Parathyroid glands are four small glands located on the back side of the thyroid gland. When these begin to produce and release parathyroid hormone in the bloodstream it is called hyperparathyroidism or overactive parathyroid glands. The hormones produced by these glands are vital for muscle and nerve function and bones. These hormones help maintain a balance of calcium in the blood and tissues.
In any case, there are two types of overactive parathyroid glands. The first is called primary hyperparathyroidism. It causes enlargement of one or more parathyroid glands that lead to an overproduction of parathyroid hormone. As a result, calcium levels begin to increase, which may cause multiple health problems. One of the most common treatment options used for people with primary type is surgery.
People with secondary hyperparathyroidism commonly experience it due to other health diseases. The secondary type causes calcium levels to drop and over time parathyroid glands start producing more hormones trying to maintain calcium levels within normal ranges. Commonly, secondary hyperparathyroidism happens due to kidney disease or after intestinal surgeries but it also may occur due to other health problems.
Symptoms
The primary type is often diagnosed when symptoms occur and during a routine blood test. Commonly, symptoms appear due to damage or dysfunction of certain organs and tissues. Damage happens usually due to high or low calcium levels in the blood.
The symptoms caused by primary hyperparathyroidism range between mild and severe. Check below some symptoms:
- Memory problems
- Depression
- Joint and bone pain
- Increased urination
- Kidney stones
- Osteoporosis (brittle bones)
- Stomach pain
- Nausea
- Vomiting
- Lack of appetite
- Weakness
If you suspect you have hyperparathyroidism or experience any of the previous symptoms, immediately contact your healthcare professional. Not treating this condition may lead to serious complications.
Causes
There are different factors that cause parathyroid glands to produce more hormones. These glands help maintain steady and proper calcium and phosphorus levels in the body. The work process of parathyroid glands can be compared to a thermostat that controls a heating system to keep a constant temperature of the air. Moreover, vitamin D also is involved in controlling calcium levels. Check below how normally the balancing of the calcium occurs:
- Reduced calcium levels – When calcium levels in the body drop, these glands begin to release hormones enough to restore balance. It helps to increase calcium levels by absorbing it from bones and reducing the amount of calcium that passes in the urine.
- High calcium levels – In such cases, parathyroid glands start to produce fewer hormones.
Calcium is a vital mineral in the body that helps to maintain healthy bones and teeth. Furthermore, it is involved in the transmission of nerve signals and muscle contraction.
In some cases, one or more parathyroid glands begin to make high amounts of hormones, which may be a body response to low calcium levels in the blood.
Primary Hyperparathyroidism
This hyperparathyroidism type often occurs due to problems with one or more parathyroid glands. Check below some possible causes:
- Enlargement of one or more parathyroid glands (also known as hyperplasia)
- Cancerous tumors that are a very rare cause of primary hyperparathyroidism
- Adenoma (a non-cancerous growth) on one or more glands is the most common cause of the primary type.
Increased phosphorus and calcium in the blood can occur due to increased parathyroid hormone production by one or more parathyroid glands. Sometimes, people inherit an abnormal gene that causes primary hyperparathyroidism.
Secondary Hyperparathyroidism
This type of hyperparathyroidism happens due to another health problem that reduces calcium levels in the blood. As a result, parathyroid glands overwork to make high amounts of hormones to restore calcium levels to normal ranges. Check below some causes of secondary hyperparathyroidism:
- Low calcium levels – If you are not getting enough calcium from food due to a digestive system that does not absorb enough calcium from the diet. It commonly happens after certain surgeries including weight loss and intestinal.
- Very low vitamin D levels – This vitamin is very important in maintaining normal calcium levels and helps the digestive system absorb calcium from food. Vitamin D is produced naturally in the body when the skin is exposed to sunlight but it also can be obtained from food.
- Chronic kidney failure – Kidneys are responsible for converting vitamin D into a form that your body can use. However, if the kidneys do not work properly, vitamin D may decrease as well as calcium levels. As a result, parathyroid glands begin overwork to maintain calcium levels. The most common cause of secondary hyperparathyroidism is chronic kidney failure.Sometimes, parathyroid glands may become enlarged due to long-term secondary hyperparathyroidism caused by end-stage kidney disease. Thus, overproduction of parathyroid hormone may elevate calcium levels too high leading to other health problems. In such cases, this condition is called by doctors as tertiary hyperparathyroidism.
Risk Factors
Anyone may develop this condition and the following factors may elevate your risk. For example:
- Long-term very low levels of calcium or vitamin D
- Postmenopausal women
- Rare inherited disorders (such as multiple endocrine neoplasia)
- Exposure to radiation treatments including radiation therapy used to treat cancer
- An increased risk of hyperparathyroidism have people who administer Lithium (this medicine is mostly used by people with bipolar disorder)
Complications
Commonly, people experience hyperparathyroidism complications if they experience low calcium levels in the bones and bloodstream for long periods. Check below the most common of them:
- Kidney stones – High calcium levels in the blood may lead to hard deposits and other substances in the kidneys. Therefore, these deposits may turn into stones that may cause severe pain when pass through the urinary tract.
