Hyperparathyroidism - About

The parathyroid glands produce parathyroid hormone (PTH). This hormone controls calcium, phosphorus, and vitamin D levels in the blood and bone. There are four parathyroid glands (each about the size of a grain of rice) located in your neck. The glands can become overactive and produce too much parathyroid hormone into the bloodstream


Secondary hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body. The parathyroid glands produce more PTH in response and calcium is taken from the bone and reabsorbed by the intestines and kidney.

Hyperparathyroidism - Diagnosis

Hyperparathyroidism is diagnosed with a blood test measuring the amount of parathyroid hormone.

After a diagnosis of hyperparathyroidism, your doctor will likely order additional tests to rule out possible secondary causes and assess complications

Bone mineral density test (bone densitometry). The most common test to measure bone mineral density is dual energy X-ray absorptiometry, or a DXA scan. This scan measures levels of calcium and other bone minerals.

Urine tests. A 24-hour collection of urine can provide information on how well your kidneys function and how much calcium is excreted in your urine. If a very low level of calcium in the urine is found, this may indicate a condition that doesn't require treatment.


If your doctor recommends surgery, imaging tests can locate the parathyroid gland or glands that are causing problems:

Sestamibi parathyroid scan. Sestamibi is a safe radioactive compound that is absorbed by overactive parathyroid glands which can then be "seen" by a scanner.



Hyperparathyroidism - Treatment

If calcium levels, kidney function and bone densities are relatively normal then scheduling regular tests and monitoring may be a better option than treatment and your doctor may recommend a watch-and-wait approach.



If all four glands are affected, a surgeon will likely remove only three glands and perhaps a portion of the fourth - leaving some functioning parathyroid tissue.

Surgery may be done as an outpatient procedure, allowing you to go home the same day. In such cases, the surgery can be done through very small incisions in the neck, and you receive only local anesthetics. Complications from this surgical procedure are rare.


Medications to treat hyperparathyroidism include calcimimetics which mimic calcium circulating in the blood and trick the parathyroid glands into releasing less parathyroid hormone.




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