Parathyroid Disorders

What is hyperparathyroidism?

Parathyroid glands are oval, grain-of-rice sized glands situated in the neck. Usually there are four parathyroid glands located in the neck, two on each side. These glands maintain the calcium level in the body by regulating the secretion of parathyroid hormone. The gland secretes parathyroid hormone when there is a lower blood calcium level. The blood calcium level is then maintained by the effect of the parathyroid hormone on the kidneys, bones and the intestines.

Any dysfunction of the gland may increase the level of parathyroid hormone (hyperparathyroidism) and that may induce the release of calcium and may cause hypercalcaemia.

What are the causes of hyperparathyroidism?

The causes of the parathyroid disorder can be divided into primary and secondary causes.

Primary hyperparathyroidism can be caused by several conditions, including:

• Non-cancerous tumour (an adenoma) in one of the parathyroid glands, this is the most common cause.
• Enlargement of one or more of the parathyroid glands due to an overgrowth of normal cells, called hyperplasia.
• Parathyroid cancer; this is rare and accounts for less than 1 percent of all cases.

The secondary causes of the disorder may be severe calcium deficiency, severe vitamin deficiency and chronic kidney failure that may lower the calcium levels and leads the gland to overwork.

What are the signs & symptoms of hyperparathyroidism?

The signs and symptoms of hyperparathyroidism usually develop after the damage or dysfunction to organs or tissues due to high calcium levels. The symptoms of the disorder include osteoporosis, kidney stones, fatigue, abdominal pain, frequent urination, pain in the bone and joint or frequent illness, nausea, vomiting or loss of appetite and depression or forgetfulness.

How is hyperparathyroidism diagnosed?

The diagnosis of the parathyroid disorder includes blood test that reveals the elevated calcium and parathyroid hormone level in the blood and confirms the condition.

Additional tests may be performed, such as:

• Bone mineral density test to measure the quantity of the calcium and other mineral in a segment of bone.
• Urine test to check the urinary function and the excreted calcium in the urine.
• Imaging test also may be used to determine any kidney stone or other abnormalities of kidney.

If surgery is required other advance imaging such as ultrasound or sestamibi scan may be used to detect the abnormality.

What are the treatment options of hyperparathyroidism?

Surgery is the most common treatment measure for this condition and it involves the removal of the affected part of the gland. This is effective in curing hyperparathyroidism in about 95 percent of patients. The complication rate associated with surgery is very low.

Medical management of hyperparathyroidism includes ensuring good fluid intake throughout the day, exercise to maintain bone density and medications to treat bone loss and to maintain normal calcium levels.

What are the complications of hyperparathyroidism?

The possible complications related to parathyroid disorder include osteoporosis, presence of kidney stones cardiovascular diseases and depression.