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Hyperparathyroidism

What are the parathyroid glands?

The parathyroid glands are a group of (usually 4) tiny glands situated in the neck, close to the much bigger thyroid gland, hence the name para (near) the thyroid.

The parathyroid glands produce parathyroid hormone, which affects the way our bodies deal with calcium. Hyperparathyroidism is when too much of the hormone is produced, causing abnormally high levels of calcium to occur in the circulation. This produces a wide range of symptoms affecting different parts of the body. About one person in 2000 has this condition, most commonly women over the age of 50.

Hyperparathyroidism can be primary, when one or all of the glands themselves are at fault, or secondary, when the glands are responding to other problems such as kidney failure.

Symptoms of hyperparathyroidism

Symptoms such as aches and pains and vague weakness are often mild to start with. There may be no symptoms at all in the initial stages. The condition is often diagnosed on the basis of an abnormal calcium result from a routine blood test.

The kidneys are often affected, with the person passing large amounts of urine and feeling thirsty all the time. In about one-third of cases the high calcium levels will produce kidney stones, which can be very painful. High blood pressure is often present.

Muscles are affected, aching legs and sore shins being common complaints. There may be generalised weakness and backache. Hyperparathyroidism can also be a cause of weak bones — osteoporosis.

If the digestive system is affected, constipation, anorexia (loss of appetite) and nausea are the most common symptoms.

Sometimes psychological symptoms may occur. There may be depression, personality changes and, in severe cases, loss of consciousness.

Treatment of hyperparathyroidism

Hyperparathyroidism can be due to all 4 glands being too active, or one or more of them having a small tumour (adenoma). Mild hyperparathyroidism does not always require treatment, but will need to be monitored by your doctor.

When treatment is needed, surgery is usually necessary. Modern tests have made it much easier to determine the exact location and problem affecting the glands. If there is general overactivity most of the glands (at least three-and-a-half) must be removed. If there is a single adenoma in one gland, the problem is solved by removing that gland.

Medical students learn that the symptoms of hyperparathyroidism are ‘bones, moans, stones and abdominal groans’, which describes the wide range of symptoms caused by an abnormality of these tiny glands.


 

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