Overview Hyperparatiroid

Overview
Parathyroid glands
Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to

overactivity of one or more of the body's four parathyroid glands. These glands are
about the size of a grain of rice and are located in your neck.
The parathyroid glands produce parathyroid hormone, which helps maintain an

appropriate balance of calcium in the bloodstream and in tissues that depend on
calcium for proper functioning.
Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an

enlargement of one or more of the parathyroid glands causes overproduction of the
hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can
cause a variety of health problems. Surgery is the most common treatment for primary
hyperparathyroidism.
Secondary hyperparathyroidism occurs as a result of another disease that initially

causes low levels of calcium in the body and over time, increased parathyroid hormone
levels occur.
Symptoms
Hyperparathyroidism is often diagnosed before signs or symptoms of the disorder are

apparent. When symptoms do occur, they're the result of damage or dysfunction in
other organs or tissues due to high calcium levels circulating in the blood and urine or
too little calcium in bones.
Symptoms may be so mild and nonspecific that they don't seem at all related to
parathyroid function, or they may be severe. The range of signs and symptoms include:
 Fragile bones that easily fracture (osteoporosis)
 Kidney stones
 Excessive urination
 Abdominal pain
 Tiring easily or weakness
 Depression or forgetfulness
 Bone and joint pain
 Frequent complaints of illness with no apparent cause
 Nausea, vomiting or loss of appetite

When to see a doctor
See your doctor if you have any signs or symptoms of hyperparathyroidism. These
symptoms could be caused by any number of disorders, including some with serious
complications. It's important to get a prompt, accurate diagnosis and appropriate
treatment.
Request an Appointment at Mayo Clinic
Causes

Parathyroid glands
Hyperparathyroidism is caused by factors that increase the production of parathyroid

hormone.
The parathyroid glands maintain proper levels of both calcium and phosphorus in your
body by turning the secretion of parathyroid hormone (PTH) off or on, much like a
thermostat controls a heating system to maintain a constant air temperature. Vitamin D
also is involved in regulating the amount of calcium in your blood.
Normally, this balancing act works well. When calcium levels in your blood fall too low,
your parathyroid glands secrete enough PTH to restore the balance. PTH raises
calcium levels by releasing calcium from your bones and increasing the amount of
calcium absorbed from your small intestine.
When blood-calcium levels are too high, the parathyroid glands produce less PTH. But
sometimes one or more of these glands produce too much hormone, leading to
abnormally high levels of calcium (hypercalcemia) and low levels of phosphorus in your
blood.
The mineral calcium is best known for its role in keeping your teeth and bones healthy.
But calcium has other functions. It aids in the transmission of signals in nerve cells, and
it's involved in muscle contraction. Phosphorus, another mineral, works in conjunction
with calcium in these areas.
The disorder can generally be divided into two types based on the cause.
Hyperparathyroidism may occur because of a problem with the parathyroid glands
themselves (primary hyperparathyroidism) or because of another disease that affects
the glands' function (secondary hyperparathyroidism).
Primary hyperparathyroidism
Primary hyperparathyroidism occurs because of some problem with one or more of the
four parathyroid glands:
 A noncancerous growth (adenoma) on a gland is the most common cause.
 Enlargement (hyperplasia) of two or more parathyroid glands accounts for most

other cases.
 A cancerous (malignant) tumor is a rare cause of primary hyperparathyroidism.

Primary hyperparathyroidism usually occurs randomly, but some people inherit a gene
that causes the disorder.
Secondary hyperparathyroidism
Secondary hyperparathyroidism is the result of another condition that lowers calcium

levels. Therefore, your parathyroid glands overwork to compensate for the loss of
calcium. Factors that may contribute to secondary hyperparathyroidism include:
 Severe calcium deficiency. Your body may not get enough calcium from your
diet, often because your digestive system doesn't absorb the calcium from it.
 Severe vitamin D deficiency. Vitamin D helps maintain appropriate levels of

calcium in the blood, and it helps your digestive system absorb calcium from your
food.
Your body produces vitamin D when your skin is exposed to sunlight, and you
consume some vitamin D in food. If you don't get enough vitamin D, then calcium
levels may drop.
 Chronic kidney failure. Your kidneys convert vitamin D into a form that your body
can use. If your kidneys function poorly, usable vitamin D may decline and calcium
levels drop. Chronic kidney failure is the most common cause of secondary
hyperparathyroidism.
Risk factors
You may be at an increased risk of primary hyperparathyroidism if you:
 Are a woman who has gone through menopause
 Have had prolonged, severe calcium or vitamin D deficiency
 Have a rare, inherited disorder, such as multiple endocrine neoplasia, type 1,

which usually affects multiple glands
 Have had radiation treatment for cancer that has exposed your neck to radiation
 Have taken lithium, a drug most often used to treat bipolar disorder
Complications
Complications of hyperparathyroidism are primarily related to the long-term effect of too

little calcium in your bones and too much calcium circulating in your bloodstream.
Common complications include:
 Osteoporosis. The loss of calcium often results in weak, brittle bones that fracture
easily (osteoporosis).
 Kidney stones. The excess of calcium in your blood may lead to excess calcium
in your urine, which can cause small, hard deposits of calcium and other
substances to form in your kidneys. A kidney stone usually causes significant pain
as it passes through the urinary tract.
 Cardiovascular disease. Although the exact cause-and-effect link is unclear, high

calcium levels are associated with cardiovascular conditions, such as high blood
pressure (hypertension) and certain types of heart disease.
 Neonatal hypoparathyroidism. Severe, untreated hyperparathyroidism in

pregnant women may cause dangerously low levels of calcium in newborns.

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Overview

Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to

The parathyroid glands produce parathyroid hormone, which helps maintain an

Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an

Secondary hyperparathyroidism occurs as a result of another disease that initially

Hyperparathyroidism is often diagnosed before signs or symptoms of the disorder are

 Fragile bones that easily fracture (osteoporosis)

 Tiring easily or weakness

 Bone and joint pain

 Frequent complaints of illness with no apparent cause

 Nausea, vomiting or loss of appetite

Request an Appointment at Mayo Clinic

Hyperparathyroidism is caused by factors that increase the production of parathyroid

 A noncancerous growth (adenoma) on a gland is the most common cause.

 Enlargement (hyperplasia) of two or more parathyroid glands accounts for most

 A cancerous (malignant) tumor is a rare cause of primary hyperparathyroidism.

Secondary hyperparathyroidism is the result of another condition that lowers calcium

 Severe vitamin D deficiency. Vitamin D helps maintain appropriate levels of

You may be at an increased risk of primary hyperparathyroidism if you:

 Are a woman who has gone through menopause

 Have had prolonged, severe calcium or vitamin D deficiency

 Have a rare, inherited disorder, such as multiple endocrine neoplasia, type 1,

Complications of hyperparathyroidism are primarily related to the long-term effect of too

 Cardiovascular disease. Although the exact cause-and-effect link is unclear, high

 Neonatal hypoparathyroidism. Severe, untreated hyperparathyroidism in

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