Hyperparathyroidism

Hyperparathyroidism

Hyperparathyroidism is a condition when your parathyroid glands create excess parathyroid hormone in the bloodstream. The parathyroid glands are located behind the thyroid at the bottom of the neck and are about the size of a grain of rice. The parathyroid glands produce parathyroid hormones for your body, which helps maintain a proper balance of calcium in the bloodstream as well as in the tissues that require calcium in order to properly function. It is also important to note that despite having similar names, the parathyroid glands and the thyroid are quite different organs. Some people having this condition don’t experience any symptoms and also don’t require any treatment. Others can have mild or severe symptoms that may require surgery.

Symptoms

Sometimes hyperparathyroidism may be diagnosed before the signs and symptoms become apparent. However, when the symptoms do occur, they are usually the result of damage or dysfunction in other organs or tissues because of calcium levels in the blood and urine or too little calcium in the bones.

In some cases, the symptoms might be mild and nonspecific so that they don’t seem related to this condition. Or in some cases, they might even be severe. The signs and symptoms can include any of the following:

  • Osteoporosis
  • Kidney stones
  • Getting tired easily or weakness
  • Depression
  • Forgetfulness
  • Excessive urination
  • Abdominal pain
  • Bone and joint pain
  • Nausea, vomiting or loss of appetite
  • Frequent complaints of illness without any apparent cause

 

 

If you see any signs and symptoms of hyperparathyroidism, it might be important to see a doctor. These symptoms might be caused by multiple disorders, which can include some serious complications. Therefore, a prompt accurate diagnosis is important for appropriate treatment.

Types

There are two main types of hyperparathyroidism.

In primary hyperparathyroidism, there is an enlargement of one or more of the parathyroid glands which leads to overproduction of the hormone. This can cause high calcium levels in the blood, which can lead to a variety of health problems. Surgery is usually the most common treatment for this type of hyperparathyroidism.

Secondary hyperparathyroidism generally occurs due to other ailments that initially causes low calcium levels in the body. Over time, increased parathyroid hormone levels may also occur.

Tertiary hyperparathyroidism occurs when your parathyroid glands create too much parathyroid hormones after your calcium levels return to normal. This type generally occurs among people who are suffering from kidney problems.

Causes & risk factors

Hyperthyroidism is caused when one or more of your parathyroid glands become overactive and creates an excess of parathyroid hormones. This can be caused by a tumor, enlargement of the gland, or other structural problems of the parathyroid gland.

When the calcium levels are quite low, your parathyroid glands respond by increasing their production of parathyroid hormones. This leads to your kidneys and intestines absorbing a larger amount of calcium. It also helps to remove more calcium from your bones. Parathyroid hormones return to normal when your calcium level rises up again.

The following factors may increase your risk of primary hyperparathyroidism:
You may be at an increased risk of primary hyperparathyroidism if you:

 

  • Have had a prolonged or severe deficiency of calcium or vitamin D
  • Are a woman who has gone through menopause
  • Have a rare, inherited disorder like multiple endocrine neoplasia, type 1, which is known to affect multiple glands
  • Have taken lithium, a drug which is mostly used for the treatment of bipolar disorder
  • Have been treated with radiation therapy for cancer that has exposed your neck to radiation

Diagnosis

Your health care provider can suspect that you have hyperparathyroidism if high levels of calcium are detected in your blood during your routine blood tests. In order to confirm this diagnosis, your health care provider is going to need to perform a few other tests.

Blood Tests

Additional blood tests are going to help your health care provider make an accurate diagnosis. Your health care provider is then going to need to check your blood for high levels of parathyroid hormones, high alkaline phosphatase levels, as well as low levels of phosphorus.

Urine Tests

A urine test will also help your primary care provider understand how severe your condition is and whether kidney problems are causing it. Your doctor is going to check your urine in order to check how much calcium it contains.

Kidney Tests

Your health care provider may take X-rays of your abdomen in order to check for abnormalities in the kidney.

Treatment

In the following conditions, your doctor might recommend no treatment and only regular monitoring:

  • The calcium levels of your body are only slightly elevated
  • You are not having symptoms that require treatment
  • Your kidneys are functioning normally, and you don’t have kidney stones
  • Your bone density is quite normal or only slightly below normal

 

If you choose this watch-and-wait approach, tests to monitor your blood-calcium levels and bone density will be required periodically.

Surgery

Surgery is the common treatment, in most cases, for primary hyperparathyroidism, and in most cases, it provides a cure as well. A surgeon is only going to remove only those glands that are enlarged or the glands that have a tumor.

If all the four glands are affected, then your surgeon is likely going to remove three glands and probably a portion of the fourth. He/she will be leaving some functioning parathyroid tissue.

Surgery can also be done as an outpatient procedure, as this will allow you to go home the same day. In such cases, the surgery can also be done with the help of very small cuts i.e. incisions, in the neck, and only local anesthetics are provided.

Complications from surgery can happen, although it is uncommon. Sometimes there might be damage to the nerves that control the vocal cords. There might be low calcium levels that require the use of calcium as well as vitamin D supplements.

Complications

Complications of hyperparathyroidism are mostly related to the long-term effect of having very little calcium in your bones and excess in your bloodstream. Some of the common complications include:

Osteoporosis – The loss of calcium can sometimes result in weak and brittle bones that can get fractured easily.

Cardiovascular disease – Although the exact link of the cause is unclear, high calcium levels are mostly associated with cardiovascular conditions, which can include high blood pressure as well as certain types of heart disease.

Neonatal hypoparathyroidism – Severe, untreated hyperparathyroidism in pregnant women can also sometimes lead to dangerously low levels of calcium in newborn babies

Kidney stones – Excess calcium in your blood might lead to excess calcium in your urine, which can cause tiny and hard deposits of calcium and other substances to form in the kidneys. This can cause a kidney stone. A kidney stone can cause major pain while passing through the urinary tract.

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