Dr. MJ Bazos MD, Patient Handout

Hyperparathyroidism

What is hyperparathyroidism?

You have 4 pea-sized glands behind the thyroid gland at the front of your neck. These glands are called parathyroids. They make a hormone called parathyroid hormone (PTH) that keeps the right levels of calcium in your blood and bones. PTH helps you absorb calcium from your food and keeps you from losing too much calcium in your urine. When your parathyroid glands make too much of this hormone, you have a condition called hyperparathyroidism (HPT). The amount of calcium going into your bones usually matches the amount of calcium passing out of you bones. This means that the amount of calcium in your bones should stay about the same all the time. If you have HPT, more calcium is coming out of your bones than is going in, so you get too much calcium in your blood. Other parts of your body don't work as well if you have too much calcium in your blood.

What are the symptoms of hyperparathyroidism?

Someone with hyperparathyroidism may experience some of the following symptoms:

• You might feel depressed or feel tired all the time.
• Any part of your body might hurt.
• You might have heartburn because the high calcium level in your blood causes your stomach to make too much acid.
• You might have nausea, vomiting, pain in your abdomen (tummy) or constipation.
• High blood pressure.

What does HPT do to your body?

Your bones might hurt if they don't have enough calcium in them. Losing calcium also makes your bones weak. Weak bones break more easily and are slower to heal than normal bone. You might develop kidney stones, because your kidneys are trying to filter out the extra calcium in your blood. Too much calcium in your kidneys might make you thirsty or increase your need to urinate. Too much calcium in your blood also causes high blood pressure. All these things happen so slowly that you may not notice at first, or you may get used to not feeling well.

Who gets HPT?

More women get HPT than men. HPT is more common in older people. Nothing you eat or do causes this disease. You have about 1 chance in 1,000 of getting this disease after you are 60 years old.

How does my doctor know I have HPT?

HPT is most often suspected when a high level of calcium is found in your blood on a routine blood test. The test results can help your family doctor make the diagnosis even before any problems start. This is one benefit of having regular blood tests. Further blood testing proves the diagnosis, usually by measuring the amount of PTH in your blood. A special scan can find the growth on your parathyroid gland, if that is what is causing your HPT. Regular x-rays look normal until late in the disease, so they aren't much help in diagnosing HPT. Other causes of increased calcium in the blood, such as some medicines or cancer, must sometimes be considered.

How is HPT treated?

Surgery to remove the growth in your neck almost always solves the problem. The growth doesn't usually come back. Most of your symptoms will stop in the first month after surgery. For a short time after surgery, your blood calcium level may be too low. This problem is easily treated with medicine.Although surgery is usually recommended for people with HPT (unless they have no symptoms), sometimes other medical problems make surgery too risky. Then your doctor may recommend treatment with medicine alone. Medicines can treat some, but not all, of the symptoms of HPT. If you don't have surgery, tests are needed from time to time to see if the disease is hurting your kidneys, bones or other body systems. Special machines can check your bone strength. Women who take estrogen after menopause are partly protected from the effects of HPT. Most people feel much better after treatment when the discomforts that they have been trying to live with go away. Websites:Thyroid Foundation of America, Inc.: www.tsh.org