Hyperparathyroidism

A condition where the parathyroid glands produce too much parathyroid hormone, causing excess calcium in the blood.

About hyperparathyroidism

Hyperparathyroidism is a condition where one or more of your parathyroid glands are overactive, and produce too much parathyroid hormone.

This leads to too much calcium in the blood (hypercalcaemia), which can cause various health problems.

Most people have four parathyroid glands in their neck, just behind the thyroid gland. Each parathyroid gland is about the size of a grain of rice.

Your parathyroid glands produce parathyroid hormone (PTH). This hormone regulates the amount of calcium in your blood.

There are different types of hyperparathyroidism. The main two types are:

  • primary hyperparathyroidism – caused by a problem within the parathyroid gland, usually a benign tumour
  • secondary hyperparathyroidism – related to a condition like kidney failure or a deficiency in vitamin D. In this case the rise in parathyroid hormone is related to a tendency towards a low blood calcium level

Symptoms of primary hyperparathyroidism

The most obvious symptoms of primary hyperparathyroidism are kidney pain from stones and bone pain from loss of bone calcium. But many patients have no symptoms of hyperparathyroidism at all and are diagnosed on blood tests before they have any symptoms.

Some patients have non-specific symptoms that are often associated with hyperparathyroidism, including:

  • tiredness
  • feeling thirsty
  • lack of energy
  • joint pain
  • loss of appetite
  • frequent urination
  • constipation
  • feeling sick
  • muscle weakness
  • depression
  • forgetfulness
  • lack of concentration
  • fragile bones (osteoporosis)
  • kidney stones

Diagnosis of hyperthyroidism

Hyperparathyroidism is usually diagnosed through a blood test for calcium and parathyroid hormone (PTH) and some urine tests which show increased levels of calcium.

You may be referred for other tests to check for possible complications and causes, including:

  • a DEXA scan (a bone density scan)
  • an ultrasound of the kidneys

Treatment of hyperparathyroidism

If you have hyperparathyroidism, you may be referred to a consultant endocrine surgeon or endocrinologist for investigation and treatment.

Surgery

The only way to treat primary hyperparathyroidism is surgery to remove the abnormal parathyroid gland or glands. This is usually a straight forward procedure called a parathyroidectomy.

However, success in parathyroid surgery is highly dependent on the experience and practice volume of the surgeon performing the operation. You should ask your surgeon about this.

Non-surgical options

These are now rarely adopted but a 'watch and wait' approach can sometimes be appropriate in selected cases – discuss the pros and cons of your specific case with your consultant.

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Published: 6 January 2020 | Review: 6 January 2023

Disclaimer: This information is published by Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 30 years of treating patients. It has been peer reviewed by Cromwell Hospital doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of this patient information document please email info@cromwellhospital.com or telephone 020 7460 5901.