What is hyperparathyroidism?

Hyperparathyroidism occurs when 1 or more of your parathyroid glands are overactive. You have 4 of these tiny glands. Each one is about the size of a grain of rice. They are found in your neck, next to the thyroid gland. They keep the amount of calcium in your blood in a normal range. If these glands are overactive, they make too much parathyroid hormone (PTH). That raises the level of calcium in your blood.

PTH causes calcium to be released from your bones. This loss of calcium from the bones can lead to osteoporosis, osteopenia, and bone fracture. When the blood with this high calcium goes through the kidneys, the calcium may be filtered into the urine. That can lead to kidney stones.

What causes hyperparathyroidism?

Hyperparathyroidism most often happens when one of your parathyroid glands gets larger or has a tumor on it. The gland then makes too much parathyroid hormone. Most people with this problem have 1 abnormal gland. Some people may have 2 abnormal glands. A small number of people have 4 abnormal glands. Having 4 abnormal glands is rare. It is often a genetic problem.

Who is at risk for hyperparathyroidism?

These things may make it more likely for you to have hyperparathyroidism:

• Age and sex. It is more common in women who have gone through menopause.
• Genetics. People with a family history of related conditions are more likely to have this health problem.
• Radiation therapy. People who have had this treatment on the head and neck have a high risk.
• Lithium. This medicine is used to treat bipolar disorder.

What are the symptoms of hyperparathyroidism?

Each person may have symptoms in a different way. But these are the most common symptoms and signs:

• Joint aches and pains
• Depression
• Abdominal pain
• Gastroesophageal reflux disease (GERD)
• Peptic ulcer disease
• Pancreatitis
• Tiredness
• Urinating more than normal
• Confusion
• Muscle weakness
• Osteoporosis
• Kidney stones

These symptoms may look like other health problems. Always see your health care provider for a diagnosis.

How is hyperparathyroidism diagnosed?

A blood test can often find hyperparathyroidism. It can spot high levels of calcium and parathyroid hormone. You may also need a urine test. This can measure the calcium in your urine over 24 hours.

How is hyperparathyroidism treated?

Your health care provider will figure out the best treatment for you based on:

• How old you are
• Your overall health and past health
• How sick you are
• How well you can handle specific medicines, procedures, or therapies
• How long the condition is expected to last
• Your opinion or preference

You may not need treatment if you have a mild case. But your health care provider will watch your condition to make sure it doesn’t get worse. In worse cases, the parathyroid gland may need to be removed. Before surgery, you may have an imaging test to find out which gland is abnormal. You may have an ultrasound of the neck. Knowing which gland is abnormal will shorten the operation.

Living with hyperparathyroidism

You will likely need to have your calcium levels and bone density checked from time to time. Your health care provider will then be able to make sure your problem is under control.

When should I call my health care provider?

Tell your health care provider if your symptoms get worse or you have new symptoms.

Key points about hyperparathyroidism

• Hyperparathyroidism happens when 1 or more of your parathyroid glands are overactive. The glands make too much parathyroid hormone. That raises the level of calcium in your blood. It then lowers the calcium in your bones.
• It most often happens when a parathyroid gland gets larger or has a tumor on it.
• The loss of calcium from the bones can lead to osteoporosis, osteopenia, and bone fracture.
• A routine blood test can spot high levels of calcium.
• The only treatment is surgery. The abnormal gland is removed.

Next steps

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.