Chapter 1
What is hyper-parathyroidism?
Your parathyroid glands are located in the neck, typically behind the thyroid gland. Most people have four parathyroid glands, each roughly the size of a pea. These glands produce parathyroid hormone (PTH), which helps your body create, store and maintain normal levels of calcium in the body.
When the body produces too much PTH, this can cause the calcium levels in your body to rise and create a condition called hypercalcemia. When you have too much calcium in your blood, it can cause other issues such as weak or painful bones (because the excess PTH is pulling calcium from bones), kidney stones, overreactive bladder, fatigue or memory problems, to name a few.
There are three main types of hyperparathyroidism:
- Primary hyperparathyroidism. This is when one or more of the parathyroid glands are overactive and producing too much PTH.
- Secondary hyperparathyroidism. This is where a condition outside of the parathyroid glands causes the glands to produce too much PTH. These conditions may include kidney or renal failure, or vitamin D deficiency.
- Tertiary hyperparathyroidism. Often, patients who have secondary hyperparathyroidism have treatment that addresses the underlying concern (i.e., a kidney transplant or dialysis to address kidney failure). Most of the time, after treatment is complete, the parathyroid glands return to normal function. However, in some people who experienced long-term kidney or vitamin D deficiency issues, the parathyroid does not return to its normal function and continues to produce too much PTH, acting like primary hyperparathyroidism.
Less than 1% of hyperparathyroidism develops into parathyroid cancer.
Risk factors for hyperparathyroidism
The following factors may increase your risk of developing hyperparathyroidism:
- Being female
- Being over the age of 60
- Ongoing and severe vitamin D or calcium deficiencies
- Previous radiation therapy to the neck
- Using Lithium, a drug that helps treat bipolar disorder
Having a risk factor for hyperparathyroidism cancer doesn’t mean that you will get it, but it makes you more likely than someone without the risk factor. Talk to your doctor about your individual risk factors.
Symptoms of hyperparathyroidism
It is common to be diagnosed with hyperparathyroidism before you notice any symptoms. That is because your healthcare provider may notice high levels of calcium during a routine blood test.
As the body continues to overproduce PTH and cause too high calcium levels in the body, symptoms may include:
- Osteoporosis or brittle bones that break easily
- Bone and joint pain
- Kidney stones
- A general feeling of weakness or fatigue
- Depression or difficulty thinking
- Loss of appetite, nausea or vomiting
- Being more thirsty than usual
- Having to urinate more frequently than usual
- Constipation
The above symptoms can be related to a variety of medical conditions. It is important to talk to your doctor to determine the root cause of your symptoms.
In very severe cases, elevated calcium levels in the blood due to hyperparathyroidism can cause kidney failure, loss of consciousness or life-threatening heart conditions. These symptoms are typically very rare.
Chapter 2
Diagnosis
Most often, hyperparathyroidism is diagnosed during routine bloodwork that shows high levels of PTH and calcium in the bloodstream. In some instances, it may be diagnosed when the blood test was ordered for another condition.
If your healthcare provider is concerned about the possibility of hyperparathyroidism, he or she may also order some combination of the following tests:
- Parathyroid 4D CT scan. Your doctor will inject an iodine-based dye intravenously before having a 4D computerized tomography (CT) scan. The dye will attach itself to the overactive gland to help identify it in the imaging.
- Sestamibi scan. Your doctor will inject a small amount of technetium 99, which is a radioactive substance, into your bloodstream. This radioactive substance travels through the body and attaches itself to the overactive gland. The substance lights up the gland in a picture taken by a gamma camera.
- Imaging tests. Your doctor may order imaging tests – such as a computerized tomography (CT) scan, or magnetic resonance imaging (MRI) – to get a closer look inside your body.
- Additional blood tests. You might have additional blood tests to check your vitamin D levels and kidney function.
- Urine analysis and collection. You may be asked to collect your urine for up to 24 hours to measure the amount of calcium levels in your urine.
- Bone density test. Also called a DEXA scan, your doctor may want to perform this test to see if you have developed osteoporosis, which is a symptom of hyperparathyroidism.
Head & Neck Surgical Cancer Specialists of SW Florida
Surgical Oncology
4571 Colonial Blvd., Suite 210
Fort Myers, FL 33966
Tel: 239-790-3480
Our provider
Scott Larson, MD, Otolaryngologist at Head & Neck Surgical Cancer Specialists of SW Florida, specializes in the surgical management of benign and malignant tumors of the skin, salivary glands, nose/sinuses, oral cavity, pharynx, larynx, thyroid, and parathyroid glands. He is experienced in parathyroid surgery.
