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{{Template:Hyperparathyroidism (patient information)}}
'''For the WikiDoc page for this topic, click [[Hyperparathyroidism|here]]'''
'''For the WikiDoc page for this topic, click [[Hyperparathyroidism|here]]'''
{{SI}}


'''Editor-in-Chief:''' Meagan E. Doherty
{{CMG}};  '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D.


{{EJ}}
==Overview==
Hyperparathyroidism is excessive production of parathyroid hormone (PTH) by the parathyroid glands.


==What is Hyperparathyroidism?==
==What are the symptoms of Hyperparathyroidism?==
If the parathyroid glands secrete too much hormone, as happens in primary hyperparathyroidism, the balance is disrupted: Blood calcium rises. This condition of excessive calcium in the blood, called [[hypercalcemia]], is what usually signals the doctor that something may be wrong with the parathyroid glands. In 85 percent of people with primary hyperparathyroidism, a benign tumor called an [[adenoma]] has formed on one of the parathyroid glands, causing it to become overactive. Benign tumors are noncancerous. In most other cases, the excess hormone comes from two or more enlarged parathyroid glands, a condition called [[hyperplasia]]. Very rarely, hyperparathyroidism is caused by cancer of a parathyroid gland.
 
This excess PTH triggers the release of too much calcium into the bloodstream. The bones may lose calcium, and too much calcium may be absorbed from food. The levels of calcium may increase in the urine, causing kidney stones. PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.


==What are the symptoms of Hyperparathyroidism?==
* [[Back pain]]
* [[Back pain]]
* Blurred vision (because of cataracts)
* [[Blurred vision]] (because of [[cataracts]])
* [[Bone pain]] or tenderness
* [[Bone pain]] or tenderness
* Decreased height
* [[Decreased height]]
* [[Depression]]
* Depression
* [[Fatigue]]
* Fatigue
* [[Fracture]]s of long bones
* Fractures of long bones
* Increased urine output
* Increased urine output
* Increased [[thirst]]
* Increased thirst
* [[Itchy skin]]
* Itchy skin
* Joint [[pain]]
* Joint pain
* [[Loss of appetite]]
* Loss of appetite
* [[Nausea]]
* Nausea
* Muscle weakness and pain
* Muscle weakness and pain
* Personality changes
* Personality changes
* Stupor and possibly [[coma]]
* Stupor and possibly coma
* [[Upper abdominal pain]]
* Upper abdominal pain
 
==What causes Hyperparathyroidism?==
The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. They produce parathyroid hormone, which controls calcium, phosphorus, and vitamin D levels within the blood and bone.
 
When calcium levels are too low, the body responds by increasing production of parathyroid hormone. This increase in parathyroid hormone causes more calcium to be taken from the bone and more calcium to be reabsorbed by the intestines and kidney. When the calcium level returns to normal, parathyroid hormone production slows down.
 
There are two main types of hyperparathyroidism.


==What are the causes of Hyperparathyroidism?==
Primary hyperparathyroidism is caused by enlargement of one or more of the parathyroid glands. This leads to too much parathyroid hormone, which raises the level of calcium in the blood. The term "hyperparathyroidism" generally refers to primary hyperparathyroidism.
In most cases doctors don't know the cause. The vast majority of cases occur in people with no family history of the disorder. Only about 5 percent of cases can be linked to an inherited problem. Familial [[multiple endocrine neoplasia type 1]] is a rare, inherited syndrome that affects the parathyroids as well as the [[pancreas]] and the [[pituitary gland]]. Another rare genetic disorder, [[familial hypocalciuric hypercalcemia]], is sometimes confused with typical hyperparathyroidism. Each accounts for about 2 percent of primary hyperparathyroidism cases.


==Who is at risk for Hyperparathyroidism?==
Secondary hyperparathyroidism is when the body produces extra parathyroid hormone because the calcium levels are too low. This is seen when vitamin D levels are low or when calcium is not absorbed from the intestines. Correcting the calcium level and the underlying problem will bring the parathyroid levels in the normal range.
In the United States, about 100,000 people develop the disorder each year. Women outnumber men two to one, and risk increases with age. In women 60 years and older, two out of 1,000 will develop hyperparathyroidism each year.


==How to know you have Hyperparathyroidism?==
If the parathyroid glands continue to produce too much parathyroid hormone even though the calcium level is back to normal, the condition is called "tertiary hyperthyroidism." It occurs especially in patients with kidney problems
:*Diagnosis of hyperparathyroidism: Hyperparathyroidism is diagnosed when tests show that blood levels of [[calcium]] and [[parathyroid hormone]] are too high. Other diseases can cause high blood calcium levels, but only in hyperparathyroidism is the elevated calcium the result of too much parathyroid hormone. A blood test that accurately measures the amount of parathyroid hormone has simplified the diagnosis of hyperparathyroidism.


:*Assessment of [[complication]]s of hyperparathyroidism: Once the diagnosis is established, other tests may be done to assess complications. Because high PTH levels can cause bones to weaken from calcium loss, a measurement of [[bone density]] can help assess bone loss and the risk of [[fracture]]s. Abdominal images may reveal the presence of [[kidney stone]]s and a 24-hour urine collection may provide information on kidney damage, the risk of stone formation, and the risk of familial hypocalciuric hypercalcemia.
==Diagnosis==
Blood tests will be done to check for increased levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, and lower levels of phosphorus. A 24-hour urine collection test can help determine how much calcium is being removed from the body.


==When to seek urgent medical care==
Bone x-rays and bone mineral density test can help detect bone loss, fractures, or bone softening.
 
X-rays, ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.
 
==When to seek urgent medical care?==
Call for an appointment with your health care provider if you have symptoms of hyperparathyroidism.
Call for an appointment with your health care provider if you have symptoms of hyperparathyroidism.


==Treatment options==
==Treatment options==
Surgery to remove the enlarged gland (or glands) is the main treatment for the disorder and cures it in 95 percent of operations.
Treatment depends upon the severity and cause of the condition. If you have mildly increased calcium levels due to primary hyperparathyroidism and no symptoms, you may just need regular checkups with your doctor.
 
[[Calcimimetics]] are a new class of drug that turns off secretion of PTH. They have been approved by the Food and Drug Administration for the treatment of hyperparathyroidism secondary to [[kidney failure]] with [[dialysis]], and primary hyperparathyroidism caused by parathyroid cancer. They have not been approved for primary hyperparathyroidism, but some physicians have begun prescribing calcimimetics for some patients with this condition. Patients can discuss this class of drug in more detail with their physicians.


Some patients who have mild disease may not need immediate treatment, according to panels convened by the National Institutes of Health (NIH) in 2002. Patients who are symptom-free, whose blood calcium is only slightly elevated, and whose kidneys and bones are normal may wish to talk with their physicians about long-term monitoring. In the 2002 recommendation, periodic monitoring would consist of clinical evaluation, measurement of serum calcium levels, and bone mass measurement. If the patient and physician choose long-term follow-up, the patient should try to drink lots of water, get plenty of exercise, and avoid certain diuretics, such as the thiazides. Immobilization (inability to move) and gastrointestinal illness with vomiting or diarrhea can cause calcium levels to rise. Patients with hyperparathyroidism should seek medical attention if they find themselves immobilized, vomiting, or having diarrhea.
If symptoms are present or your calcium level is very high, surgery may be needed to remove the parathyroid gland that is overproducing the hormone.


==Diseases with similar symptoms==
Treatment of secondary hyperparathyroidism depends on the underlying cause.
* [[Familial hypocalciuric hypercalcemia]]
* [[Hypercalcemia]] of malignancy
* Multiple [[myeloma]]
* [[Familial hypocalciuric hypercalcaemia]]
* [[Sarcoidosis]]
* [[Hyperthyroidism]]


==Where to find medical care for Hyperparathyroidism==
==Where to find medical care for Hyperparathyroidism?==
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|yourdisease}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Hyperparathyroidism]
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|yourdisease}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Hyperparathyroidism]


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Getting the proper amount of calcium in your diet or through supplements may reduce your risk of secondary hyperparathyroidism.
Getting the proper amount of calcium in your diet or through supplements may reduce your risk of secondary hyperparathyroidism.


==What to expect (Outlook/Prognosis)==
==What to expect (Outlook/Prognosis)?==
The outlook depends on the specific type of hyperparathyroidism.
The outlook depends on the specific type of hyperparathyroidism.
===Possible Complications===
 
==Possible complications==
Complications may include:
Complications may include:
* Increased risk of fractures
* Increased risk of fractures
* [[Urinary tract infection]] due to kidney stones and blockage
* Urinary tract infection due to kidney stones and blockage
* [[Peptic ulcer disease]]
* Peptic ulcer disease
* [[Pancreatitis]]
* Pancreatitis
* [[Pseudogout]]
* Pseudogout


Surgery for hyperparathyroidism may lead to low blood calcium levels, which causes tingling and muscle twitching. This requires immediate treatment.
Surgery for hyperparathyroidism may lead to low blood calcium levels, which causes tingling and muscle twitching. This requires immediate treatment.


