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What is primary hyperparathyroidism?
Primary hyperparathyroidism is a hormonal disorder that occurs when the parathyroid glands, four small glands located near the thyroid gland in the neck, produce too much parathyroid hormone (PTH). This hormone plays an important role in regulating calcium levels in the blood, which is crucial for the body's muscle and nerve functions, as well as for keeping bones strong.
In primary hyperparathyroidism, PTH production becomes excessive, which leads to too much calcium being released from the bones and absorbed into the blood. The elevated calcium levels can affect several organs and systems in the body, leading to various health problems, such as osteoporosis, kidney stones, and effects on the heart and kidneys. In some cases
Causes of primary hyperparathyroidism
The most common cause of primary hyperparathyroidism by far is an adenoma, which is a benign tumor on one of the parathyroid glands that causes the gland to overproduce PTH.
In rarer cases, all four glands are affected by enlarged tissue, known as hyperplasia. There are also hereditary factors and genetic syndromes that can increase the risk of developing the condition.
Symptoms
The symptoms of primary hyperparathyroidism can vary greatly depending on how high the calcium levels in the blood are and how long the condition has been present. Some people may have mild or no symptoms at all, while others may experience significant discomfort. The most common symptoms include:
- Fatigue
- Muscle weakness
- Depression
- Confusion
- Increased thirst and urination
- Abdominal pain
In some cases, the disease does not cause any symptoms and is first detected through blood tests that show high calcium levels.
Diagnosis of primary hyperparathyroidism
Making a diagnosis is mainly about confirming the disturbed hormonal relationships via blood and urine tests:
- Blood tests for calcium and PTH: The diagnosis is confirmed when test results show simultaneous excesses of both parathyroid hormone (PTH) and calcium. In other types of high calcium values, the body's PTH levels are usually low or normal instead.
- Diurnal urine: A sample of how much calcium is excreted in the urine during a day is often taken to strengthen the diagnosis.
Difference from secondary hyperparathyroidism
It is important to distinguish the primary form from secondary hyperparathyroidism. In the secondary form, calcium levels in the blood are normal or low, while PTH is elevated. This occurs as a result of other problems in the body, such as vitamin D deficiency kidney failure, malabsorption, or side effects of certain medications.
Treatment options
Surgery
Surgery is the most effective treatment and involves removing the overactive parathyroid gland. Many patients experience noticeable improvement after surgery.
Medical treatment
For those who cannot have surgery, there are medications that can help control calcium levels. These include bisphosphonates and calcimimetics, which reduce the production of PTH.
Practical tips for managing hyperparathyroidism
- Regular medical follow-up: Make sure you have regular visits to your doctor to monitor your calcium levels.
- Dietary adjustments: Eat a balanced diet rich in vitamin D, but avoid excessive intake of calcium-rich foods unless your doctor recommends it.
- Exercise: Regular physical activity can help strengthen your bones and improve your health.
- Hydration: Drink plenty of water to help your kidneys get rid of excess calcium.
