The term hyperparathyroidism describes an overactive parathyroid gland. This means that the patient’s parathyroid gland is producing too much parathyroid hormone.
What is hyperparathyroidism?
Primary hyperparathyroidism often shows no symptoms in the person affected, so that the disease is often only discovered by chance during a blood test. The concentration of calcium in the blood is usually significantly increased. See AbbreviationFinder for abbreviations related to Hyperparathyroidism.
Hyperparathyroidism (overactive parathyroid gland) is when the parathyroid gland is overactive, causing it to produce too much parathyroid hormone. This hormone is responsible for regulating the phosphate and calcium levels in the body.
If the organism has a high proportion of parathyroid hormone, the calcium level in the blood increases. Many of the patients do not feel any symptoms, so that hyperparathyroidism is usually discovered by the doctor by chance. However, some sufferers may experience symptoms that include gastrointestinal complications, muscle weakness, loss of appetite, and high blood pressure.
Hyperfunction of the parathyroid glands is diagnosed much more frequently in women than in men. About two-thirds of all those affected are female. The disease can occur at any age. However, hyperparathyroidism mainly occurs after the age of 40.
There are different causes for hyperparathyroidism. Primary hyperparathyroidism develops when diseases of the parathyroid gland itself are the cause. However, if other diseases are responsible for the overactive parathyroid gland, it is referred to as secondary hyperparathyroidism.
The most common causes of this condition are diseases of the parathyroid glands. Usually, the affected person has benign tumors in the parathyroid glands that produce hormones. These include, in particular, accessory gland adenomas. If secondary hyperparathyroidism is present, this is usually due to diseases that lower the calcium level in the bloodstream.
This can be, for example, reduced calcium intake due to unbalanced food intake or a vitamin D deficiency. In contrast to the primary form of hyperparathyroidism (overactive parathyroid glands), the calcium value in secondary hyperparathyroidism is lower and not increased.
Symptoms, Ailments & Signs
In many cases, a routine blood test will reveal an elevated calcium level, which is the first indication of the presence of hyperparathyroidism. Complaints do not yet occur with this so-called asymptomatic parathyroid hyperfunction.
If the hormonal disorder remains undetected, the excess calcium in the blood can make itself felt through a series of symptoms: The first noticeable signs of hyperparathyroidism can be severe thirst and increased urine output, often accompanied by loss of appetite, nausea, vomiting, constipation and weight loss. High blood pressure, cardiac arrhythmia and chronic fatigue are also occasionally due to increased calcium levels.
Many of those affected suffer from kidney stones, which can subsequently trigger very painful kidney colic. Kidney stone disease must also be considered in the case of recurring urinary tract infections that are associated with back pain and pain in the upper abdomen.
As the disease progresses, the bone metabolism is often affected: those affected report joint and bone pain, which is often misinterpreted as rheumatic symptoms. An X-ray shows changes in the sense of osteoporosis (bone atrophy), and there is a risk of a bone fracture even with low loads. Calcification of blood vessels and muscles due to the increased concentration of calcium and phosphate in the blood is also possible. Rarely do those affected develop psychiatric illnesses such as depression, psychosis or dementia as part of hyperparathyroidism.
Diagnosis & History
Examination of the thyroid.
Primary hyperparathyroidism often shows no symptoms in the person affected, so that the disease is often only discovered by chance during a blood test. The concentration of calcium in the blood is usually significantly increased.
However, even with the primary form of this disorder, there does not have to be an increase in the calcium level. A simultaneous lack of vitamin D or renal insufficiency can regulate the calcium level, even though the parathyroid gland is overactive. Doctors use different imaging methods to determine the cause of hyperparathyroidism. These include, among other things, the ultrasound examination and a scintigraphy.
In some cases, cross-sectional imaging methods are also used, including magnetic resonance imaging (MRI) and computed tomography (CT).
The course of the disease depends on the cause. The prognosis for primary hyperparathyroidism is good if surgical treatment is possible. If there are no other side effects, the patient is symptom-free after the operation because of his hyperparathyroidism.
Hyperparathyroidism causes various symptoms. The patient primarily suffers from nausea and vomiting. There is also increased thirst and thus increased urination by the patient. Loss of appetite can also occur, leading to underweight or deficiency symptoms. In the worst case, hyperparathyroidism leads to renal insufficiency.
In this case, the affected person is then dependent on a kidney transplant or dialysis in order to continue to survive. It is not uncommon for hyperparathyroidism to result in psychological upsets and symptoms, so that psychological treatment is necessary in most cases. This disease is usually treated by surgery, with no particular complications or other symptoms.
The symptoms can be alleviated or even completely eliminated. Whether life expectancy has been reduced by the disease depends heavily on the severity and duration of hyperparathyroidism. In some cases, the disease leads to increased bone fragility. This can also be prevented by treatment.
When should you go to the doctor?
A doctor’s visit is necessary as soon as symptoms such as nausea, vomiting or dizziness appear. If there are any abnormalities when going to the toilet, these must be observed. If they persist for several days, they should be examined more closely. If you experience unusual bowel noises, flatulence, digestive problems, constipation or diarrhea, you need to see a doctor. If the symptoms persist or increase in intensity, a doctor must be consulted.
