Hyperparathyroidism happens when the parathyroid glands make too much parathyroid hormone. This can affect your calcium levels and cause other health problems.

You may have hyperparathyroidism if your parathyroid glands make too much parathyroid hormone (PTH).

The parathyroid glands are four pea-sized endocrine glands in your neck, near or attached to the back of your thyroid. Endocrine glands secrete hormones necessary for the functioning of your body.

Despite having similar names and being adjacent in your neck, the parathyroid glands and the thyroid are different organs. PTH helps regulate the levels of calcium, vitamin D, and phosphorus in your bones and blood.

Some people with this condition do not experience any symptoms and may not need treatment. Others have mild or severe symptoms that may require surgery.

Keep reading to learn the causes, types, and treatment of hyperparathyroidism.

In hyperparathyroidism, one or more of your parathyroid glands becomes overactive and makes excess PTH. This could be due to a tumor, gland enlargement, or other structural problems of the parathyroid glands.

When your calcium levels are too low, your parathyroid glands respond by increasing the production of PTH.

This causes your kidneys and intestines to absorb a larger amount of calcium. It also removes more calcium from your bones. PTH production returns to typical levels when your calcium level goes up again.

Sometimes, another condition may cause you to develop hyperparathyroidism.

There are three types of hyperparathyroidism: primary, secondary, and tertiary.

Primary hyperparathyroidism

This type occurs when you have at least one overactive parathyroid gland.

Causes of parathyroid problems can include:

  • benign growths on the gland
  • enlargement of at least two glands
  • rarely, a cancerous tumor

An increased risk of developing primary hyperparathyroidism also occurs in people who:

  • have certain inherited disorders that affect several glands throughout the body, such as multiple endocrine neoplasia
  • have been exposed to radiation from cancer treatment
  • have taken a drug called lithium, which mainly treats bipolar disorder

Secondary hyperparathyroidism

This type occurs when you have an underlying condition that causes your calcium levels to be abnormally low. Most cases of secondary hyperparathyroidism are due to vitamin D deficiency and chronic kidney failure that results in low active vitamin D and calcium levels.

Tertiary hyperparathyroidism

This type occurs after longstanding secondary hyperparathyroidism. The parathyroid glands keep making too much PTH after your calcium levels return to typical levels. This type usually occurs in people with kidney problems.

Symptoms can vary from mild to severe, depending on your type of hyperparathyroidism.

Primary hyperparathyroidism

Some people with primary hyperparathyroidism don’t have any symptoms. If you do have symptoms, they can range from mild to severe. Milder symptoms may include:

More severe symptoms can include:

Secondary hyperparathyroidism

With this type, you may have skeletal abnormalities that may include:

  • fractures
  • swollen joints
  • bone deformities

Other symptoms can depend on the underlying cause of your hyperthyroidism, such as chronic kidney failure or severe vitamin D deficiency.

A healthcare professional might suspect you have hyperparathyroidism if routine blood tests show high calcium levels in your blood. To confirm this diagnosis, they will likely need to perform other tests.

Blood tests

Additional blood tests can help your primary care provider make an accurate diagnosis. A doctor may check your blood for high PTH levels, alkaline phosphatase levels, and low phosphorus levels.

Urine tests

A urine test can help a doctor determine how severe your condition is and whether kidney problems may be the cause. A doctor can check your urine to see how much calcium it contains.

Kidney tests

A technician might take an ultrasound of your abdomen to check for kidney abnormalities.

You can find a primary care doctor near you through the Healthline FindCare tool.

The treatment for hyperparathyroidism may vary depending on the cause and severity of your symptoms.

Primary hyperparathyroidism

You might not need treatment if your kidneys are working fine, if your calcium levels are only slightly high, if your bone density is within typical levels. In this case, a doctor may use yearly blood tests to monitor your kidney health and calcium levels. You may need a test every one or two years to measure your bone density.

If you are older than 50, you may not need surgery.

A doctor may recommend drinking plenty of water to reduce your risk of kidney stones. Regular exercise can help strengthen your bones.

If treatment is necessary, a doctor may recommend:


Surgical procedures involve removing enlarged parathyroid glands or tumors on the glands. Complications are rare and include damaged vocal cord nerves and long-term, low calcium levels.


If you are unable to have surgery, a doctor may recommend certain medications. Calcimimetics act like calcium in the blood and cause your glands to make less PTH. Bisphophonates keep your bones from losing calcium and can help reduce your risk of osteoporosis.

Secondary hyperparathyroidism

Treatment involves bringing your PTH to typical levels by treating the underlying cause.

Methods of treatment can include:

  • vitamin D supplements for severe deficiencies
  • calcium and vitamin D supplements, if you have chronic kidney failure
  • medication and dialysis, if you have chronic kidney failure

Hyperparathyroidism can occur with other conditions that may include:

  • low vitamin D levels
  • kidney issues
  • osteoporosis, or bone weakening

If you have osteoporosis, you may experience additional symptoms. Primary hyperparathyroidism leads to osteoporosis because high levels of PTH cause the release of calcium from the bones, thereby weakening them. Symptoms may include:

  • bone fractures
  • height loss
  • bone weakness

A doctor can check for signs of osteoporosis with bone X-rays or by performing a bone mineral density test. This test measures calcium and bone mineral levels using X-ray devices.

Surgery treats most cases of primary hyperparathyroidism. Doctors also treat some cases of tertiary hyperparathyroidism with surgery.

If you and a doctor opted to monitor your condition rather than perform surgery, taking prescribed medications, drinking enough water, and engaging in regular exercise may help reduce or prevent symptoms.

Hyperparathyroidism occurs when at least one overactive parathyroid gland makes too much PTH. This may affect the amount of calcium in your blood and cause symptoms ranging from mild to severe.

Doctors typically recommend surgery to remove the affected parathyroid gland or glands. In some cases, especially if they don’t have symptoms, they may opt to monitor your condition.