Hyperparathyroidism
What is Hyperparathyroidism? Hyperparathyroidism is the abnormally high concentration of parathyroid hormones in the blood, resulting in the loss or absence of calcium in the bones, which leads to the weakening of bones. Read More
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Hyperparathyroidism
Table of contents
What is Hyperparathyroidism?
Hyperparathyroidism is the abnormally high concentration of parathyroid hormones in the blood, resulting in the loss or absence of calcium in the bones, which leads to the weakening of bones.
What are the types of hyperparathyroidism?
Hyperparathyroidism can be categorized into the following:
- Primary Hyperparathyroidism
This occurs when one or more of the parathyroid glands has a problem leading to an excess release of parathyroid hormones. Often caused by a benign growth or cancerous tumor in the gland.
- Secondary Hyperparathyroidism
This occurs when an underlying condition such as chronic kidney failure causes calcium and vitamin D levels to decrease.
- Tertiary Hyperparathyroidism
This occurs when parathyroid glands produce parathyroid hormones, even when the calcium level is normal.
Causes
Hyperparathyroidism is a health disorder caused by an abnormal release of excess parathyroid hormones from parathyroid glands in the neck into the bloodstream.
Parathyroid hormone regulates calcium levels in the blood, largely by increasing the level when calcium is too low.
Bones have a very large calcium deposit, and so when there is a shortfall of calcium in the blood, the parathyroid hormones stimulate the release of calcium from the bones into the bloodstream.
However, with the high concentration of parathyroid hormones, there is excessive stimulation of calcium release from the bones into the blood, which can result in a decrease of calcium in the bones. This decrease of calcium stored in the bone results in the weakening of the bone and decreases the formation of new bones.
Symptoms
Often, symptoms take a long time to develop, but when they occur, they may include the following:
- Excessive thirst
- Fatigue
- Frequent and excess urination
- Loss of appetite
- Depression
- Nausea
- Muscle weakness
- Kidney stones
- Osteoporosis; weakness and breaking of bones.
How is hyperparathyroidism diagnosed?
On the occurrence of symptoms, one should visit and consult a doctor. After going through the medical history and physical examination, these tests may be recommended:
Laboratory Tests; to check the level of calcium in the body, such as:
Imagery Tests such as:
- Dual Energy X-ray Absorptiometry (DEXA); bone mineral density test to reveal if the patient has developed osteoporosis.
- Abdominal X-ray; to determine if they have kidney stones or other kidney abnormalities.
- Sestamibi Parathyroid Scan; to check abnormalities in the parathyroid glands.
- Computerized Tomography (CT)
- Ultrasound Transducer.
How is hyperparathyroidism treated?
Hyperparathyroidism can be treated, managed, and controlled through the use of the following:
Medications
- Calcium mimetics such as Cinacalcet (Sensipar); regulate the level of calcium stimulation from the bones.
- Hormone Replacement Therapy; to regulate parathyroid hormone levels.
- Bisphosphonates.
Surgery
- Minimally Invasive Radioguided Parathyroid (MIRP) Surgery; to stop the parathyroid glands from producing excess parathyroid hormones.
- Parathyroidectomy; surgery to remove damaged and irreparable parathyroid glands.
- Parathyroid Transplant; a transplant of one parathyroid gland from a donor if all 4 parathyroid glands are damaged and removed.
Home Management Remedies
The patient can adhere to the following guidelines to help control the condition:
- Monitor the dietary calcium and vitamin D intake as recommended by the dietician.
The daily recommended calcium intake for adults ages 19 to 50 and males ages 51 to 70 is 1000mgCa/day. Females of age 51 and older and males of age 71 and older have a recommended dose of 1200mgCa/day. The daily recommended vitamin D intake for people of age 1 to 70 is 600IUs/day and for adults of age 71 and older is 800IUs/day.
- Drink plenty of fluids, mostly water.
- Engage in regular exercise.
- Do not smoke or take hard drugs.
- Avoid calcium-raising drugs such as diuretics, lithium, etc.
FAQ
Hyperparathyroidism may go on its own if it is less severe. Otherwise, one may live with it for about 10 years without causing too many problems. Problems that may begin to occur include kidney stones, osteoporosis, memory loss, excessive urination, thirst, nausea, weakness, etc. However, one should not be careless and leave it untreated as the condition can kill when it is advanced, like beyond 15 to 20 years without medications.
The three types of hyperparathyroidism are:
1) Primary,
2) Secondary,
3) Tertiary.
Chronic fatigue is an experience of a hyperparathyroidism patients, which makes them less active and more prone to weight gain.
Hospitalization after parathyroid surgery may be more than one night, depending on the type of surgery carried out and the recovery rate of each surgery.
Minimally invasive parathyroid surgery has lesser hospital time, which can be a day or less, compared to parathyroid surgery or transplant. Rarely, all 4 parathyroid glands may be removed, and sometimes, one can be transplanted. A transplant has more hospital stay time because the patient’s adaptation to the new organ has to be monitored.
Certain side effects are prominent after parathyroidectomy. The patient may experience the following:
1) Hoarseness of voice
2) Low blood calcium levels
3) Weakness.
The complications associated with hyperparathyroidism are listed below:
1) Osteoporosis– It is caused due to loss of calcium in the bones and often results in weak, brittle bones
2) Neonatal hypoparathyroidism- It occurs during pregnancy due to severe untreated low levels of calcium in newborns
3) Cardiovascular diseases
4) Kidney stones
The risk factors associated with hyperparathyroidism are:
1) Women who have attained menopause
2) A patient who is suffering from prolonged calcium and vitamin D deficiency
3) Patients who are diagnosed with rare inherited genetic disorders such as MEN1 (multiple endocrine neoplasias), which usually affect the multiple glands.
4) Patients who are under certain medications such as lithium which is most commonly used to treat bipolar disorders.
5) Exposure to radiations
In most cases, one cannot prevent hyperparathyroidism.
