Disorders of the Thyroid
Our doctors are Harvard Medical School faculty who specialize in the evaluation, diagnosis and long-term care of patients affected by a range of thyroid disorders.
Primary hyperparathyroidism is when one or more of the parathyroid glands makes too much parathyroid hormone. This can lead to bone tissue loss. Here's what you need to know.
Specialists from the Thyroid Nodule Program answer frequently asked questions about thyroid nodules and goiters.
Your parathyroid glands make parathyroid hormone (PTH). Primary hyperparathyroidism happens when one or more of the parathyroid glands makes too much PTH. This can lead to bone tissue loss, high levels of calcium in your blood, and kidney stones. This condition is more common in females than in males. Sometimes primary hyperparathyroidism is part of a hereditary condition that involves tumors in many parts of the body.
PTH keeps the levels of calcium in your blood from going too low. It does this by releasing calcium from bones and reabsorbing calcium from the kidneys. And PTH increases how much calcium is absorbed from food. Too much PTH causes too much calcium to be released from bone. And the level of calcium in your blood rises.
In some cases, no cause can be found. Some known causes include benign tumors on the parathyroid glands, or enlargement of the glands. When a tumor is benign, that means it's not cancer. When there is a benign tumor in a parathyroid gland, it is called a parathyroid adenoma. When more than one gland becomes enlarged, it is called parathyroid hyperplasia. Both of these conditions are not cancer. In rare cases, it can be caused by a tumor that is cancer or a cyst that is not cancer.
Each person may experience symptoms differently. Symptoms of too much calcium in the blood may include:
Other serious symptoms may include:
The symptoms of primary hyperparathyroidism may look like other health problems. Always talk with your doctor for a diagnosis. There are many other possible causes of a high calcium level. These may need to be checked for as well.
The condition may not have any symptoms or complications. Sometimes a high calcium level is found during a routine blood test as part of a physical exam.
You'll likely have additional blood tests done to check the levels of calcium, PTH, and vitamin D. You'll also likely have urine tests to check on the level of calcium in your urine and to check your kidney function.
Your doctor may want to scan your thyroid after giving you an injection of a substance that collects in the parathyroid glands. This substance is called sestamibi. You may also have an ultrasound study of your neck. This could find a parathyroid adenoma.
You may have dual-energy X-ray absorptiometry. This test is also called bone densitometry (or DXA scan). It's done to figure out bone density and to reveal loss of bone tissue, as can occur with this condition. It's also used to help your doctor monitor your condition. Testing can also help decide if surgery may be needed.
Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.
Surgery to remove the affected gland may be needed. Treatment may include medicines, regular bone densitometry testing to reveal loss of bone tissue, and follow-up tests of kidney function.
Tips to help you get the most from a visit to your doctor:
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