If there is a loss of appetite and weight, a medical examination should be carried out. If the person concerned suffers from frequent urination, this is a warning from the organism. Since other diseases can occur, a doctor should be consulted. If there are problems with the heart rhythm, changes in the usual performance or vegetative abnormalities, a doctor’s visit is necessary. A check-up visit should take place in the event of sweating, insomnia, bone pain or swelling.
If you have problems with your spine or body aches, you should consult a doctor. See a doctor if you have emotional problems, mood swings, depressive behaviors, or a loss of well-being. Irregular heart rhythms, high blood pressure or a feeling of internal heat should be checked and examined. Failure to receive medical care can result in sudden bone fractures that require treatment.
Treatment & Therapy
The treatment of hyperparathyroidism aims to regulate the level of calcium in the bloodstream. If primary hyperparathyroidism is present, an operation is one of the typical measures of therapy.
In this surgical procedure, the doctor removes the affected parathyroid gland or the designated epithelial bodies. If all four parathyroid glands are enlarged, the surgeon usually has to remove the entire organ. Part of the parathyroid gland is then transplanted to another part of the body. This transplant usually takes place in the arm muscles.
This can effectively prevent a lack of hormones. If surgery is not possible or necessary as a treatment method for hyperparathyroidism, the doctor resorts to a conservative therapy method. This includes, above all, sufficient fluid intake and a separate intake of vitamin D.
For women who have already passed the point of menopause, a supply of biophosphonates can also be helpful. This prevents increased bone fragility. In some cases, therapy with the active ingredient cinacalcet is also necessary to relieve the affected person of his or her symptoms. If there is secondary hyperparathyroidism (excessive function of the parathyroid glands), the primary disease is treated first.
Outlook & Forecast
The disease has a very favorable prognosis when diagnosed early. Often no treatment is necessary. A monitoring of the health functions is initiated and checked at regular intervals.
In some cases, an operation is performed. Since this is always associated with risks, complications and consequences can occur. This worsens the otherwise good prognosis. If the operation is successful, the patient is usually released from treatment as symptom-free. Nevertheless, regular check-ups are also necessary here in order to be able to identify and treat possible disorders or changes at an early stage.
The living conditions usually do not have to be changed, since there are no impairments afterwards. If complications occur during the procedure, they must be assessed and recorded individually. The further treatment plan depends on the damage or injuries that have occurred. A general statement cannot be made.
If the disease progresses severely, kidney failure can occur. This course occurs only in exceptional cases, but has a life-threatening character. It is an acute condition that requires immediate intensive care. If the functional inability of the kidneys cannot be adequately treated in time, the patient dies prematurely. If the patient survives, permanent impairment of kidney function can occur and further secondary diseases are possible.
So far, no measures are known that could prevent hyperparathyroidism . However, protection against very serious complications in the primary form of hyperparathyroidism is surgical removal of the affected parathyroid gland.
In hyperparathyroidism, the method of follow-up depends on whether the condition has been treated conservatively or through surgery. In both cases, health is closely monitored in order to quickly identify any relapses.
As part of conservative therapy and follow-up treatment, patients must drink plenty of fluids and vitamin D. This can alleviate the symptoms associated with hyperfunction of the parathyroid glands. Spending time in the fresh air is also helpful. Outside, sunlight stimulates the production of vitamin D. Following a detailed medical consultation, those affected can take dietary supplements to support the vitamin balance.
However, patients should not take this additional intake of vitamin D without consulting their doctor. With this method, complications such as osteoporosis can be avoided or at least postponed. With a regular blood test, the doctor determines whether any adjustments are necessary for the state of health or the balanced vitamin balance.
Depending on the situation, dietary advice can help stabilize calcium levels. For patients, this means above all that they have to drink a lot and only eat small amounts of dairy products and legumes. In self-help groups, they can exchange information about their problems and the recommended change in life.
You can do that yourself
Hyperfunction of the parathyroid glands is often associated with a vitamin D deficiency. Those affected therefore benefit from spending time outdoors on a regular basis. Sunlight promotes the production of the vitamin. After consultation with the doctor treating you, dietary supplements also help to keep the vitamin balance in balance. In this way, patients can prevent long-term effects such as osteoporosis from developing. It should be said that a regular blood test must be carried out. In this way, you can always react directly to the current vitamin status.
Nutritional advice is also recommended. Since in most cases of hyperparathyroidism there is an increased calcium level, a low-calcium diet is advisable. This includes the moderate consumption of dairy products and legumes. Patients should also drink a lot to increase calcium excretion. Here, a mineral water with a low calcium content should be selected.
In addition, there are support groups for people suffering from hyperparathyroidism. Those affected have the opportunity to exchange ideas here. Such regular meetings with other patients often help people to cope better with the disease. A visit to a non- medical practitioner is often worthwhile. This recognizes regulatory disorders of the vitamin balance and can contribute to a better quality of life with natural methods. Accompanying symptoms such as tiredness are also often treated with Schuessler salts, globules or herbal remedies.