Hyperparathyroidism

You have 4 pea-sized glands behind the thyroid gland at the front of your neck. These glands are called parathyroids. They make a hormone called parathyroid hormone (PTH) that keeps the right levels of calcium and phosphorus in your body. PTH helps you absorb calcium from your food and keeps you from losing too much calcium through your urine. Sometimes, a growth on the parathyroid glands causes them to make too much PTH. Other times, medical conditions (such as kidney failure and rickets) can cause your parathyroid glands to make too much PTH. This is called hyperparathyroidism.

Most people who have hyperparathyroidism do not experience any symptoms. However, hyperparathyroidism may cause the following symptoms:

Normally, the amount of calcium going into your bones matches the amount of calcium passing out of your bones. This means that the amount of calcium in your bones should stay about the same all the time. If you have hyperparathyroidism, more calcium is coming out of your bones than is going back in. When this happens, your bones might hurt or become weak. Weak bones break more easily and heal slower than normal bones.

The calcium from your bones enters your bloodstream, causing your blood to have too much calcium. Too much calcium in your blood causes high blood pressure. You might also develop kidney stones, because your kidneys are trying to filter out the extra calcium in your blood. Too much calcium in your kidneys might also make you thirsty or increase your need to urinate.

All these things happen so slowly that you may not notice at first.

Nothing you eat or do causes this disease. More women develop hyperparathyroidism than men. Hyperparathyroidism is also more common in older people. You have about a 2 in 1,000 chance of developing this disease if you are a woman more than 65 years old. People who have vitamin D deficiency are also at an increased risk of developing hyperparathyroidism.

Hyperparathyroidism is also hereditary (which means it runs in families).

Hyperparathyroidism is most often suspected when a high level of calcium is found in your blood on a routine blood test, especially since symptoms of hyperparathyroidism are often not present. The test results can help your family doctor make the diagnosis even before any problems start. This is one benefit of having regular blood tests. Further blood testing proves the diagnosis, usually by measuring the amount of PTH in your blood.

A special scan can find any abnormal growth on your parathyroid gland, if that is what is causing your hyperparathyroidism. Regular X-rays look normal until late in the disease, so they aren't much help in diagnosing hyperparathyroidism. Other causes of increased calcium in the blood, such as some medicines or cancer, must sometimes be considered.

If a growth on your parathyroid is causing your hyperparathyroidism, surgery to remove it usually solves the problem. The growth doesn't typically come back. Most of your symptoms will stop in the first month after surgery. For a short time after surgery, your blood calcium level may be too low. This problem is treated with medicine.

Surgery is usually recommended for people who have hyperparathyroidism and are experiencing moderate to severe symptoms. If you are not experiencing any symptoms or your symptoms are not severe, your doctor may recommend treatment with medicine alone. Medicines can treat some (but not all) of the symptoms of hyperparathyroidism. If you don't have surgery, tests are needed from time to time to see if the disease is hurting your kidneys, bones or other body systems. Special machines can check your bone strength. This treatment approach is called watchful waiting.

Most people feel much better after treatment when the discomforts that they have been trying to live with go away.

If a medical condition is causing your hyperparathyroidism, treatment is aimed at treating the underlying cause.