What is primary hyperparathyroidism?

Your parathyroid glands make parathyroid hormone (PTH). Primary hyperparathyroidism is when one or more of the parathyroid glands makes too much PTH. This can lead to bone tissue loss, high blood levels of calcium, and kidney stones. This condition is more common in women than in men. Sometimes primary hyperparathyroidism is part of a hereditary condition that involves tumors in many parts of the body.

PTH keeps blood calcium levels from going too low. It does this by releasing calcium from bones and reabsorbing calcium from the kidney. The hormone also conserves calcium that would be given off by the kidneys. And it increases how much calcium is absorbed from food. Too much PTH causes too much calcium to be released from bone. And the level of calcium in your blood rises.

What causes primary hyperparathyroidism?

In some cases, no cause can be found. Some known causes include non-cancer (benign) tumors on the parathyroid glands, or enlargement of the glands. When there is a benign tumor in a parathyroid gland, it is called a parathyroid adenoma. When more than one gland becomes enlarged, it is called parathyroid hyperplasia. Both of these conditions are noncancer. In rare cases, it can be caused by a tumor that is cancer or a cyst that is noncancer.

What are the symptoms of primary hyperparathyroidism?

Each person may experience symptoms differently. Symptoms of too much calcium in the blood may include:

• Constipation

• Frequent urination

• Increased thirst

• Joint pain

• Kidney pain (due to the presence of kidney stones)

• Lack of energy and extreme tiredness (fatigue)

• Loss of appetite

• Muscle weakness

Other serious symptoms may include:

• Belly pain

• Depression

• Memory loss

• Nausea

• Vomiting

The symptoms of primary hyperparathyroidism may look like other health problems. Always talk with your healthcare provider for a diagnosis.

How is primary hyperparathyroidism diagnosed?

The condition may not have any symptoms or complications. Sometimes this problem is found during a routine blood test as part of a physical exam.

You'll likely have additional blood tests done to check the levels of calcium and PTH. You'll also likely have urine tests to check on the level of calcium in your urine and to check your kidney function. Your healthcare provider may want to scan your thyroid. You may also have an ultrasound study of your neck. This could find a parathyroid adenoma. You may also have dual energy X-ray absorptiometry. This test is also called bone densitometry (or DXA scan). It's done to figure out bone density and to reveal loss of bone tissue (as can occur with hyperparathyroidism.) It's also used to help your healthcare provider keep an eye on the condition. Testing can also help decide if surgery may be needed.

How is primary hyperparathyroidism treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Surgery to remove the affected gland may be needed. Treatment may include medicines, regular bone densitometry testing to reveal loss of bone tissue, and follow-up tests of kidney function.

Key points about primary hyperparathyroidism

• Primary hyperparathyroidism is when one or more of the parathyroid glands makes too much hormone. This can lead to bone tissue loss.

• This condition is more common in women than in men.

• Some known causes include noncancer (benign) tumors on the parathyroid glands or enlargement of the glands, or the cause may be unknown.

• Symptoms include loss of appetite, increased thirst, frequent urination, lack of energy and extreme tiredness (fatigue), muscle weakness, joint pain, constipation, and kidney pain.

• Treatment may include regular bone densitometry testing to reveal bone tissue loss and to decide if surgery may be needed.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.