Understanding Primary Hyperparathyroidism

Back view of thyroid showing three normal parathyroids and one enlarged one.The parathyroid glands are 4 tiny glands in the neck. They make parathyroid hormone (PTH). PTH controls the amount of calcium and phosphorus in your blood. Primary hyperparathyroidism is when there is too much PTH in your blood. It occurs when one or more of the glands are too active.

What causes primary hyperparathyroidism?

Primary hyperparathyroidism can occur when a parathyroid gland becomes enlarged. Hyperparathyroidism can also occur as a complication of other medical conditions, such as kidney failure, or rickets, but in these conditions, calcium is usually not high. This is called secondary hyperthyroidism.

Why is it a problem?

With primary hyperparathyroidism, your glands make too much PTH. The job of PTH is to tell the body how to control calcium. Too much PTH means the body increases the amount of calcium in the blood. This leads to a problem called hypercalcemia. This is when the amount of calcium in the blood becomes too high. Hypercalcemia can cause serious health problems.

High calcium can be caused by other conditions, like taking too many calcium and vitamin D supplements, certain genetic conditions, or other circumstances. Your doctor will find out if primary hyperparathyroidism is the cause of your high calcium levels. If so, treatment options will be discussed with you.

What are the risk factors for primary hyperparathyroidism?

The risk factors for developing this condition include:

  • Being a woman (it’s less common in men)

  • Being older (it’s more likely to occur with age)

  • Having parents or siblings with the condition or other endocrine tumors

  • Having certain kidney problems

  • Taking certain medications

  • Having had radiation treatment in the head or neck

What are the symptoms of primary hyperparathyroidism?

Symptoms of the condition can include:

  • Muscle weakness

  • Depression

  • Tiredness

  • Confusion and memory loss

  • Poor memory

  • Nausea and vomiting

  • Pain in the stomach area (abdomen)

  • Hard stools (constipation)

  • Stomach ulcers

  • Need to urinate often

  • Kidney stones

  • Joint or bone pain

  • Bone disease (osteopenia or osteoporosis), an increase in bone fractures

  • High blood pressure

  • Increased thirst

How is primary hyperparathyroidism treated?

If primary hyperparathyroidism is not treated, it can get worse over time. Surgery may be done to remove any enlarged parathyroid glands. This lets the amount of calcium in the blood go back to normal. Your doctors may want to ensure that you have enough vitamin D and calcium nutrition before the surgery. This will reduce the risk of low calcium after the surgery. You and your doctor can discuss your treatment options. Be sure to ask any questions you have.


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