Part 1 of 3 A Common Guide to Hyperparathyroidism:
Most people know that they have a thyroid gland, but the parathyroid glands that sit just behind the thyroid get less attention. The four parathyroid glands are about the size of a grain of rice, and they perform an essential function: releasing parathyroid hormone (PTH), which regulates calcium, magnesium, and phosphorus levels in the body.
For a snapshot of what this looks like, let’s take a look at calcium. This mineral plays a crucial role in bone strength, proper muscle contraction, nerve function, and blood clotting. Roughly 99% of the body’s calcium is stored in the bones. The other 1% is in the blood and tissues. The parathyroid hormone helps balance the amount of calcium in the blood. If the blood calcium level drops, PTH will prompt the bones to release calcium into the bloodstream.
When more calcium is needed in the bloodstream, PTH helps release the mineral from our bones so it can enter the bloodstream and travel to the tissues that need it. Additionally, PTH can use vitamin D to help the intestines absorb calcium from food and helps prevent the kidneys from flushing too much calcium in the urine.
What is Hyperparathyroidism and Who Does it Affect?
Hyperparathyroidism is when the parathyroid glands stop working as they should, producing an excess of parathyroid hormone (PTH). This overabundance of PTH plays a role in pulling too much calcium from the bones, which can cause bone fragility and osteoporosis. Excessive calcium in the bloodstream can also cause kidney stones, joint and muscle pain, fatigue, abdominal upset, depression, and a general feeling of discomfort.
For reference, a normal parathyroid hormone level is 14 to 65 picograms (pg) per milliliter (mL). A normal blood calcium level is 8.6 to 10.3 milligrams (mg) per deciliter (dL).
Hyperparathyroidism tends to affect people over the age of 60 and women in particular. Other risk factors for the condition include people who have had radiation therapy in the neck area, people with ongoing, acute Vitamin D or calcium deficiencies, and patients who take lithium. There are three main types of hyperparathyroidism: primary, secondary, and tertiary.
The Difference Between Primary, Secondary, and Tertiary Hyperparathyroidism:
Several factors can influence how much parathyroid hormone the parathyroid glands produce. Each type of hyperparathyroidism can have different symptoms and causes. Knowing the difference between the three can help patients decide which type of care to seek out. It’s important to seek out medical care if you are experiencing any of the symptoms of HPT. Left untreated, HPT only gets worse, causing bone, kidney, and even heart problems.
Primary Hyperparathyroidism:
With primary hyperparathyroidism, the cause is an enlarged parathyroid gland that produces too much PTH, causing blood calcium levels to rise. Parathyroid gland enlargement can be caused by:
Adenoma: An adenoma is a benign tumor, which is usually present only in one gland. This type of enlargement causes approximately 85% of hyperparathyroidism cases.
Hyperplasia: The presence of abnormal cells in each gland is called hyperplasia. Hyperplasia causes all four glands to enlarge and malfunction, and roughly 15% of hyperparathyroidism cases are caused by this condition.
Parathyroid Cancer: Most hyperparathyroidism patients do not have parathyroid cancer, as cancerous cells cause less than 1% of all HPT cases, but it is a potential cause of hyperparathyroidism.
The most common symptoms of primary hyperparathyroidism are frequent urination, constipation, excessive thirst, joint pain, abdominal pain, lethargy, weakness, bone pain and/or fragility fractures, nausea, vomiting, and memory loss.
Because primary hyperparathyroidism is caused by abnormal cells or growth in one or more parathyroid glands, the most effective treatment is surgery to remove the dysfunctional gland. While the idea of neck surgery can be intimidating, a skilled parathyroid surgeon can perform a minimally invasive parathyroidectomy with intraoperative parathyroid testing to ensure a high level of success. With a minimally invasive parathyroidectomy, surgeons utilize local anesthesia instead of general anesthesia, meaning patients do not need to have a breathing tube or stay in a hospital overnight. The incision on a minimally invasive parathyroidectomy is smaller and can be blended into the neck’s natural creases, and recovery time tends to be shorter than it is with a more involved surgery.
Secondary Hyperparathyroidism:
Secondary hyperparathyroidism happens when a condition outside of the parathyroid glands causes all four glands to enlarge and release an excess of PTH. The most common causes of