HyperparathyroidismSymptoms, Doctors, Treatments, Advances & More
Learn About Hyperparathyroidism
Hyperparathyroidism is a condition in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
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There are 4 tiny parathyroid glands in the neck, near or attached to the back side of the thyroid gland.
The parathyroid glands help regulate calcium absorption, use and removal by the body. They do this by producing parathyroid hormone (PTH). PTH helps regulate calcium, phosphorus, and vitamin D levels in the blood and bone. It is important for healthy bones.
When the blood calcium level is too low, the body responds by making more PTH. This causes the calcium level in the blood to rise.
If one or more of the parathyroid glands grow larger, it may lead to too much PTH. Most often, the cause is a benign tumor of the parathyroid glands (parathyroid adenoma). These benign tumors are common and happen without a known cause.
- The disease is most common in people over age 60, but it can also occur in younger adults. Hyperparathyroidism in childhood is very unusual.
- Women are more likely to be affected than men.
- Radiation to the head and neck increases the risk.
- Some genetic syndromes (multiple endocrine neoplasia I) make it more likely to have hyperparathyroidism.
- In very rare cases, hyperparathyroidism is caused by parathyroid cancer.
Medical conditions that cause low blood calcium or increased phosphate can also lead to hyperparathyroidism. Common conditions include:
- Conditions that make it hard for the body to remove phosphate
- Kidney damage or failure
- Not enough calcium in the diet
- Too much calcium lost in the urine
- Vitamin D disorders (may occur in children who do not eat a variety of foods, and in older adults who do not get enough sunlight on their skin or who have poor absorption of vitamin D from food such as after bariatric surgery)
- Problems absorbing nutrients from food
Hyperparathyroidism is often diagnosed by common blood tests before symptoms occur.
Symptoms are mostly caused by damage to organs from high calcium level in the blood, or by the loss of calcium from the bones. Symptoms can include:
- Bone pain or tenderness
- Depression and forgetfulness
- Feeling tired, ill, and weak
- Fragile bones of the limbs and spine that can break easily
- Increased amount of urine produced and needing to urinate more often
- Kidney stones
- Nausea and loss of appetite
If you have a mildly increased calcium level and don't have symptoms, you may choose to have regular checkups or get treated.
If you decide to have treatment, it may include:
- Drinking more fluids to prevent kidney stones from forming
- Exercising
- Not taking a type of water pill called thiazide diuretic
- Estrogen for women who have gone through menopause
- Having surgery to remove the overactive glands
If you have symptoms or your blood calcium level is very high, you may need surgery to remove the parathyroid gland that is producing too much PTH.
If you have hyperparathyroidism from a medical condition, your provider may prescribe vitamin D, if you have a low vitamin D level.
If hyperparathyroidism is caused by kidney disease or failure, treatment may include:
- Extra calcium and vitamin D
- Avoiding phosphate in the diet
- The medicine cinacalcet (Sensipar)
- Dialysis or a kidney transplant
- Parathyroid surgery, if the PTH level becomes uncontrollably high
NewYork Presbyterian Columbia University Irving Medical Center
John Bilezikian is an Internal Medicine provider practicing medicine in New York, New York. Dr. Bilezikian is rated as an Elite provider by MediFind in the treatment of Hyperparathyroidism. He is also highly rated in 21 other conditions, according to our data. His clinical expertise encompasses Hyperparathyroidism, Hypoparathyroidism, Hypercalcemia, Parathyroidectomy, and Hormone Replacement Therapy (HRT).
Northwell Health Physician Partners Endocrinology At East 59th Street
"Natalie E. Cusano, MD, MS is the Director, Bone Metabolism Program, Division of Endocrinology, Lenox Hill Hospital. She provides compassionate care to patients with endocrine issues such as diabetes and thyroid disease, with a special interest in osteoporosis and bone health. She received her undergraduate training at the Massachusetts Institute of Technology and her medical training at the Boston University School of Medicine. She completed residency training in Internal Medicine at Beth Israel Deaconess Medical Center in Boston and fellowship training in endocrinology, diabetes and metabolism at the College of Physicians & Surgeons, Columbia University. Dr. Cusano is an Associate Professor of Medicine at the Zucker School of Medicine at Hofstra/Northwell. She is a member of the Katz Institute for Women's Health.Dr. Cusano serves on the editorial board of ""Endocrine Practice"". She also serves as a member of the Endocrine Society's Endocrine Board Review Faculty Group, writing questions for the board review course for the calcium and bone section. She lists over 100 publications of original research, invited articles, chapters, and abstracts in the field of metabolic bone disease. Her family is originally from Uruguay, South America, and she is fluent in Spanish.To view a list of recent publications, please visit these sites:PubMed: https://pubmed.ncbi.nlm.nih.gov/?term=natalie+cusanoResearch Gate: https://www.researchgate.net/search/publication?q=natalie+cusano". Dr. Cusano is rated as an Elite provider by MediFind in the treatment of Hyperparathyroidism. She is also highly rated in 8 other conditions, according to our data. Her clinical expertise encompasses Hypoparathyroidism, Hyperparathyroidism, Postmenopausal Osteoporosis, Parathyroidectomy, and Hormone Replacement Therapy (HRT).
Cleveland Clinic Main Campus
Eren Berber is a General Surgeon practicing medicine in Cleveland, Ohio. Dr. Berber is rated as an Elite provider by MediFind in the treatment of Hyperparathyroidism. He is also highly rated in 29 other conditions, according to our data. His clinical expertise encompasses Thyroid Cancer, Hyperparathyroidism, Pheochromocytoma, Thyroidectomy, and Parathyroidectomy. Dr. Berber is board certified in American Board Of Surgery, 2006.
Outlook depends on the cause of hyperparathyroidism.
Long-term problems that can occur when hyperparathyroidism is not well controlled include:
- Bones become weak, deformed, or can break
- High blood pressure and heart disease
- Kidney stones
- Long-term kidney disease
Parathyroid gland surgery can result in hypoparathyroidism and damage to the nerves that control the vocal cords.
Background: People have 4 parathyroid glands near the thyroid gland in the neck. Surgery is needed to remove a parathyroid gland that is too large or has a tumor. These glands can be in different places, so doctors use an imaging scan with contrast dye to help find them before surgery. Researchers want to know if a different type of scan and a new tracer can make it easier to find the tumors in the parathyroi...
Background: Parathyroid disorders are very common in the general population and include disorders of parathyroid excess, deficiency, or defects in parathyroid hormone (PTH) signaling. PTH, the main secretory product of parathyroid glands is responsible for regulation of calcium-phosphate homeostasis.
Published Date: May 20, 2024
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Reid LM, Kamani D, Randolph GW. Management of parathyroid disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 123.
Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 227.
Walker MD, Bilezikian JP. Primary hyperparathyroidism. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 54.