to be overactive. In this event, three and a half of the glands will be surgically removed. This leaves a small portion of healthy parathyroid tissue to regulate calcium levels. Any additional tumors affecting the glands may also be removed during the surgery. Medication alone may be sufficient to control cases of secondary hyperparathyroidism.
The risks of surgery to correct issues with the parathyroid gland are low. In rare cases, the patient may require life-long calcium supplements or experience damage to the nerve responsible for controlling the vocal cords.