- Primary—a benign tumor of the parathyroid gland that makes too much PTH (most common form)
- Secondary—occurs in patients with long-standing kidney failure or a vitamin D deficient state
- Tertiary—also occurs in patients with very long-standing kidney failure and dialysis
|Thyroid and Parathyroid Glands: Posterior (Back) View|
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- Noncancerous tumor in the parathyroid gland (most common cause)
- Parathyroid cancer (very rare)
- Familial hyperparathyroidism
- Multiple endocrine neoplasia (MEN)
- Vitamin D deficiency (due to inadequate dietary intake, lack of sunlight exposure, or malabsorption condition like celiac disease)
- Kidney failure or other medical problems that make the body resistant to the action of the parathyroid hormone
- Enlargement of the parathyroid glands—common cause
- Age: older than 50 years
- Multiple endocrine neoplasia
- Having specific genetic factors that increase your risk
- Radiation therapy to head or neck during childhood
- Blood tests—to measure calcium, phosphorus, magnesium, alkaline phosphatase, vitamin D, and PTH, kidney and liver function tests
- Urine test—a 24-hour urine collection to measure calcium excretion and kidney function (very important test)
- Neck ultrasound —a test that uses sound waves, not radiation, to detect a large parathyroid tumor (adenoma)
- Technetium 99m sestamibi scan—a nuclear medicine test that uses safe nuclear molecules to make pictures of the parathyroid glands to help locate a single parathyroid adenoma in primary hyperparathyroidism
- If a growth is causing the problems, surgery may be done to remove the growth. This can often result in a growth.
Hyperaparthyroidism due to a vitamin D deficiency may be treated with:
- Vitamin D ergocalciferol or cholecalciferol —for treating secondary hyperparathyroidism due to vitamin D deficiency.
- Calcitriol (the most active vitamin D metabolite)—helps to reduce PTH production in secondary hyperparathyroidism in chronic kidney failure
- Cinacalcet —helps to lower PTH blood levels for secondary and tertiary hyperparathyroidism in chronic kidney disease or parathyroid cancer
- Treating underlying causes
- Medication to manage possible side effects
Monitoring of Blood Calcium Levels
American Association of Clinical Endocrinologists http://www.aace.com/
The Hormone Foundation http://www.hormone.org/
National Institute of Diabetes and Digestive and Kidney Disorders http://www2.niddk.nih.gov/
Canada Health Portal http://chp-pcs.gc.ca/CHP/
Canadian Society of Endocrinology and Metabolism http://www.endo-metab.ca/
Hyperparathyroidism. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/hyperparathyroidism/treatment.html . Updated November 2010. Accessed June 17, 2013.
Hyperparathyroidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 24, 2012. Accessed June 17, 2013.
Silverberg SJ, Bilezikian JP. The diagnosis and management of asymptomatic primary hyperparathyroidism. Nat Clin Pract Endocrinol Metab . 2006;2:494-503.
Taniegra E. Hyperparathyroidism. Am Fam Physician . 2004 Jan 15;69(2):333.
11/26/2012 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Paik J, Curhan G, Taylor E. Calcium intake and risk of primary hyperparathyroidism in women: prospective cohort study. BMJ. 2012;345:e6390
- Reviewer: Kim Carmichael, MD
- Review Date: 06/2013
- Update Date: 06/03/2013