Hyperparathyroidism is one such condition where a cluster of tiny glands in our neck called the parathyroid glands become overactive and start producing excess parathyroid hormone (PTH). This can lead to the depletion of calcium from our bones, causing osteoporosis, and the formation of kidney stones. The increased levels of PTH can also lead to hypercalcemia, a condition in which there is too much calcium in the blood, leading to a range of health problems.
Sounds terrifying, right?
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What is hyperparathyroidism?
Our bodies secrete hundreds of hormones- chemical messengers that aid chemical reactions. While most of us are aware of the major ones such as insulin, adrenaline and thyroid hormones, there are others, more obscure but just as vital.
One such hormone is the parathyroid hormone or PTH. PTH helps to maintain normal calcium levels in our blood. In some scenarios, the body produces excessive amounts of PTH leading to a condition known as hyperparathyroidism.
What are the parathyroid glands?
The parathyroid hormone is produced by the parathyroid glands. These are four small oval glands found behind and embedded in the main lobes of the thyroid gland. They best resemble peas. These tiny glands play a vital role in calcium balance. When the body senses low levels of calcium, PTH is released to increase serum calcium.
How does hyperparathyroidism occur?
There are different types of hyperparathyroidism with varying aetiology-
Primary Hyperparathyroidism- occurs when there is some pathology in the glands themselves. Most frequently, this is a benign tumor known as a parathyroid adenoma (85%). Sometimes, it may be due to an abnormal increase in the number of cells in the gland, called parathyroid hyperplasia (10-15%). In very rare situations, it may be caused by a cancerous growth or parathyroid carcinoma. (<1%)
Secondary Hyperparathyroidism- develops when the parathyroid glands themselves are healthy but are triggered by chronic calcium insufficiency to produce excessive amounts of PTH. This is most commonly associated with chronic renal disease. In kidney disease, the kidneys fail to perform their function of producing the active form of Vitamin D. Vitamin D is essential for calcium absorption from the gut and so diseased kidneys lead to low calcium levels.
Tertiary Hyperparathyroidism- Long-standing cases of secondary hyperparathyroidism may start to behave like primary hyperparathyroidism.
What are the symptoms of hyperparathyroidism?
A little earlier, we discussed how the parathyroid hormone’s function is to increase serum calcium levels. It does this by causing the release of calcium ions from their storehouses in our bodies. Where are these storehouses? Mainly in the bones, teeth and other hard tissues of the body. The depletion of these storehouses to pump excessive amounts of calcium into the blood leads to the symptoms of Parathyroid hormone.
The classic hyperparathyroidism symptoms are “stones, bones, and abdominal groans”
- Marked tendency to develop kidney stones
- Abnormal calcification in blood vessels and soft tissues
- Osteoporosis and increased risk of fracture
- Pain and tenderness in bones and joints
- Frequent urination
- Excessive thirst
- Dehydration
- Depression
- Confusion
- Weakness
- Nausea and vomiting
- Stomach ulcers
- Abdominal pain
- Pancreatitis
- Muscle spasms
- Irregular heartbeat
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How is hyperparathyroidism diagnosed?
As with any other condition, treatment of hyperparathyroidism is predicated upon a swift and accurate diagnosis.
A simple blood test is performed. High levels of PTH and high serum calcium levels are diagnostic of hyperparathyroidism.
A DEXA scan, which tells us about bone density, is often performed to gauge bone loss and risk of fracture.
Your healthcare provider may choose to perform other X-rays, CT scans or Ultrasonography to detect kidney stones or abnormal calcification.
Also Check: Hyperphosphatemia: Symptoms, Treatment, Causes
How is hyperparathyroidism treated?
The symptoms of hyperparathyroidism are fairly simple to manage
- Drink plenty of fluids to avoid dehydration
- Eat a healthy, balanced diet while avoiding calcium-heavy foods.
- A group of medicines known as bisphosphonates may be prescribed to combat the symptoms over a short-term
- Vitamin D supplements may be needed to combat renal insufficiency
However, hyperparathyroidism treatment modalities are not definitive in nature.
The only treatment for primary hyperparathyroidism is surgical excision of the tumour. PTH levels drop to normal within 10 minutes of the surgery.
For secondary hyperparathyroidism, the underlying disease must be treated as soon as possible.
Conclusion
Hyperparathyroidism results from a derangement of PTH levels in the body. This leads to increased serum calcium levels and depleted stores of calcium in the other tissues. Symptoms are usually moderate and simple to manage but can be life-threatening if not addressed. Surgery and treatment of the underlying pathology are the definitive solutions to this condition.
Hyperparathyroidism Related FAQs
Here are the answers to some frequently asked questions
