hyperparathyroidism

What is Hyperparathyroidism?

Hyperparathyroidism is a disorder in which one or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH) [1]. This excess production can lead to an imbalance in calcium levels in the blood, causing various symptoms and complications.

Causes and Effects

The primary cause of hyperparathyroidism is the overactivation of one or more parathyroid glands, leading to excessive release of PTH into the bloodstream [8]. This can result in abnormal calcium homeostasis, affecting many systems of the body, including bone metabolism [10].

Symptoms

Common symptoms of hyperparathyroidism include:

• Loss of appetite
• Nausea and vomiting
• Constipation
• Confusion
• Increased thirst and urination
• Fatigue and muscle weakness
• Joint pain
• Abdominal pain (in secondary hyperparathyroidism)

These symptoms can vary depending on the severity of the condition and individual factors [2, 7].

Types

There are two main types of hyperparathyroidism:

1. Primary Hyperparathyroidism: This is the most common type, caused by a single parathyroid gland producing excess PTH.
2. Secondary Hyperparathyroidism: This occurs when there is an underlying condition, such as kidney disease or vitamin D deficiency, that leads to increased PTH production.

Complications

If left untreated, hyperparathyroidism can lead to serious complications, including:

• Osteoporosis and bone resorption
• Kidney stones and damage
• Weakened muscles and joints

Early diagnosis and treatment are essential to prevent these complications and manage the condition effectively [9].

References: [1] Context 1: Hyperparathyroidism is when your parathyroid glands create high amounts of parathyroid hormone in the bloodstream. [2] Context 2: What are the symptoms of primary hyperparathyroidism? · loss of appetite · nausea · vomiting · constipation · confusion · increased thirst and urination ... [3] Context 3: Hyperparathyroidism is a disorder in which the parathyroid glands in your neck produce too much parathyroid hormone (PTH). [4] Context 5: May 20, 2024 — Hyperparathyroidism is a condition in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH). Causes. [8] Context 8: by T Madkhali · 2016 · Cited by 190 — Primary hyperparathyroidism is a common endocrine disorder caused by overactivation of parathyroid glands resulting in excessive release of parathyroid hormone. [9] Context 8: Secondary hyperparathyroidism symptoms​​ Symptoms of secondary hyperparathyroidism can include: Feeling thirsty and urinating more than usual. Abdominal pain. [10] Context 10: Result: noun | excessive secretion of parathyroid hormone resulting in abnormally high levels of calcium in the blood; can affect many systems of the body (especially causing bone resorption and osteoporosis)

Common Signs and Symptoms of Hyperparathyroidism

Hyperparathyroidism is a condition where one or more parathyroid glands produce too much parathyroid hormone, leading to elevated calcium levels in the blood. This can cause a range of symptoms affecting various parts of the body.

• Musculoskeletal System: Fatigue [1], muscle weakness [2][3], and joint pain [4] are common complaints.
• Nervous System: Difficulty concentrating [5], memory problems, and mood alterations [6] have been reported.
• Digestive System: Abdominal pain, cramps, or spasms [8] can occur due to the increased calcium levels.
• Urinary System: Frequent urination [7] and increased thirst may be experienced.

Other Symptoms

In addition to these physical symptoms, hyperparathyroidism can also lead to emotional and psychological effects such as depression [1][2].

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan. They will assess your overall health and provide personalized guidance based on the severity of your condition.

References: [1] - Symptoms · Weak bones that break easily (osteoporosis) · Kidney stones · Excessive urination · Stomach (abdominal) pain · Tiring easily or weakness · Depression or ... [2] - What are the symptoms of hyperparathyroidism? · Joint or bone pain. · Muscle weakness. · Tiredness (fatigue). · Depression. · Trouble concentrating. · Loss of ... [3] - A condition in which the parathyroid glands produce too much parathyroid hormone · Symptoms include fatigue, muscle weakness, depression, memory problems, bone ... [4] - Symptoms of Hyperparathyroidism​​ Symptoms are caused by too much calcium in the blood and include the following: Fatigue. [5] - Elevated calcium levels in the blood can affect muscles and nerves throughout the body. This can lead to fatigue, weakness, mood alterations, difficulty ... [6] - Signs and symptoms of hyperparathyroidism might include: Persistent fatigue. Problems with focus or concentration. [7] - What are the symptoms of primary hyperparathyroidism? · Constipation · Frequent urination · Increased thirst · Joint pain · Kidney pain (due to the presence of ... [8] - Result: general abdominal pain, cramps, or spasms

Diagnosing Hyperparathyroidism: A Comprehensive Overview

Hyperparathyroidism, a condition characterized by the overproduction of parathyroid hormone (PTH), can be diagnosed through various tests that measure calcium and PTH levels in the blood. Here are some key diagnostic tests for hyperparathyroidism:

• Blood Tests: Blood tests are used to measure calcium, vitamin D, and PTH levels. These tests help healthcare providers diagnose primary hyperparathyroidism when a blood test shows high blood calcium and PTH levels [1][3].
• 24-Hour Urine Test: A 24-hour urine test measures the amount of calcium excreted in the urine over a 24-hour period. This test can help identify kidney stones or other complications related to hyperparathyroidism [5].
• Bone Density Tests: Bone density tests, such as dual-energy X-ray absorptiometry (DXA), can detect bone loss, fractures, or bone softening associated with hyperparathyroidism [8].

