Hyperparathyroidism: What It Is, Symptoms, Treatment, Diagnosis, Treatment

What Is Hyperparathyroidism?

Hyperparathyroidism is one of the disorders of the parathyroid gland, wherein excess parathyroid hormone causes high calcium levels in the blood. This imbalance leads to bone weakening and neurological problems and kidney stones. Understanding the basics of hyperparathyroidism is very important, as it is an imbalance related to calcium metabolism, which is very important for bone health, nerve functions, and muscle contraction.

Role of Parathyroid Glands in Calcium Balance

Role of parathyroid gland in calcium balance:

• Four small glands located behind the thyroid.

• Secretion of PTH to regulate concentration of calcium in the blood.

• PTH actions: Bone resorption, Increases intestinal absorption in the gut, and reduces renal excretion of calcium.

Types of Hyperparathyroidism

The types of hyperparathyroidism are:

Primary Hyperparathyroidism

Causes:

• Parathyroid adenomas, that is, benign tumours

• Hyperplasia, enlargement of the glands

• Carcinoma (rarely)

Effect:

• Excess secretion of PTH will lead to high blood calcium levels

Secondary Hyperparathyroidism

Causes:

• Chronic renal failure

• Vitamin D deficiency

Mechanism:

• Compensatory PTH overproduction due to low calcium

Tertiary Hyperparathyroidism

Causes:

• Prolonged secondary hyperparathyroidism

• Typically in chronic kidney disease.

Feature:

• Autonomous PTH secretion even after correction of cause.

Causes and Risk Factors

The causes and risk factors associated with hyperparathyroidism are:

Genetic Factors

• Family history of hyperparathyroidism.

• Multiple Endocrine Neoplasia (MEN) syndromes

Environmental And Lifestyle Factors

• Inadequate dietary intake of calcium or vitamin D.

• Prior radiation therapy to the neck.

• Advanced age

• Female sex

• Certain medications.

Symptoms and Complications

The details are given below:

Common Symptoms

• Fatigue

• Muscle weakness

• Bone pain

• Digestive issues

Complications

• Osteoporosis: Weak and brittle bones.

• Kidney stones: Due to high calcium levels in urine.

• Cardiovascular problems: Hypertension, arrhythmias.

Diagnosis of Hyperparathyroidism

The details are given below:

Clinical Evaluation

• Family history.

• Signs of hypercalcemia.

Laboratory Tests

• Elevated serum calcium.

• Elevated serum PTH

• Phosphate, vitamin D, renal function tests.

Imaging Techniques

• Ultrasound of parathyroid glands.

• Sestamibi scan for overactive glands.

• CT/MRI in complicated cases.

Treatment Options

The treatment options for hyperparathyroidism are given below:

Surgical Treatments

• Parathyroidectomy: Excision of the overactive glands.

Non-Surgical Treatments

• Calcimimetics, for example, cinacalcet and bisphosphonates.

• Dietary alterations

• Increased fluid intake

• Monitoring of calcium and vitamin D intake.

Prevention and Long-Term Management

The details are given below:

Preventive Measures

• Adequate calcium and vitamin D intake.

• Regular exercise

• Avoid smoking and excessive alcohol intake.

Long-Term Management

• Regular blood tests to check the calcium and PTH levels.

• