Hyperparathyroidism

Hyperparathyroidism Parathyroid Condition Sydney Endocrine Surgeon

What are the parathyroid glands?

The parathyroid glands are small glands located near or attached to the back of the thyroid gland. There are normally four parathyroid glands and they are usually no larger than a grain of rice. Parathyroid glands regulate the level of calcium in your body by regulating the secretion of PTH (parathyroid hormone).

What is hyperparathyroidism?

Hyperparathyroidism is an elevated level of parathyroid hormone in the blood. Depending on the cause of hyperparathyroidism, this can lead to elevated levels of calcium in the blood (hypercalcaemia). Hyperparathyroidism can be caused by a disorder of the parathyroid glands (primary hyperparathyroidism), which includes the following conditions:

  • Parathyroid adenoma – a benign (non-cancerous) enlargement and hyperfunctioning of one of the parathyroid glands

  • Parathyroid hyperplasia – enlargement of one or more of the parathyroid glands due to an overgrowth of normal cells

  • Parathyroid cancer – this is rare and accounts for less than 1% of all cases of primary hyperparathyroidism

Secondary hyperparathyroidism is excess secretion of PTH in response to hypocalcaemia (low calcium levels. This results in hyperplasia (overgrowth) of the parathyroid glands. This condition is primarily seen in patients with chronic kidney failure.

What are the symptoms of hyperparathyroidism?

Many people with this condition have no symptoms. The symptoms that develop are related to having elevated calcium in their blood (hypercalcaemia). These symptoms include:

  • Joint pain

  • Fatigue

  • Weakness

  • Loss of appetite

  • Stomach pains

  • Depression

  • Trouble concentrating or forgetfulness

  • Constipation

  • Increased thirst

  • Frequent urination

  • Kidney stones

  • Weak bones

How is hyperparathyroidism diagnosed?

Hyperparathyroidism is diagnosed on blood tests. Many people with primary hyperparathyroidism do not have any symptoms. Often, hypercalcaemia is diagnosed on blood tests performed for another reason and hyperparathyroidism is subsequently diagnosed.

Additional tests may be required to identify any other complications of hyperparathyroidism. These include:

  • Bone mineral density test to check for osteoporosis

  • Urine test to check how much calcium is excreted in the urine

If surgery is recommended, other tests such as an ultrasound of the neck and a nuclear medicine scan called a sestamibi scan may be ordered to identify the hyperfunctioning gland.

How is hyperparathyroidism treated?

Surgery is the most common treatment for primary hyperparathyroidism. The surgery aims to remove the gland or glands that are causing the problem. In most cases, surgery cures the condition. Surgery is recommended if you have any of the following:

  • You have very high calcium levels in your blood

  • The high calcium levels are causing problems with your kidneys or bones

  • You are under 50 years of age

Secondary hyperparathyroidism is treated by managing the underlying causes of the hyperparathyroidism (vitamin and mineral deficiencies and underlying kidney problems). Surgery is reserved for patients with severe disease who have hyperparathyroidism that cannot be managed adequately with medical therapy.