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</div><div><span>Hyperparathyroidism</span></div></div>
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</a><h1 class="with-also" itemprop="name">Hyperparathyroidism</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Hyperparathyroidism is a condition in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>There are 4 tiny parathyroid glands in the neck, near or attached to the back side of the thyroid gland.</p><p>The parathyroid glands help regulate calcium absorption, use and removal by the body. They do this by producing parathyroid hormone (PTH). PTH helps regulate calcium, phosphorus, and vitamin D levels in the blood and bone. It is important for healthy bones.</p><p>When the blood calcium level is too low, the body responds by making more PTH. This causes the calcium level in the blood to rise.</p><p>If one or more of the parathyroid glands grow larger, it may lead to too much PTH. Most often, the cause is a benign tumor of the parathyroid glands (<a test="test" href="./001188.htm">parathyroid adenoma</a>). These benign tumors are common and happen without a known cause.</p><ul><li>The disease is most common in people over age 60, but it can also occur in younger adults. Hyperparathyroidism in childhood is very unusual.</li><li>Women are more likely to be affected than men.</li><li>Radiation to the head and neck increases the risk.</li><li>Some genetic syndromes (<a test="test" href="./000398.htm">multiple endocrine neoplasia I</a>) make it more likely to have hyperparathyroidism.</li><li>In very rare cases, hyperparathyroidism is caused by <a test="test" href="./007264.htm">parathyroid cancer</a>.</li></ul><p>Medical conditions that cause low blood calcium or increased phosphate can also lead to hyperparathyroidism. Common conditions include:</p><ul><li>Conditions that make it hard for the body to remove phosphate</li><li><a test="test" href="./000500.htm">Kidney damage or failure</a></li><li>Not enough calcium in the diet</li><li>Too much calcium lost in the urine</li><li>Vitamin D disorders (may occur in children who do not eat a variety of foods, and in older adults who do not get enough sunlight on their skin or who have poor absorption of vitamin D from food such as after bariatric surgery)</li><li>Problems absorbing nutrients from food</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Hyperparathyroidism is often diagnosed by common blood tests before symptoms occur.</p><p>Symptoms are mostly caused by damage to organs from high calcium level in the blood, or by the loss of calcium from the bones. Symptoms can include:</p><ul><li><a test="test" href="./003180.htm">Bone pain or tenderness</a></li><li><a test="test" href="./003213.htm">Depression</a> and forgetfulness</li><li>Feeling tired, ill, and weak</li><li>Fragile bones of the limbs and spine that can break easily</li><li>
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Increased amount of urine produced and needing to urinate more often</li><li><a test="test" href="./000458.htm">Kidney stones</a></li><li>
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Nausea and loss of appetite
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will do a physical exam and ask about symptoms.</p><p>Tests that may be done include:</p><ul><li>Creatinine, BUN (<a test="test" href="./003435.htm">kidney function tests</a>)</li><li><a test="test" href="./003690.htm">PTH blood test</a></li><li><a test="test" href="./003477.htm">Calcium blood test</a></li><li><a test="test" href="./003470.htm">Alkaline phosphatase</a></li><li>Magnesium</li><li><a test="test" href="./003478.htm">Phosphorus</a></li><li>Vitamin D</li><li><a test="test" href="./003425.htm">24-hour urine test</a> - done to determine how much calcium is being filtered out of the body into the urine</li></ul><p>Other tests include:</p><ul><li>Bone density exam</li><li>Kidney <a test="test" href="./003336.htm">ultrasound</a> or <a test="test" href="./003330.htm">CT scan</a> (may show kidney stones or calcification)</li><li>Kidney <a test="test" href="./003337.htm">x-rays</a> (may show kidney stones)</li><li>MRI</li><li>Neck ultrasound</li><li>Sestamibi neck scan (to identify the location of the parathyroid adenoma)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>If you have a mildly increased calcium level and don't have symptoms, you may choose to have regular checkups or get treated.</p><p>If you decide to have treatment, it may include:</p><ul><li>Drinking more fluids to prevent kidney stones from forming</li><li>Exercising</li><li>Not taking a type of water pill called thiazide diuretic</li><li>Estrogen for women who have gone through menopause</li><li>Having surgery to remove the overactive glands</li></ul><p>If you have symptoms or your blood calcium level is very high, you may need surgery to remove the parathyroid gland that is producing too much PTH.</p><p>If you have hyperparathyroidism from a medical condition, your provider may prescribe vitamin D, if you have a low vitamin D level.</p><p>If hyperparathyroidism is caused by kidney disease or failure, treatment may include:</p><ul><li>Extra calcium and vitamin D</li><li>Avoiding phosphate in the diet</li><li>The medicine cinacalcet (Sensipar)</li><li>Dialysis or a kidney transplant</li><li>Parathyroid surgery, if the PTH level becomes uncontrollably high </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Outlook depends on the cause of hyperparathyroidism.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Long-term problems that can occur when hyperparathyroidism is not well controlled include:</p><ul><li>Bones become weak, deformed, or can break</li><li>High blood pressure and heart disease</li><li>Kidney stones</li><li>Long-term kidney disease</li></ul><p>Parathyroid gland surgery can result in <a test="test" href="./000385.htm">hypoparathyroidism</a> and damage to the nerves that control the vocal cords.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Parathyroid-related hypercalcemia; Osteoporosis - hyperparathyroidism; Bone thinning - hyperparathyroidism; Osteopenia - hyperparathyroidism; High calcium level - hyperparathyroidism; Chronic kidney disease - hyperparathyroidism; Kidney failure - hyperparathyroidism; Overactive parathyroid; Vitamin D deficiency - hyperparathyroidism</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/8890t.jpg" alt="Parathyroid glands" title="Parathyroid glands" class="side-img"/><a href="../imagepages/8890.htm">Parathyroid glands</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Reid LM, Kamani D, Randolph GW. Management of parathyroid disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. <em>Cummings Otolaryngology: Head and Neck Surgery</em>. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 123.</p><p>Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 227.</p><p>Walker MD, Bilezikian JP. Primary hyperparathyroidism. In: Robertson RP, ed. <em>DeGroot's Endocrinology</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 54.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 5/20/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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