Understanding Endocrine and Metabolic Conditions

Hyperparathyroidism is a condition in which the parathyroid glands — four small glands located behind the thyroid — produce too much parathyroid hormone (PTH). PTH helps regulate calcium and phosphate levels in the blood. When too much PTH is released, it can lead to elevated calcium levels (hypercalcemia) in the blood, causing various health issues.

1. Primary Hyperparathyroidism: This occurs when one or more of the parathyroid glands become overactive, often due to benign tumors called adenomas.
2. Secondary Hyperparathyroidism: This occurs as a response to another condition, such as kidney disease or vitamin D deficiency, that causes low calcium levels.
3. Tertiary Hyperparathyroidism: This occurs when secondary hyperparathyroidism becomes persistent, usually in patients with chronic kidney disease.

Hyperparathyroidism can cause a range of symptoms due to high calcium levels, including:

• Weak bones or fractures due to calcium being leached from bones
• Kidney stones or frequent urination
• Fatigue and muscle weakness
• Depression or memory problems
• Nausea, vomiting, or loss of appetite
• Abdominal pain
• Bone pain or tenderness, particularly in the joints

Some individuals with primary hyperparathyroidism may not experience noticeable symptoms and are diagnosed incidentally during blood tests showing elevated calcium levels.

Diagnosis typically includes:

• Blood tests to measure calcium and PTH levels. Elevated PTH with high calcium levels confirms primary hyperparathyroidism.
• Imaging (ultrasound, Sestamibi scan, or CT scan) to locate any abnormal parathyroid glands.
• Bone density tests to check for bone loss or osteopenia.

Treatment depends on the type and severity of the condition:

• Surgery is the most common treatment for primary hyperparathyroidism, especially if symptoms are present or calcium levels are very high. It involves removing the overactive parathyroid gland(s).
• Medications such as bisphosphonates or calcimimetics can help manage symptoms or prevent further bone loss in some cases.
• Monitoring for secondary hyperparathyroidism due to kidney disease or vitamin D deficiency may involve addressing the underlying cause and dietary management, including vitamin D supplementation.
• Dietary changes may be recommended to control calcium levels, such as reducing calcium intake and staying hydrated.

Comprehensive lab testing to assess calcium and PTH levels

Coordination with specialists including endocrinologists and surgeons for treatment and management

Patient education on lifestyle changes, including nutrition and hydration

Ongoing care and monitoring to track calcium levels and ensure proper management