HYPERPARATHYROIDISM

 Basic information

description

Hyperparathyroidism occurs when the parathyroid glands become overactive and produce too much parathyroid hormone (PTH). The parathyroids are four pea-sized glands located next to the thyroid gland in the neck. PTH helps maintain the body's levels of certain minerals. Excess PTH leads to high calcium levels (hypercalcemia) and low phosphorous levels in the blood. Hyperparathyroidism is more common in older adults and in women more than men.

FREQUENT SIGNS & SYMPTOMS

• There may be no symptoms, or the symptoms may be mild to severe. It comes on over years and may be first diagnosed on routine blood tests.
• Feeling tired, depressed, or forgetful.
• Muscle weakness and bone and joint pain.
• Loss of appetite, thirst, frequent urination, weight loss, or constipation.
• Nausea, vomiting.
• Severe side (flank) pain caused by kidney stones.
• Easy bone fractures due to osteoporosis.
• High blood pressure.
• Pain in the upper abdomen caused by a peptic ulcer or pancreatitis (inflammation of the pancreas).

causes

• Primary hyperparathyroidism begins in the parathyroid itself. It is often caused by a benign tumor (adenoma) that grows in one or two of the parathyroid glands. Why the tumors occur is unknown. Enlargement of the glands (hyperplasia) is another cause, and why this occurs is also unknown. Rarely, cancer or a hereditary disorder is the cause.
• Secondary hyperparathyroidism is due to disorders (e.g., kidney failure) that affect parathyroid function.

risk increases with

• Older adults; females over age 50.
• Severe vitamin D or calcium deficiency, kidney disease, certain cancers, malnutrition, or malabsorption.
• Family history of hyperparathyroidism and certain inherited conditions.
• Radiation therapy that affected the neck.
• Use of the drug lithium.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

• Surgery usually solves the problem of primary type.
• With secondary type, outcome depends on the cause. It can require parathyroid surgery if it no longer responds to treatment (tertiary hyperparathyroidism).

possible complications

• Weak bones (osteopenia and osteoporosis), kidney problems, ulcers, pancreatitis, or heart problems.
• Rarely, surgery complications may occur.

 diagnosis & treatment

general measures

• Your health care provider will usually do a physical exam and ask questions about any symptoms. Urine and blood studies are done to check levels of calcium, phosphorus, and PTH. Bone scans may be done.
• Severe symptoms may require hospital care.
• Primary hyperthyroidism:
  • Surgery is usually the best form of treatment. The parathyroid gland or glands that are producing the excess hormones are removed. There are different types of operations that are done. Your health care provider will explain them to you.
  • In mild cases, or if there are no symptoms, or surgery is not desired, watchful waiting may be an option. This means monitoring the patient for a time to see if the disorder worsens.
• Secondary hyperthyroidism:
  • Treatment depends on the underlying cause and may include drug therapy and/or surgery.

medications

• Estrogen for postmenopausal females may be prescribed.
• Bone-building drugs or a special form of vitamin D may be prescribed.

activity

• Follow medical advice about activities after surgery.
• Exercise daily to maintain good health.

diet

• Drink extra water to help prevent complications.
• Your health care provider will discuss the amount of daily calcium intake that is recommended.

 notify our office if

• You or a family member has hyperparathyroidism symptoms.
• Any new symptoms occur after or during treatment.

Special Notes: