Patient education: Primary hyperparathyroidism (The Basics)

What is primary hyperparathyroidism? — Primary hyperparathyroidism is a disorder of the parathyroid glands in your neck (figure 1). These glands make a hormone that helps control the amount of calcium in the blood. This hormone is called "parathyroid hormone," or "PTH."  

Primary hyperparathyroidism is when your parathyroid glands make too much PTH. This can cause too much calcium to build up in your blood. It can happen when a gland develops an abnormal benign (non-cancer) growth. It can also happen when 1 or more of the glands grow bigger than they should. Parathyroid cancer is a very rare cause of primary hyperparathyroidism.

What are the symptoms of primary hyperparathyroidism? — Most people with this condition have no symptoms. But some people do have symptoms that might be related to having more calcium in their blood than normal. These symptoms include:

●Pain in the joints

●Feeling tired or weak

●Loss of appetite

●Feeling depressed

●Trouble concentrating

If your PTH and blood calcium levels get very high, you might get constipated, feel very thirsty, or urinate more often than usual. Some people have more serious symptoms, such as:

●Problems with how the kidneys work

●Kidney stones

●Weak bones

●Gout (a kind of arthritis) or other problems in the joints

●Chemical imbalances in the blood

"Parathyroid crisis" is a rare but serious problem. It can happen if you have primary hyperparathyroidism and get sick with something that causes you to lose fluids (like vomiting or diarrhea). This causes the amounts of PTH and calcium in the blood to go up suddenly. If this happens, you might have belly pain, nausea, and sometimes problems thinking clearly and staying alert. It is important to see a doctor or nurse right away if you have primary hyperparathyroidism plus lasting vomiting or diarrhea, and can't keep fluids down.

Is there a test for primary hyperparathyroidism? — Yes. A doctor or nurse can do tests to measure the levels of PTH and calcium in your blood. Many people with primary hyperparathyroidism do not notice any symptoms. The condition is often found when a doctor or nurse does a blood test for some other reason.

If you have primary hyperparathyroidism, your doctor or nurse might do other tests, too. You will probably get a special kind of X-ray to see if your bones are weaker than normal. Plus, you might get checked for kidney stones.

Is there anything I can do on my own to help my condition? — Yes. Even if you do not have any symptoms, there are things you can do to help prevent problems:

●Drink plenty of liquids, and try not to get dehydrated. This can help to prevent kidney stones.

●Stay active. This can help keep your calcium levels normal and your bones healthy.

●Try to get about 1000 milligrams of calcium each day. These tables show how much calcium is in certain foods and vitamin supplements (table 1 and table 2). It is better to get your calcium from foods and drinks rather than supplements. Some people might need to reduce the amount of calcium in their diet. Your doctor will let you know if this is the case for you.

●Try to get about 400 to 800 international units (IU) of vitamin D each day (table 3). This is the same as 10 to 20 micrograms of vitamin D. Not having enough vitamin D can weaken your bones.

●Do not take certain medicines that can affect the amount of calcium in the blood. Your doctor or nurse can tell you which medicines to avoid.

Even if you feel healthy, your doctor or nurse should still check your blood calcium every 6 months. They will also do regular tests to check your kidneys and bones. (People whose bones are weakened because of their condition can get medicines to help protect their bones.)

How is primary hyperparathyroidism treated? — The main treatment is surgery to remove the gland or glands that are causing the problem. In most cases, surgery cures the condition. Still, people who have no symptoms do not always need surgery.

You will most likely need surgery if:

●The amount of calcium in your blood is much higher than normal

●Your primary hyperparathyroidism is causing problems with your kidneys or bones

●You are younger than 50

●You are not able to get regular checkups and tests

More on this topic

Patient education: Osteoporosis (The Basics)
Patient education: Bone density testing (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Kidney stones in adults (The Basics)

Patient education: Primary hyperparathyroidism (Beyond the Basics)
Patient education: Osteoporosis prevention and treatment (Beyond the Basics)
Patient education: Bone density testing (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)
Patient education: Kidney stones in adults (Beyond the Basics)