Parathyroid-related hypercalcemia; Osteoporosis - hyperparathyroidism; Bone thinning - hyperparathyroidism; Osteopenia - hyperparathyroidism; High calcium level - hyperparathyroidism; Chronic kidney disease - hyperparathyroidism; Kidney failure - hyperparathyroidism; Overactive parathyroid; Vitamin D deficiency - hyperparathyroidism
Hyperparathyroidism is a disorder in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
There are 4 tiny parathyroid glands in the neck, near or attached to the back side of the thyroid gland.
The parathyroid glands help control calcium absorption, use and removal by the body. They do this by producing parathyroid hormone (PTH). PTH helps control calcium, phosphorus, and vitamin D levels in the blood and bone. It is important for healthy bones.
When the blood calcium level is too low, the body responds by making more PTH being made. This causes the calcium level in the blood to rise.
When one or more of the parathyroid glands grow larger, it may lead to too much PTH. Most often, the cause is a benign tumor of the parathyroid glands (parathyroid adenoma). These benign tumors are common and happen without a known cause.
Medical conditions that cause low blood calcium or increased phosphate can also lead to hyperparathyroidism. Common conditions include:
Hyperparathyroidism is often diagnosed by common blood tests before symptoms occur.
Symptoms are mostly caused by damage to organs from high calcium level in the blood, or by the loss of calcium from the bones. Symptoms can include:
The health care provider will do a physical exam and ask about symptoms.
Tests that may be done include:
Bone x-rays and bone mineral density (DXA) tests can help detect bone loss, fractures, or bone softening.
X-rays, ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.
Ultrasound or a nuclear medicine scan of the neck (sestamibi) is used to see if a benign tumor (adenoma) in a parathyroid gland is causing hyperparathyroidism.
If you have a mildly increased calcium level and don't have symptoms, you may choose to have regular checkups or get treated.
If you decide to have treatment, it may include:
If you have symptoms or your blood calcium level is very high, you may need surgery to remove the parathyroid gland that is producing too much PTH.
If you have hyperparathyroidism from a medical condition, your provider may prescribe vitamin D, if you have a low vitamin D level.
If hyperparathyroidism is caused by kidney disease or failure, treatment may include:
Outlook depends on the cause of hyperparathyroidism.
Long-term problems that can occur when hyperparathyroidism is not well controlled include:
Parathyroid gland surgery can result in hypoparathyroidism and damage to the nerves that control the vocal cords.
Hollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.
Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 232.BACK TO TOP
Review Date: 4/29/2022
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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