Hyperparathyroidism causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]


Hyperparathyroidism is caused by an increase in concentration of parathyroid hormone in serum. There are three type of hyperparathyroidism including primary, secondary and tertiary hyperparathyroidism. There are an array of different causes for all types of hyperparathyroidism. Most common cause of primary hyperparathyroidism is parathyroid adenoma (85%) followed by parathyroid hyperplasia (15%), and parathyroid carcinoma (5%). Most common cause of secondary hyperparathyroidism is chronic renal failure and vitamin D deficiency. Most common cause of tertiary hyperparathyroidism is post renal transplantation.

Hyperparathyroidism causes

Hyperparathyroidism causes can be divided based on the hyperthyroidism category.

Causes of Primary hyperparathyroidism

Causes of primary hyperparathyroidism are as follows:

Life Threatening causes

Life threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life threatening causes of primary hyperparathyroidism.

Common causes
Less common causes
Genetic causes

Causes of secondary hyperparathyroidism

Causes of secondary hyperparathyroidism are as follows:

Common causes
Less common causes

Causes of tertiary hyperparathyroidism

Causes of tertiary hyperparathyroidism are as follows:

Common causes
Less common cause

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental Hyperparathyroidism-jaw tumor syndrome
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma, neonatal severe primary hyperparathyroidism, familial isolated hyperparathyroidism, Familial hypocalciuric hypercalcemia
Environmental No underlying causes
Gastroenterologic Celiac disease, gastric bypass surgery, malabsorption syndrome
Genetic Familial hypocalciuric hypercalcemia, neonatal severe primary hyperparathyroidism
Hematologic No underlying causes
Iatrogenic Gastric bypass surgery, radiation exposure
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Vitamin D deficiency, severe calcium deficiency
Obstetric/Gynecologic No underlying causes
Oncologic Hyperparathyroidism-jaw tumor syndrome, parathyroid adenoma,parathyroid carcinoma, multiple endocrine neoplasia type 1 (MEN 1), multiple endocrine neoplasia type 2A (MEN 2A), multiple endocrine neoplasia type 4 (MEN 4)
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Chronic renal failure, renal transplant, severe calcium deficiency
Rheumatology/Immunology/Allergy Celiac disease
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


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  2. Boehm BO, Rosinger S, Belyi D, Dietrich JW (2011). "The parathyroid as a target for radiation damage". N Engl J Med. 365 (7): 676–8. doi:10.1056/NEJMc1104982. PMID 21848480.
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  5. 5.0 5.1 Maida MJ, Praveen E, Crimmins SR, Swift GL (2006). "Coeliac disease and primary hyperparathyroidism: an association?". Postgrad Med J. 82 (974): 833–5. doi:10.1136/pgmj.2006.045500. PMC 2653933. PMID 17148709.
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  7. Hosokawa Y, Pollak MR, Brown EM, Arnold A (1995). "Mutational analysis of the extracellular Ca(2+)-sensing receptor gene in human parathyroid tumors". J. Clin. Endocrinol. Metab. 80 (11): 3107–10. doi:10.1210/jcem.80.11.7593409. PMID 7593409.
  8. Shattuck TM, Välimäki S, Obara T, Gaz RD, Clark OH, Shoback D; et al. (2003). "Somatic and germ-line mutations of the HRPT2 gene in sporadic parathyroid carcinoma". N Engl J Med. 349 (18): 1722–9. doi:10.1056/NEJMoa031237. PMID 14585940.
  9. 9.0 9.1 Westin G, Björklund P, Akerström G (2009). "Molecular genetics of parathyroid disease". World J Surg. 33 (11): 2224–33. doi:10.1007/s00268-009-0022-6. PMID 19373510.
  10. Hsi ED, Zukerberg LR, Yang WI, Arnold A (1996). "Cyclin D1/PRAD1 expression in parathyroid adenomas: an immunohistochemical study". J Clin Endocrinol Metab. 81 (5): 1736–9. doi:10.1210/jcem.81.5.8626826. PMID 8626826.
  11. Agarwal SK, Kester MB, Debelenko LV, Heppner C, Emmert-Buck MR, Skarulis MC; et al. (1997). "Germline mutations of the MEN1 gene in familial multiple endocrine neoplasia type 1 and related states". Hum Mol Genet. 6 (7): 1169–75. PMID 9215689.
  12. Marquard, Jessica; Eng, Charis (September 27, 1999). "Multiple Endocrine Neoplasia Type 2". GeneReviews® [Internet].
  13. Rodriguez M, Nemeth E, Martin D (2005). "The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism". Am J Physiol Renal Physiol. 288 (2): F253–64. doi:10.1152/ajprenal.00302.2004. PMID 15507543.
  14. Lips P (2001). "Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications". Endocr Rev. 22 (4): 477–501. doi:10.1210/edrv.22.4.0437. PMID 11493580.
  15. Mehrotra M, Gupta SK, Kumar K, Awasthi PK, Dubey M, Pandey CM; et al. (2006). "Calcium deficiency-induced secondary hyperparathyroidism and osteopenia are rapidly reversible with calcium supplementation in growing rabbit pups". Br J Nutr. 95 (3): 582–90. PMID 16512945.
  16. Johnson JM, Maher JW, DeMaria EJ, Downs RW, Wolfe LG, Kellum JM (2006). "The long-term effects of gastric bypass on vitamin D metabolism". Ann. Surg. 243 (5): 701–4, discussion 704–5. doi:10.1097/01.sla.0000216773.47825.c1. PMC 1570540. PMID 16633006.
  17. Pitt SC, Sippel RS, Chen H (2009). "Secondary and tertiary hyperparathyroidism, state of the art surgical management". Surg. Clin. North Am. 89 (5): 1227–39. doi:10.1016/j.suc.2009.06.011. PMC 2905047. PMID 19836494.
  18. Kilgo MS, Pirsch JD, Warner TF, Starling JR (1998). "Tertiary hyperparathyroidism after renal transplantation: surgical strategy". Surgery. 124 (4): 677–83, discussion 683–4. doi:10.1067/msy.1998.91483. PMID 9780988.
  19. Pitt SC, Sippel RS, Chen H (2009). "Secondary and tertiary hyperparathyroidism, state of the art surgical management". Surg. Clin. North Am. 89 (5): 1227–39. doi:10.1016/j.suc.2009.06.011. PMC 2905047. PMID 19836494.