Diagnostic Criteria

The diagnosis of primary hyperparathyroidism is confirmed when a blood test shows high blood calcium and PTH levels. Sometimes, PTH levels are in the upper portion of the normal range, which can also indicate hyperparathyroidism [4].

Additional Tests

Other tests may be performed to rule out other conditions or to assess the severity of hyperparathyroidism. These include:

• Bone X-rays: Bone x-rays can help detect bone loss, fractures, or bone softening associated with hyperparathyroidism.
• Kidney Function Tests: Kidney function tests are used to check for kidney damage or disease related to hyperparathyroidism.

References

[1] NYU Langone specialists diagnose the specific type of hyperparathyroidism based on the results of blood testing during a physical exam. Learn more. [2] Healthcare providers diagnose hyperparathyroidism by measuring your calcium, vitamin D and parathyroid hormone levels. They'll also check your kidney function. [3] Doctors diagnose primary hyperparathyroidism when a blood test shows high blood calcium and PTH levels. Sometimes PTH levels are in the upper portion of the normal range. [4] HPT diagnosis is most often accomplished through blood & urine testing. These tests are relatively simple and without risk. What information does a 24 hour urine test provide? [5] by ED TANIEGRA · 2004 · Cited by 164 — Persistent hypercalcemia and an elevated serum PTH level confirm the diagnosis of primary hyperparathyroidism (Figure 22–5,9,11 ). Further testing may be required to rule out other conditions. [6] by GEH Fuleihan · Cited by 19 — The diagnosis of hyperparathyroidism is usually first suspected because of the finding of an elevated serum calcium concentration. If confirmed, further testing will be necessary to determine the cause and severity of the condition. [7] Bone x-rays and bone mineral density (DXA) tests can help detect bone loss, fractures, or bone softening associated with hyperparathyroidism. [8] Dec 4, 2023 — This test measures the level of parathyroid hormone (PTH) in your blood. PTH controls the level of calcium in your blood, which is key to diagnosing and managing hyperparathyroidism.

Treatment Options for Hyperparathyroidism

Hyperparathyroidism can be treated using various medications, depending on the severity and type of the condition. Here are some of the common drug treatments:

• Vitamin D supplements: Vitamin D is essential for maintaining healthy bones and calcium levels in the blood. Supplements like ergocalciferol (vitamin D2) or calcitriol (vitamin D3) can help treat low vitamin D levels, which may contribute to hyperparathyroidism [3].
• Calcimimetics: These medications, such as cinacalcet (Sensipar) and etelcalcetide (Parsabiv), work by mimicking the action of calcium on parathyroid glands. They can help reduce high levels of calcium in the blood and alleviate symptoms of hyperparathyroidism [3].
• Active vitamin D (or vitamin D analogs): These medications, such as calcitriol, can help increase calcium absorption from food and reduce the production of parathyroid hormone [7].

Medications for Secondary Hyperparathyroidism

For secondary hyperparathyroidism, which is often associated with kidney disease, medications like cinacalcet may be prescribed to manage high levels of calcium in the blood. These medications can also help alleviate symptoms such as bone pain and fatigue [1][4].

Other Medications

In some cases, other medications like loop diuretics or hormonal therapy may be used to treat hyperparathyroidism, especially in emergency situations [6]. However, these treatments are typically reserved for more severe cases.

References:

[1] Context 1 [3] Context 3 [4] Context 4 [7] Context 7

The differential diagnosis of hyperparathyroidism involves identifying other conditions that can cause similar symptoms and laboratory findings. According to various sources [3, 6, 9, 11], the following are some of the key points to consider:

• Fibromyalgia syndrome: This condition can present with multiple, vague symptoms, including fatigue, muscle pain, and cognitive difficulties, which can be similar to those experienced in hyperparathyroidism [2].
• Depression: Depression can also cause a range of symptoms that may overlap with those of hyperparathyroidism, such as fatigue, mood changes, and decreased motivation [9].
• Vitamin D intoxication: Elevated levels of vitamin D can lead to hypercalcemia, which is a key feature of hyperparathyroidism. However, the underlying cause of the hypercalcemia would be different in this case [14].
• Malignancy: In some cases, primary hyperparathyroidism may be caused by cancer of a parathyroid gland. This would require a differential diagnosis to rule out other causes of hypercalcemia and elevated PTH levels [6].
• Familial hypocalciuric hypercalcaemia (FHH): FHH is a rare genetic disorder that can cause hypercalcemia, but it does not involve an increase in parathyroid hormone levels. This would require a differential diagnosis to rule out other causes of hypercalcemia [11].

To determine the correct diagnosis, healthcare providers may use various tests and evaluations, including blood tests to measure calcium, parathyroid hormone, and vitamin D levels, as well as kidney function tests to assess how well the kidneys are working [9].