Hyperparathyroidism - Medtick

Hyperparathyroidism

What is it?

Parathyroid hormone gland (the parathyroid gland is located behind the thyroid gland in the neck) helps to:

  • Move calcium from the bones to the blood
  • Make the kidney remove less calcium from the body
  • Digest more calcium
  • Tell the kidney to produce more vitamin D to absorb more calcium

Primary hyperparathyroidism

When there is high levels parathyroid hormone in blood released from the parathyroid gland causing:

  • An increase in calcium levels in blood, (this hormone cause calcium  and phosphorus to be removed from the bones and into the blood).
  • Release calcium stored in the kidneys into the blood and releases phosphates to our urine (hypophosphatemia – low phosphate in our blood)
  • Releases vitamin D from the kidney into the intestine and this causes calcium to be reabsorbed in to the intestines and released into our blood.

Secondary Hyperparathyroidism

When there is high levels parathyroid hormone in blood released from the parathyroid gland but:

  • No change or a decrease in calcium levels in the blood- the body sends a response to release more parathyroid hormone to increase calcium levels in the blood however the body releases more parathyroid hormone over time but levels of calcium still remain low.
  • Medical treatment may be required to bring down the parathyroid hormone levels.

Tertiary hyperparathyroidism 

  • When medical treatment is not effective and parathyroid hormone levels are very high.
  • The gland becomes enlarged and starts releasing parathyroid hormone on its own and is not released due to low calcium levels in the blood.
  • Surgery may be required to remove the parathyroid hormone gland.

Cause

  • Family history
  • Neonatal severe hyperparathyroidism
  • Non-cancerous enlargement of parathyroid gland.
  • Non-cancer tumours of parathyroid gland.
  • Cancer of parathyroid gland
  • Have a rare, inherited disorder i.e.
  • Acromegaly
  • Menopause

Treatments

  • Kidney transplantation
  • Radiation therapy near neck

Vitamins, herbals and minerals

Syndromes

Medication

Secondary hyperparathyroidism (increase of parathyroid hormone due to other medical conditions not directly linked with parathyroid gland

  • Long term kidney disease including high phosphate levels in the blood (hyperphosphatemia)
  • the kidney  helps to change vitamin D to a form that the body can use, if the kidney does not function as it should i.e. kidney disease then the usable vitamin D levels drop causing calcium levels to drop and activating the parathyroid hormone gland.

Vitamins, herbals and minerals

  • Severe Calcium deficiency – the body cannot absorb enough calcium from your diet
  • Severe Vitamin D deficiency – the body cannot absorb enough Vitamin D – Vitamin D helps calcium to be maintained at appropriate levels in the blood, it also helps your digestion to absorb calcium from your food and move calcium from the intestine into your blood.

Tertiary hyperparathyroidism 

Symptoms

  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)
  • Abdominal pain and/or are constant violently vomiting or vomiting longer than two days (one day if a child)?
  • Find passing stools difficult and constipated?
  • Thirsty?
  • Urinate more frequently especially at night?
  • Low mood and depressed?
  • Balance and dizziness problems?
  • Altered heart rhythm (slow beating of heart)?
  • Swollen ankles?
  • High blood pressure?

Complications /Information to beware of/General tips:

Do not wait, phone for an ambulance if have or develop:

Treatment of Parathyroid (Hypercalcemic) Crisis in hospital

  • The treatment of a parathyroid crisis is to normalize calcium levels.
  • The initial and most important step in the management of hypercalcemia is to administer intravenous isotonic saline for extracellular volume expansion and promote hypercalciuria, with or without the usage of loop diuretics to prevent volume overload.
  • Biphosphonate and calcitonin can also be used to treat parathyroid crises.

Hypercalcaemic crisis due to primary hyperparathyroidism: report of two cases. Sala TD, Mureşan S, Roman R, Lazăr A, Ion R, Paşcanu I. J Crit Care Med (Targu Mures) 2019;5:34–39. [PMC free article] [PubMed[] [Ref list]

  • Surgery to remove the parathyroid hormone gland or if one has cancer of the parathyroid hormone gland, if the above has not helped.

This condition can lead to:

  • Osteoporosis
  • Kidney stones and blockage, and kidney damage or failure
  • Peptic ulcers
  • Pancreatitis
  • High calcium level conditions
  • Depression and or forgetfulness
  • Bone and joint pain (osteitis fibrosa cystica –  skeletal disorder resulting in a loss of bone mass, a weakening of the bones as their calcified supporting structures are replaced with fibrous tissue and the formation of cyst-like brown tumours in and around the bone.
  • Calcium Pyrophosphate deposition disease (pseudogout)
    • A form of arthritis that results from deposits of calcium pyrophosphate crystals.
    • Commonly affects knees and wrists.
    • Similar symptoms to gout:
      • Sudden intense joint pain
      • Swollen joint is warm and tender to touch
      • Red skin involving the affected joint
    • It can mistaken for arthritis attack and osteoarthritis
  • High parathyroid hormone levels may increases the secretion of aldosterone from the adrenal glands  directly as well as indirectly by activating the renin–angiotensin system in the kidneys, this may lead to:

Pregnancy

  • Neonatal hypoparathyroidism. Severe, untreated hyperparathyroidism in pregnant women may cause dangerously low levels of calcium in new borns.

This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Hyperparathyroidism in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

  • NHS

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