==Sources==
==Sources==
*http://www.nlm.nih.gov/medlineplus/ency/article/001215.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001215.htm
*http://www.wrongdiagnosis.com/h/hyperparathyroidism/misdiag.htm
{{WH}}
*http://www.endocrine.niddk.nih.gov/pubs/hyper/hyper.htm
{{WS}}


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{{WH}}
 
{{WS}}
[[Category:Disease]]
[[Category:Patient Information]]
[[Category:Medicine]]
'''Bold text'''
[[Category:Endocrinology]]
[[Category:Parathyroid disorders]]
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Latest revision as of 22:16, 29 July 2020

Hyperparathyroidism

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Hyperparathyroidism?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Hyperparathyroidism On the Web

Ongoing Trials at Clinical Trials.gov

Images of Hyperparathyroidism

Videos on Hyperparathyroidism

FDA on Hyperparathyroidism

CDC on Hyperparathyroidism

Hyperparathyroidism in the news

Blogs on Hyperparathyroidism

Directions to Hospitals Treating Hyperparathyroidism

Risk calculators and risk factors for Hyperparathyroidism

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview

Hyperparathyroidism is excessive production of parathyroid hormone (PTH) by the parathyroid glands.

What are the symptoms of Hyperparathyroidism?

  • Back pain
  • Blurred vision (because of cataracts)
  • Bone pain or tenderness
  • Decreased height
  • Depression
  • Fatigue
  • Fractures of long bones
  • Increased urine output
  • Increased thirst
  • Itchy skin
  • Joint pain
  • Loss of appetite
  • Nausea
  • Muscle weakness and pain
  • Personality changes
  • Stupor and possibly coma
  • Upper abdominal pain

What causes Hyperparathyroidism?

The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. They produce parathyroid hormone, which controls calcium, phosphorus, and vitamin D levels within the blood and bone.

When calcium levels are too low, the body responds by increasing production of parathyroid hormone. This increase in parathyroid hormone causes more calcium to be taken from the bone and more calcium to be reabsorbed by the intestines and kidney. When the calcium level returns to normal, parathyroid hormone production slows down.

There are two main types of hyperparathyroidism.

Primary hyperparathyroidism is caused by enlargement of one or more of the parathyroid glands. This leads to too much parathyroid hormone, which raises the level of calcium in the blood. The term "hyperparathyroidism" generally refers to primary hyperparathyroidism.

Secondary hyperparathyroidism is when the body produces extra parathyroid hormone because the calcium levels are too low. This is seen when vitamin D levels are low or when calcium is not absorbed from the intestines. Correcting the calcium level and the underlying problem will bring the parathyroid levels in the normal range.

If the parathyroid glands continue to produce too much parathyroid hormone even though the calcium level is back to normal, the condition is called "tertiary hyperthyroidism." It occurs especially in patients with kidney problems

Diagnosis

Blood tests will be done to check for increased levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, and lower levels of phosphorus. A 24-hour urine collection test can help determine how much calcium is being removed from the body.

Bone x-rays and bone mineral density test can help detect bone loss, fractures, or bone softening.

X-rays, ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of hyperparathyroidism.

Treatment options

Treatment depends upon the severity and cause of the condition. If you have mildly increased calcium levels due to primary hyperparathyroidism and no symptoms, you may just need regular checkups with your doctor.

If symptoms are present or your calcium level is very high, surgery may be needed to remove the parathyroid gland that is overproducing the hormone.

Treatment of secondary hyperparathyroidism depends on the underlying cause.

Where to find medical care for Hyperparathyroidism?

Directions to Hospitals Treating Hyperparathyroidism

Prevention of Hyperparathyroidism

Getting the proper amount of calcium in your diet or through supplements may reduce your risk of secondary hyperparathyroidism.

What to expect (Outlook/Prognosis)?

The outlook depends on the specific type of hyperparathyroidism.

Possible complications

Complications may include:

  • Increased risk of fractures
  • Urinary tract infection due to kidney stones and blockage
  • Peptic ulcer disease
  • Pancreatitis
  • Pseudogout

Surgery for hyperparathyroidism may lead to low blood calcium levels, which causes tingling and muscle twitching. This requires immediate treatment.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001215.htm Template:WH Template:WS

​

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