- Osteoporosis – Those who have low calcium levels may also experience this condition. Such people are at increased risk of bone fractures.
- Cardiovascular disease – Experts do not fully understand why low calcium levels lead to problems with the cardiovascular system. However, hypertension and other heart disease may occur.
- Neonatal hypoparathyroidism – Pregnant women who suffer from severe hyperparathyroidism may cause very low calcium levels in babies. However, this condition occurs rarely.
Diagnosis
High calcium levels are often found during a routine blood test. In such cases, doctors may suspect you have hyperparathyroidism. To confirm the condition, doctors usually perform additional tests. Check below some examples:
Blood Tests
Repeated blood tests are required to see if calcium levels remain high. However, there are different health conditions that may increase calcium levels. Doctors diagnose hyperparathyroidism if blood tests show high parathyroid hormone levels.
Other Tests
Healthcare professionals perform the following tests to exclude other conditions that cause similar symptoms and determine the severity of the disease. Check below some tests:
- Urine test – Doctors may perform a urine test, which involves collection of urine over 24 hours that may help them get more information about kidney function and the amount of calcium that passes through the urine.This test may also help doctors diagnose kidney conditions that cause hyperparathyroidism. However, if calcium levels found in the urine are low, treatment is not necessary.
- Kidney imaging tests – Sometimes, physicians perform kidney imaging tests to check for kidney stones and other kidney problems.
- Bone mineral density test – The most common test used to measure calcium and other mineral levels in the bones is called dual-energy X-ray absorptiometry (DEXA). It helps doctors determine if you have developed osteoporosis.
Treatment
The following treatment options are usually recommended by doctors for people with hyperparathyroidism. These include:
Surgery
This is the most common treatment for people with primary hyperparathyroidism. Moreover, it helps to cure the condition in most cases. During the procedure, surgeons will remove the glands that are enlarged or have tumors.
If all parathyroid glands are negatively affected, surgeons will remove only three of them, and the last one is left to maintain some parathyroid function. Unfortunately, there are some possible complications after surgery. Check below some of them:
- The use of calcium and vitamin D supplements for long periods is caused by the removal of the parathyroid glands.
- Damage to the vocal cords nerves.
Medicines
- Calcimimetics – This is a medicine used to mimic calcium in the blood. It helps parathyroid glands to reduce hormone production. This medication is sold as Cinacalcet and it is a good option to treat primary hyperparathyroidism, especially if surgery is not successful or is not possible.Furthermore, this medicine and vitamin D analogs are frequently used to treat secondary hyperparathyroidism in chronic kidney disease. They help maintain a balance of phosphorus and calcium in the blood, which helps reduce the parathyroid gland’s work.
The most common adverse reactions of Cinacalcet include joint and muscle pain, diarrhea, nausea, and respiratory infection.
- Hormone Replacement Therapy – This treatment option is effective for postmenopausal women with symptoms of osteoporosis. It helps maintain a healthy calcium level and prevent bone fractures.However, this therapy is used for short periods because long-term use of hormone replacement therapy may lead to blood clots and breast cancer. Dizziness, headaches, breast tenderness, and pain are the most common side effects of this therapy.
- Bisphosphonates – These are specific medications that help prevent calcium loss from bones. As a result, it may lessen osteoporosis caused by hyperparathyroidism. Common negative effects associated with bisphosphonates include hypotension (low blood pressure), fever, and vomiting.
Frequently Asked Questions
What are the primary symptoms of hyperparathyroidism?
These include:
- Depression
- Tiredness
- Loss of appetite
- Increased thirst
- Abdominal pain
- Constipation
- Difficulty concentrating
- Muscle weakness
Do not hesitate to visit a doctor if any of the symptoms listed above occur.
What is the best treatment for people with hyperparathyroidism?
Commonly, doctors recommend surgery that removes parathyroid glands. However, physicians may prescribe some medications when surgery is not an option. Consult with your doctor for more details.
What should be avoided by people with hyperparathyroidism?
Limit or avoid the following products because they can worsen this condition. For example:
- Foods high in phosphate – For example hard cheeses, oats, rice, carbonated drinks, and red meat.
- Refined Foods – These include breads, pastas, and desserts.
- Foods that may interact with calcium absorption – For instance, spinach, potatoes (including sweet ones), beets, beans, raspberries, tea, nuts, and others.
- Stimulants, alcohol, and tobacco products should be avoided completely.
If you have additional questions, ask your physician.
