Overview

What Is Hyperparathyroidism?

Hyperparathyroidism is a condition in which there is a high level of calcium in the bloodstream because there is too much parathyroid hormone (PTH) in the bloodstream. 

PTH is made by the parathyroid glands, which are four tiny glands located next to the thyroid gland. In hyperparathyroidism, one or more of these glands produce too much PTH, which causes the increased calcium in the bloodstream.

Untreated hyperparathyroidism can eventually cause osteoporosis and bone fractures. Common symptoms include:

• Low energy
• Thin bones
• Joint pain
• Constipation
• Kidney stones
• Muscle weakness
• Excessive urination

Primary hyperparathyroidism is caused by benign tumors of the parathyroid glands, overgrowth of the glands, or cancers in the parathyroid glands. Parathyroid cancer is extremely rare.

Secondary hyperparathyroidism occurs when the parathyroid glands produce excess PTH in response to low blood calcium levels caused by kidney failure, vitamin D deficiency, gastric bypass, or calcium deficiencies.

The Northwestern Medicine Comprehensive Thyroid and Endocrine Surgery Program can diagnose hyperparathyroidism using blood tests to determine the amount of calcium and PTH in the blood, urine tests, bone mineral density tests, and imaging tests of the kidneys to detect kidney stones and other abnormalities.

An ultrasound of the neck, a sestamibi scan (which uses a radioactive compound injected into the bloodstream), or other imaging studies may also be performed to localize an overactive parathyroid gland. It is not necessary to have these studies completed before seeing the physicians in the Comprehensive Thyroid and Endocrine Surgery Program.

Treatment

Primary hyperparathyroidism is typically treated by removing only the parathyroid glands that are enlarged or contain a tumor. If all four glands are affected, your surgeon may remove only three glands and part of the fourth to leave as much parathyroid function as possible.

Patients may have to use calcium and vitamin D supplements to counteract low blood calcium levels after the surgery.

There are no medications that can treat primary hyperparathyroidism. Medications such as calcimimetics (like Sensipar) that cause the parathyroid glands to produce less PTH can be used for patients with secondary hyperparathyroidism due to kidney failure.

Your doctor may also recommend lifestyle changes such as monitoring your calcium intake, drinking water to prevent kidney stones, exercising regularly and quitting smoking to help prevent bone loss.