Primary hyperparathyroidism Health Article

Definition

Primary hyperparathyroidism is an endocrine disorder in which the parathyroid glands in the neck produce too much parathyroid hormone (PTH).

See also:

• Hyperparathyroidism
• Secondary hyperparathyroidism

Alternative Names

Parathyroid-related hypercalcemia; Hyperparathyroidism - primary

Causes, incidence, and risk factors

The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. They produce parathyroid hormone, which controls calcium, phosphorus, and vitamin D levels within the blood and bone.

When calcium levels are too low, the body responds by increasing production of parathyroid hormone. This increase in parathyroid hormone causes more calcium to be taken from the bone and more calcium to be reabsorbed by the intestines and kidney. When the calcium level returns to normal, parathyroid hormone production slows down.

Primary hyperparathyroidism is caused by swelling of one or more of the parathyroid glands. This leads to the release of too much parathyroid hormone, which raises the level of calcium in the blood. The term "hyperparathyroidism" generally refers to primary hyperparathyroidism.

Rarely, the disease is caused by parathyroid cancer.

The disease is most common in people over 60, but can also be seen in younger adults. Hyperparathyroidism in childhood is very unusual.

Women are more likely to be affected than men. Radiation to the head and neck increases your risk.

Symptoms

• Decreased height
• Depression
• Fatigue
• Fractures
• Increased urination
• Kidney stones
• Loss of appetite
• Muscle weakness and pain
• Nausea
• Personality changes
• Upper abdominal pain
• Stupor and possibly coma

Signs and tests

Blood tests will be done to check for increased levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, and lower levels of phosphorus.

Bone x-rays and a bone mineral density test can help detect bone loss, fractures, or bone softening.

X-rays, ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.