HYPERPARATHYROIDISM

General Information

DEFINITION--Excess parathyroid hormone circulating in the blood. The excess amounts increase blood levels of calcium (hypercalcemia) and decrease blood levels of phosphorous (hypophosphatemia).

BODY PARTS INVOLVED--Parathyroid glands (4 pea-sized glands located on the back and side of the thyroid gland); teeth; blood, which affects all body tissues--especially the heart, blood vessels, bones, kidneys, gastrointestinal tract, central nervous system and skin.

SEX OR AGE MOST AFFECTED--Both sexes and all ages, but most common in women between ages 30 and 50.

SIGNS & SYMPTOMS--

Often none; may be discovered as part of routine blood screening. When there are symptoms, they may include:

• Severe flank pain caused by kidney stones.
• Chronic low-back pain caused by bone softening.
• Easy bone fractures caused by decreased calcium in the bones.
• Upper abdominal pain caused by a peptic ulcer or pancreatitis.
• Depression.

CAUSES

• Benign tumors of the parathyroid glands.
• Sometimes caused by enlargement of the glands; the cause for this is unknown.

RISK INCREASES WITH

• Recent illness, especially endocrine disorders.
• Medical history of rickets or vitamin-D deficiency.
• Kidney failure.
• Use of laxatives.
• Use of digitalis.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of blood and urine.
• X-rays of bones; CT or MRI scan and ultrasound (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to remove all abnormal parathyroid tissue usually cures the condition. Normally the remaining parathyroid tissue is sufficient to produce enough hormone. If it isn't, you may require treatment for underactive parathyroid (hypoparathyroidism).
• Sometimes, in mild cases, therapies other than surgery may be recommended. They consist of forcing fluids, limiting dietary intake of calcium, or forced diuresis to get rid of excess calcium.
• Treatment may be necessary to correct any underlying disorder causing the hyperparathyroidism.

POSSIBLE COMPLICATIONS

• Cataracts.
• Kidney damage.
• Peptic ulcer.
• Pancreatitis.
• Psychosis.
• Hypoparathyroidism caused by removal of too much parathyroid tissue during surgery.
• Hypothyroidism if the thyroid gland is injured inadvertently during surgery on the parathyroid glands.

PROBABLE OUTCOME--Curable with surgery.

How To Treat

GENERAL MEASURES----Sometimes, in mild cases, therapies other than surgery may be recommended. They consist of forcing fluids, limiting dietary intake of calcium, or forced diuresis to get rid of excess calcium.

MEDICATION--

• Your doctor may prescribe: Diuretics to force sodium and calcium excretion. Vitamin D. Estrogen for postmenopausal women.
• Don't take antacids that contain calcium.

ACTIVITY--Follow medical advice about returning to normal activities following surgery.

DIET--

• Drink extra water to prevent kidney stones.
• Limit calcium-containing foods, such as milk and cheese.
• Avoid highly seasoned or spicy foods, especially if you have an ulcer.

Call Your Doctor If

• You have symptoms of hyperparathyroidism.
• The following occurs during treatment: Muscle cramps, numbness or weakness. Breathing difficulty. Persistent heartburn or pain in the upper abdomen. Drastic mood or behavior changes.