Hyperparathyroidism happens when one or more of your parathyroid glands release too much parathyroid hormone, causing calcium levels in your blood to rise. Symptoms are often absent in early disease. Treatments include no treatment but close monitoring of your health, medications or surgery if symptoms are severe or you have an enlarged parathyroid gland.
Hyperparathyroidism is a condition in which one or more of your parathyroid glands become overactive and release (secrete) too much parathyroid hormone (PTH). This causes the levels of calcium in your blood to rise, a condition known as hypercalcemia.
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Your parathyroid glands secrete PTH to help control the levels of calcium and phosphorous in your body. You have four parathyroid glands, located on the outside borders on the backside of your thyroid gland. Your thyroid gland is located on the front of your neck.
If you have an overactive parathyroid, one or more of your parathyroid glands makes too much parathyroid hormone (PTH). Too much PTH signals your body to make more calcium available. Your body responds by:
Approximately 100,000 people develop hyperparathyroidism in the United States every year. Older women who are postmenopausal are at the highest risk for the condition.
There are two types of hyperparathyroidism, primary and secondary:
Causes of primary hyperparathyroidism include:
If you have early hyperparathyroidism, you may not have any symptoms. If you have mild hyperparathyroidism, you may have some of the following symptoms:
If your hyperparathyroidism is more severe, you may have these symptoms:
Other problems associated with severe hyperparathyroidism include:
Because the symptoms of hyperparathyroidism can be nonexistent, mild or common to many other disorders, a diagnosis of hyperparathyroidism can be missed. Often, the condition is discovered through a blood test that is ordered for another condition.
If you have primary hyperparathyroidism, your blood test will show a higher-than-normal levels of calcium and parathyroid hormone. Your provider may order a sestamibi scan to check for any growths on your parathyroid glands or enlargement of the gland(s).
Other tests may be ordered to check for complications of hyperparathyroidism. These tests may include:
If you have mild hyperparathyroidism (no symptoms, blood calcium levels only slightly elevated), your healthcare provider may not choose to treat it right away. Instead, your provider will monitor your blood calcium levels (every six months), blood pressure (every six months), kidney function (every year), and bone density (every one to three years).
If your healthcare provider believes your hyperparathyroidism doesn’t need immediate treatment, be sure to:
If you have more severe hyperparathyroidism symptoms or have an enlarged parathyroid gland (or glands) or a growth on your parathyroid gland, your provider may recommend surgery to remove the overactive gland(s). Surgery by an experienced surgeon can cure hyperparathyroidism in about 95% of cases.
Cinacalcet (Sensipar®) has been approved by the Food and Drug Administration for the treatment of secondary hyperparathyroidism. The drug works by signaling the parathyroid glands to produce less PTH. Although cinacalcet is intended for secondary hyperparathyroidism, some healthcare providers prescribe it for primary hyperparathyroidism.
Another medication type that is sometimes prescribed is bisphosphonates. These drugs help prevent loss of calcium from bones, which reduces the risk of fracture and osteoporosis. Examples of bisphosphonates include etidronate (Didronel®), alendronate (Fosamax®), zoledronic acid (Zometa®) and ibandronate (Boniva®).
If you're a woman and you’ve already gone through menopause and have signs of osteoporosis, your provider may prescribe hormone replacement therapy (HRT). HRT may help your bones retain calcium.
No. Hyperparathyroidism can’t be prevented.
Surgery will cure nearly all cases of hyperparathyroidism. If you have surgery, your provider may want to check your calcium and PTH levels six weeks after surgery, and then on a yearly basis. You may also have a bone density test every year as well.
If you have mild symptoms and do not need surgery right now, your provider will carefully monitor your health and order blood tests to check your calcium and PTH levels. He or she will also order tests to watch for bone loss and other tests as needed.
Last reviewed by a Cleveland Clinic medical professional on 01/01/2021.
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