Primary hyperparathyroidism (patient information)

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Overview
Primary hyperparathyroidism is an endocrine disorder in which the parathyroid glands produce too much parathyroid hormone (PTH). This kind of hormone plays an important role in regulating and maintaining a balance of calcium and phosphorus. This disorder affects about 100,000 people in the US each year. Studies demonstrate that conditions such as parathyroid tumor and radiation therapy to the head and neck may be associated with the cause of primary hyperparathyroidism. The high production of parathyroid hormone in primary hyperparathyroidism may lead to symptoms such as loss of appetite, nausea and vomiting, abdominal pain, fatigue, muscle weakness, constipation, kidney stones, fractures, even stupor or coma. Tests on levels of blood-calcium, alkaline phosphatase, blood-phosphorus and parathyroid hormone can help diagnose primary hyperparathyroidism. Treatments for primary hyperparathyroidism include drinking more fluids, taking bisphosphonates or calcitonin to decrease blood-calcium levels and parathyroidectomy. Prognosis of primary hyperparathyroidism depends on severity of symptoms, complications and treatment effectiveness.

How do I know if I have primary hyperparathyroidism and what are the symptoms of primary hyperparathyroidism?
Signs and symptoms of primary hyperparathyroidism include the following:
 * Loss of appetite
 * Nausea and vomiting
 * Abdominal pain
 * Fatigue and muscle weakness
 * Constipation
 * Increased urination
 * Kidney stones
 * Joint pain
 * Fractures
 * Decreased height
 * Depression and memory loss
 * Stupor, even coma

Who is at risk for primary hyperparathyroidism?
The cause of primary hyperparathyroidism is not clear. Researches suggest the following factors may be associated with the disorder.
 * Benign tumors on the parathyroid glands
 * Parathyroid cancer
 * Radiation therapy to the head and neck
 * Age over 60
 * Female: The incidence of primary hyperparathyroidism in women is 2-3 times the incidence in men.

How to know you have primary hyperparathyroidism?

 * Blood tests: Patients with primary hyperparathyroidism may indicate signs, such as high levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, a low level of phosphorus.
 * Bone densitometry: The doctor may arrange a dual x-ray absorptiometry to determine bone density and to reveal bone loss, fractures, or bone softening.
 * Imaging tests: Imaging tests such as x-rays, ultrasound, CT or MRI scans of the kidneys or urinary tract and nuclear imaging may show calcium deposits or a blockage, localize parathyroid tumors, and evaluate ectopic parathyroid adenomas.

When to seek urgent medical care?
Call your health care provider if symptoms of primary hyperparathyroidism develop. If you suffer either of the following symptoms, seeking urgent medical care as soon as possible:
 * Severe abdominal pain or joint pain
 * Fractures
 * Stupor
 * Coma

Treatment options
Treatments of primary hyperparathyroidism depend on the extent of the disease. For patients without symptoms, they may just need regular check ups with the doctor. However, if patients show signs of kidney stones or calcium loss from bones, they need to be treated. Treatments opinion include medications, surgery and parathyroid autotransplantation.
 * Medications:
 * Drinking more fluids to prevent the formation of kidney stones. If it is urgent, fluids may be given through a vein.
 * Movement and exercise
 * Avoiding thiazide-type diuretics
 * Medications such as bisphosphonates and calcitonin, can be used to decrease blood-calcium levels quickly.
 * Using estrogen therapy (for postmenopausal women)


 * Surgery: If the patient is less than 50 years, or symptoms are present, or the blood-calcium level is very high, parathyroidectomy may be needed. The decision of surgery requires careful evaluation and individual assessment.
 * Parathyroid autotransplantation: Parathyroid autotransplantation is reserved for patients who result in hypoparathyroidism after the surgery of removal all or excessive amounts of parathyroid tissue.

Diseases with similar symptoms

 * Secondary hyperparathyroidism
 * Multiple myeloma
 * Sarcoidosis

Where to find medical care for primary hyperparathyroidism?
Directions to Hospitals Treating primary hyperparathyroidism

Prevention of primary hyperparathyroidism
The preventive measurement of primary hyperparathyroidism is unknown.

What to expect (Outook/Prognosis)?
Prognosis of primary hyperparathyroidism depends on:
 * Severity of symptoms
 * Complications
 * Treatment effectiveness