What is Primary Hyperparathyroidism?

Primary hyperparathyroidism is a disorder of the parathyroid glands. People who have primary hyperparathyroidism produce excessive amounts of hormones. The symptoms and treatment options vary depending on the patient.

The parathyroid glands are four small glands located in the neck on the thyroid gland. They release a substance called parathyroid hormone (PTH). These hormones help the body maintain the proper amounts of phosphorus and calcium.

When the parathyroid glands become enlarged or swollen, they release too much PTH into the body. In turn, the PTH signals the body to release large amounts of calcium. The calcium enters the bloodstream and travels throughout the body, causing problems such as kidney stones, brittle bones and stomach ulcers. The excess PTH also flushes much of the body's phosphorus out through the urine.

Primary hyperparathyroidism most commonly happens when noncancerous tumors called adenomas form on the parathyroid glands. In rare instances, the disorder can occur as the result of cancer of the parathyroid glands. This uncommon form of cancer typically affects men and women who are more than 30 years old.

The disorder can be traced to an inherited condition in about 5 percent of cases, but it most often occurs without any evident reason. Men are less likely to be affected by primary hyperparathyroidism than women. Children rarely develop the condition. It usually affects people who are more than 60 years old, but young adults occasionally are affected as well.

People who have primary hyperparathyroidism experience a range of symptoms, such as depression, changes in their personality and a lack of physical energy. They might need to urinate more often than usual. Other people complain of pain or weakness in their muscles, stomach pains and nausea. Many individuals do not demonstrate any symptoms at all.

An endocrinologist can diagnose the condition by performing a blood test that measures the levels of calcium and phosphorus in the blood. He or she might take a blood test to measure the amount of PTH in the bloodstream. The doctor might also perform computed tomography (CT) scans of the urinary tract and kidneys to look for kidney stones or other evidence of excess calcium, or he or she might conduct bone scans to look for signs of osteoporosis or fractures.

Most physicians recommend surgically removing the damaged parathyroid gland. Some doctors prescribe calcimimetics, which are drugs that inhibit the body's ability to produce PTH, as a form of treatment. Patients who do not demonstrate symptoms or who have normal levels of calcium and phosphorus might need only to be monitored for changes in their condition and do not necessarily require immediate surgery.