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Hyperparathyroidism (primary)

Most patients with hyperparathyroidism have primary hyperparathyroidism, which occurs when one or more of the four parathyroid glands next to the thyroid gland are secreting too much parathyroid hormone (PTH).

PTH regulates the amount of calcium, phosphorus and vitamin D in your blood and bones. Too much PTH triggers the bones to release calcium into the blood. The kidneys then react to the high levels of calcium in the blood by excreting more calcium in the urine. The result is high blood calcium, or hypercalcemia.

Primary hyperparathyroidism causes multiple health problems, including osteoporosis, kidney stones, chronic fatigue, and difficulty with memory and concentration. It has also been linked to other chronic conditions, including heart disease, high blood pressure, depression, and anxiety.

Primary hyperparathyroidism: what you should know

  • A routine calcium blood test that is above normal range is usually the first indicator primary hyperparathyroidism, even before you notice any symptoms.
  • In more than 99 percent of cases, the cause of primary hyperparathyroidism is a benign (noncancerous) tumor in one or more of the parathyroid glands.
  • Using minimally invasive surgical techniques, experienced endocrine surgeons cure primary hyperparathyroidism in more than 95 percent of cases with minimal complications and minimal recovery time.
  • Primary hyperparathyroidism is the most common type of hyperparathyroidism. Other types include secondary and tertiary hypoparathyroidism. These types are caused by other conditions, most commonly kidney disease.

Primary hyperparathyroidism symptoms

Symptoms are caused by too much calcium in your blood. They include the following:

  • Fatigue
  • Bone and joint pain
  • Bone fractures
  • Kidney stones
  • Muscle weakness
  • Depression
  • Confusion or memory issues
  • Increased thirst and urination

How can I get help for primary hyperparathyroidism?

Your primary care physician can diagnose primary hyperparathyroidism if your blood tests show high levels of calcium and PTH at the same time. You may need additional tests to assess possible complications such as osteoporosis and kidney stones. Your doctor may refer you to an endocrinologist or endocrine surgeon for further evaluation and treatment.

Care for primary hyperparathyroidism at Rush

Monitoring

If you have no symptoms, your bone density is normal, you do not have kidney stones (or heightened risk of kidney stones), and your levels of PTH and calcium are only mildly elevated, you and your doctor may decide to closely monitor your health until something changes.

Surgery

If you have primary hyperparathyroidism and you meet specific guidelines, you may benefit from surgery to remove overactive parathyroid glands, even if you have no symptoms. An experienced endocrine surgeon is key to successful surgery. There are two types of surgery for hyperparathyroidism:

  • Minimally invasive parathyroidectomy: This surgery is performed through a very small neck incision and allows for rapid recovery. Using this technique, an experienced endocrine surgeon can examine all four parathyroid glands to determine which of them need to be removed. Surgeons at Rush use this technique in more than 95 percent of cases.
  • Standard neck exploration: In the most complicated cases, patients may benefit from this traditional surgery, which results in a larger neck incision.

Medications

Your doctor may prescribe calcimimetics, a class of medications used to treat certain cases of primary hyperparathyroidism. Other medications are also being studied.

Why choose Rush for primary hyperparathyroidism care

  • Team-based approach: Working collaboratively to ensure that you receive the best care possible, your team is led by an endocrinologist and may include an endocrine surgeon, a nephrologist and other specialists.
  • Nationally recognized experts: The endocrinology and endocrine surgery team at Rush includes nationally recognized experts in the care of thyroid and parathyroid conditions.
  • Minimally invasive surgery: Rush offers minimally invasive techniques for parathyroid surgery. This type of surgery leaves a smaller scar, with faster healing and less pain.

Departments and programs that treat this condition