The parathyroid glands are four small glands found at the back of the thyroid gland in the neck. The parathyroid glands are responsible for secreting the parathyroid hormone (PTH) into the bloodstream. Hyperparathyroidism is when these glands are too active and secrete more PTH than is healthy.
PTH is responsible for regulating the level of calcium in the bones and bloodstream. When there is too much PTH, calcium is drawn (leached) out of the bones, into the bloodstream and removed by the kidneys. The imbalance of calcium can cause a range of problems, although most people with too much PTH are not aware of their condition.
Hyperparathyroidism is diagnosed in about one of every 1000 men and 2-3 of every 1000 women.
The parathyroid glands, located at the back of the thyroid gland, secrete parathyroid hormone.
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.
A large gland located in the lower front part of the neck that produces hormones that regulate metabolism, growth and development, especially during childhood.
This is when a problem with the parathyroid gland itself makes it secrete too much PTH. The most common causes of this is a benign (non-cancerous) tumor (known as an adenoma) in one or more of the parathyroid glands.
In 75-85% of cases, only one gland develops an adenoma [1] . In uncommon cases, all four parathyroid glands are enlarged and over-secreting (a condition known as parathyroid hyperplasia). In rare cases, only two of the glands are enlarged.
Very rarely, the tumor is not benign, but cancerous (parathyroid cancer) [1] .
There are also some cases in which additional parathyroid glands are found in the thyroid area (or, rarely, elsewhere in the body). These can sometimes be the cause of hyperparathyroidism.
When a problem in the body, such as chronic kidney problems or vitamin D deficiency, lowers blood calcium levels, the parathyroid gland secretes more PTH.
Secondary hyperparathyroidism is not a medical problem, but a normal response of the body.
When secondary hyperparathyroidism has gone on for a long time, the body has become used to secreting a lot of PTH. The parathyroid glands compensate by secreting too much PTH.
Also known as 'parathyroid storm', this is a rare medical emergency. It is a complication of primary hyperparathyroidism and is usually associated with a parathyroid cancer, in which blood calcium levels become several times higher than normal. It has serious effects on the brain and nervous system, and requires immediate surgical intervention.
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
The extensive network of cells and structures that is responsible for activating and coordinating the body's functions, sensory input and cognition.
A large gland located in the lower front part of the neck that produces hormones that regulate metabolism, growth and development, especially during childhood.
A growth caused by an abnormal and uncontrolled reproduction of cells.
A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.
A rare cancer that arises within one or more of the four parathyroid glands located in the neck. These glands produce parathyroid hormone (PTH), a natural chemical that regulates the amount of calcium and phosphate in the bones and blood.
Fraser, W.D. (2009) Hyperparathyroidism. The Lancet 374:145–158.
Fraser, W.D. (2009) Hyperparathyroidism. The Lancet 374:145–158.
Risk factors for hyperparathyroidism include:
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
The stage in a woman's life where she no longer experiences menstruation. This is usually defined as occurring 12 months after her last period/menses.
The symptoms of hyperparathyroidism are not easy to detect. Many people with high PTH levels show no symptoms at all, or only mild ones, for a long time.
People with hyperparathyroidism often believe they are feeling fine, but after they are treated, they feel better - their sleep and thinking improve.
Symptoms include:
A mnemonic for symptoms of hyperparathyroidism is 'moans, groans, bones and stones', as they include symptoms of bone aches, kidney stones, stomach pains (moans) and mental changes (groans).
A state of exhaustion and weakness.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
A sensation of sickness and unease, typically felt in the stomach, often accompanied by the urge to vomit. Nausea is a common symptom with many possible causes.
Hyperparathyroidism is diagnosed based on blood test results and symptoms. Your doctor will look for high calcium levels in your blood, low bone density, and calcium build-up in your kidneys (kidney stones).
Because it often shows no symptoms, hyperparathyroidism is most often diagnosed in blood tests that are taken for other purposes.
During a blood test, blood can be drawn using a needle or by a finger prick. Your blood can then be analyzed to help diagnose and monitor a wide range of health conditions.
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
Also known as bone mineral density, it is a measure of bone strength calculated as the mineral content per square centimeter of bone. The higher the mineral content, the denser and stronger the bones.
If your blood calcium levels are just a little higher than normal, there might be no reason for treatment. In that case, your doctor will suggest monitoring your blood calcium and bone density regularly, and ways you can lower the risk of developing hyperparathyroidism (see the 'Prevention' section below).
Surgical removal of the parathyroid gland (parathyroidectomy) is the most effective treatment for hyperparathyroidism. It has a high success rate (95%) [1] and a low chance of complications.
In cases where surgery is not possible or not recommended, there are medications that can help treat hyperparathyroidism [1] . Bisphosphonates, such as alendronate, help slow the leaching of calcium from bones.
A group of drugs that prevent the loss of bone mass by reducing the normal turnover of bone. They are used to treat osteoporosis and other bone diseases.
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
Also known as bone mineral density, it is a measure of bone strength calculated as the mineral content per square centimeter of bone. The higher the mineral content, the denser and stronger the bones.
Fraser, W.D. (2009) Hyperparathyroidism. The Lancet 374:145–158.
Fraser, W.D. (2009) Hyperparathyroidism. The Lancet 374:145–158.
As calcium levels rise, the symptoms listed above become progressively worse. Common complications include:
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
A state of exhaustion and weakness.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
Inflammation of the pancreas.
Relating to cognition, which are the mental processes and abilities associated with acts of judgement, reasoning and understanding.
Relating to cognition, the mental processes and abilities characterized by knowing and learning.
With treatment, hyperparathyroidism can be successfully cured. The health of bones can improve and the risk of future fractures decreases [1] , but the rate of improvement depends on your age and other medical conditions.
Fraser, W.D. (2009) Hyperparathyroidism. The Lancet 374:145–158.
There is not much you can do to prevent hyperparathyroidism, other than being vigilant to the appearance of symptoms. People who are at risk, or have already been diagnosed with mild hyperparathyroidism with no symptoms, can make sure they get enough physical activity and drink enough fluids. They can also watch their calcium and vitamin D intake, making sure that the levels of these two are in the recommended range.
A chemical element, important for many biological functions. Particularly central to maintaining bone and tooth health.
A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.