Hyperparathyroidism is a condition in which the parathyroid glands, located in the neck, secrete too much parathyroid hormone (PTH). Parathyroid hormone regulates the amount of calcium and phosphorus (minerals necessary for strong bones and teeth) in the body, by controlling how much calcium is taken from bones, absorbed in the intestines, and lost in urine. When too much parathyroid hormone is secreted, levels of calcium in the blood and urine rise, and bones may lose calcium, leading to osteoporosis.
In about half of the cases of primary hyperparathyroidism, the patient has either vague symptoms or no symptoms at all. The condition is often diagnosed through routine blood tests that show high levels of calcium. When symptoms do occur, they are generally due to persistently high levels of calcium and may include:
In most cases, the cause of hyperparathyroidism is not known. It may develop as a result of one of the following conditions:
The following conditions or characteristics put you at higher risk for developing primary hyperparathyroidism:
Hyperparathyroidism is diagnosed through blood tests that show high levels of calcium and parathyroid hormone. About half the time, health care providers discover primary hyperparathyroidism from a routine blood test. If your doctor suspects primary hyperparathyroidism, the doctor will do a physical examination and ask about symptoms of abdominal pain and constipation, depression, anxiety, memory loss, muscle weakness, and urinary problems. The health care provider may take a sample of your urine to test to check for kidney problems caused by excess calcium, and have you take a bone density scan to check bone health. An ultrasound of the neck may be performed to see if the parathyroid glands are enlarged. A computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used to check for a tumor.
There is no known way to prevent primary hyperparathyroidism. However, people who are at risk should avoid dehydration.
Surgery to remove one or more of the parathyroid glands is very successful in treating primary hyperparathyroidism. Sometimes, if a person does not show any signs or symptoms of the disease and has only mildly elevated calcium levels, they may not need immediate treatment -- but they will need to be monitored (for calcium blood levels and bone density) to watch for any changes in their condition.
Surgery is the primary treatment. However, under certain circumstances, the following medications may be used:
Parathyroidectomy involves removal of one or more of the four parathyroid glands.
Hyperparathyroidism should never be treated by alternative medicine alone. Some CAM therapies may be supportive when used along with conventional treatment. Keep all of your health care providers informed about any CAM therapies you are considering using.
Following these nutritional tips may help reduce symptoms of hyperparathyroidism. Do not take these supplements without your doctor's supervision:
You may address nutritional deficiencies with the following supplements:
Your doctor may recommend you take calcium with a glass of orange juice -- some forms of calcium are better absorbed in an acidic environment. You can also add acid to your diet by squeezing lemon juice over leafy greens.
Herbs are generally available as standardized dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1 - 2 heaping teaspoonfuls/cup water steeped for 10 - 15 minutes (roots need longer).
No scientific research has studied the use of herbs to treat hyperparathyroidism. The following herbs are sometimes used to counter the bone loss that can occur from hyperparathyroidism. Talk to your health care provider before taking any herbs if you have hyperparathyroidism.
Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of hyperparathyroidism based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
The prognosis is excellent for persons with primary hyperparathyroidism who have no symptoms, as well as those who have surgery to remove one or more parathyroid glands, with cure rates of 94 - 96%. Possible complications include skeletal damage, urinary tract infections, kidney damage or kidney stones, peptic ulcers, inflammation of the pancreas, high blood pressure, nervous system disorders, and rare complications from surgery. Various cardiovascular conditions are also associated with hyperparathyroidism.
If you have surgery, your doctor will check your blood calcium levels for several months to be sure that the levels remain stable. If you do not have surgery, your calcium levels will need to be checked over a longer period of time, and your checkups will include a careful assessment of your bones and kidneys.
Parathyroid - overactive
Abdelhadi M, Nordenstrom J. Bone mineral recovery after parathyroidectomy in patients with primary and renal hyperparathyroidism. J Clin Endocrinol Metab. 1998;83(11):3845-3851.
Adler JT, Sippel RS, Schaefer S, Chen H. Surgery improves quality of life in patients with "mild" hyperparathyroidism. Am J Surg. 2009;197(3):284-90.
Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA. 2001;285:1482-8.
Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1254-1255, 1256, 1258-1259.
Chertok-Shacham E, Ishay A, Lavi I, Luboshitzky R. Biomarkers of hypercoagulability and inflammation in primary hyperparathyroidism. Med Sci Monit. 2008;14(12):CR628-32.
Fauci A , Kasper D, Longo DL, et al, eds. Harrison's Principals of Internal Medicine. 17th ed. [online version]. New York, NY: McGraw Hill; 2008.
Felger E, Kandil E. Primary Hyperparathyroidism. Otolaryngologic Clinics of North America. 2010;43(2).
Ferri: Ferri's Clinical Advisor 2011, 1st ed. St. Louis, MO: Mosby. 2010.
Head KA. Ipriflavone: an important bone-building isoflavone. Altern Med Rev. 1999;4(1):10-22.
Jorde R, Szumlas K, Haug E, Sundsfjord J. The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake. Eur J Nutr. 2002 Dec;41(6):258-63.
Lydeking-Olsen E, Beck-Jensen JE, Setchell KD, Holm-Jensen T. Soymilk or progesterone for prevention of bone loss -- a 2 year randomized, placebo-controlled trial. Eur J Nutr. 2004;43(4):246-57.
NIH Osteoporosis and Related Bone Diseases National Resource Center. Information for Patients about Primary Hyperparathyroidism. National Institutes of Health.
Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlove-Wuttke D. Chaste tree (Vitex agnus-castus) -- pharmacology and clinical indications. Phytomedicine. 2003;10(4):348-57.
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