Hyperparathyroidism

Also called parathyroid disease

Hyperparathyroidism is when the parathyroid glands, located in your neck, secrete too much parathyroid hormone.

What is the parathyroid gland?

The parathyroid glands are four small glands (each about the size of a grain of rice) found in the neck, close to the thyroid gland. They produce the hormone called parathyroid hormone (also called PTH). 

This hormone is important because it helps control the amount of calcium and phosphorus in your body. These are necessary for strong bones and teeth. It controls how much calcium is taken from bones, absorbed in the gut and lost in urine (pee).

When too much parathyroid hormone is secreted, levels of calcium in the blood and urine rise, and bones may lose calcium, leading to osteoporosis.

Note: The parathyroid glands are nothing to do with the thyroid gland. Parathyroid means near the thyroid. Parathyroid disorders shouldn't be confused with an underactive thyroid or overactive thyroid.

What causes hyperparathyroidism?

In most cases, the cause of hyperparathyroidism is not known. It may be caused by benign (non-cancerous) tumours in the parathyroid gland, or the parathyroid gland may become overactive (called hyperplasia). In rare cases, it may be caused by cancer of the parathyroid gland. 

Who is at risk of getting hyperparathyroidism?

Hyperparathyroidism is most common in women between the age of 50 and 60 years old (after menopause). People who have had radiation therapy to their neck have a higher chance of getting hyperparathyroidism.

What are the symptoms of hyperparathyroidism?

Most people with hyperparathyroidism have no symptoms. Doctors often diagnose the condition through routine blood tests that show high levels of calcium. When symptoms do occur, they are usually because of ongoing high levels of calcium and may include:

  • pain in the joints
  • feeling tired
  • having weak muscles
  • loss of bone leading to osteoporosis
  • tummy pain, nausea (feeling sick) and vomiting (being sick)
  • constipation (not being able to pass poos)
  • lack of appetite
  • kidney stones
  • feeling thirsty all the time
  • passing urine more often than usual
  • fast, irregular heartbeats.

How is hyperparathyroidism diagnosed?

Doctors usually diagnose hyperparathyroidism after finding a high level of calcium on a blood test. You may also be asked to take a urine test. If your bones have become weak because of abnormal calcium levels, your doctor may request you have a bone density scan.  

How is hyperparathyroidism treated?

There are some different options for treating hyperparathyroidism.The treatment that you have will depend on your condition.

Surgery

The main treatment for hyperparathyroidism is an operation to remove the gland or glands. In most cases, the operation can cure hyperparathyroidism, but not all people will need surgery. People who do not have symptoms usually do not need surgery. You are most likely to need surgery if you have problems with your bones or kidneys.

Watch and wait

If the levels of calcium in your blood are only slightly high and you do not have any symptoms, then your doctor will monitor your condition on an ongoing basis. This will involve having blood tests every six months to check your calcium levels and kidneys. You may also be advised to adopt some self-care measures.

Self-care

Although hyperparathyroidism cannot be prevented, there are a few measures that you can do to look after yourself and prevent harm to your kidneys:

  • avoid any medicines that may further increase your calcium levels, such as thiazide diuretics or lithium
  • avoid dehydration and the chance of kidney stones by drinking enough fluids every day
  • ensure you are having a balanced diet with enough calcium and vitamin D.

Learn more

The following links provide further information on hyperparathyroidism. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Hyperparathyroidism Patient Info, UK

References

  1. Hyperparathyroidism and hypercalcaemia with lithium treatment Medsafe Prescriber Update, 2014, Sept.
  2. Primary hyperparathyroidism: Is vitamin D supplementation safe? AFP, 2011, Nov.
  3. Hyperparathyroidism Am Fam Phyisician, 2004; 69: 333–90.
Credits: Editorial team. Last reviewed: 09 May 2017