Hyperparathyroidism is excessive production of parathyroid hormone by the parathyroid glands. Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). This hormone helps maintain the proper levels of calcium and phosphorus in your body. Primary hyperparathyroidism is one of the most common causes of hypercalcemia and should be considered in any individual with an elevated calcium level. The incidence of this disease is approximately 25-28 cases/100,000 people per year. In women 60 years and older, two out of 1,000 will develop hyperparathyroidism each year. Syndromes to be considered include type I and type II multiple endocrine neoplasia (MEN) or less commonly familial hypocalciuric hypercalcemia and hyperparathyroidism-jaw tumor syndrome. Secondary hyperparathyroidism occurs when the parathyroid glands become hyperplastic after long-term hyperstimulation and release of PTH.
Hyperparathyroidism is rare in children. The symptoms frequently come on slowly and are usually subtle, such as a feeling of weakness or fatigue, or vague aches and pains. The most common symptoms of excess calcium in the bloodstream are loss of appetite, thirst, frequent urination, lethargy, fatigue, muscle weakness, joint pains, and constipation. More severe symptoms may include nausea and vomiting, abdominal pain, memory loss, and depression. Osteoporosis associated with hyperparathyroidism is caused by the high parathyroid hormone that is secreted by the overactive parathyroid gland(s). This excess parathyroid hormone (PTH) acts directly on the bones to remove calcium from the bones. HPT is most often suspected when a high level of calcium is found in your blood on a routine blood test. Treatment depends upon the severity and cause of the condition. Secondary hyperparathyroidism is treated by giving calcium and vitamin D alone or together, depending on the underlying disorder.
Hypercalcemia is mild in most asymptomatic patients with hyperparathyroidism and may be controlled with gentle hydration with normal saline. Surgery to remove the tumor or removal of excess parathyroid tissue resulting from hyperplasia is necessary for severely high calcium levels. Surgery is also recommended for patients less than 50 years of age. Calcimimetics are a new class of drug that turnss. The drugoff secretion of PTH. Medication cinacalcet (Sensipar) has been approved to treat secondary hyperparathyroidism in people with kidney disease and parathyroid cancer. In clinical trials, it also appeared to effectively treat primary hyperparathyroidism. Estrogen therapy in postmenopausal women has been shown to cause a small reduction in serum calcium and increases in BMD. Chronic kidney failure is the most common disease causing secondary hyperparathyroidism. Vitamin D treatment can lose its effectiveness in some people, and excessively high levels of both calcium and phosphorus may occur. Getting the proper amount of calcium diet.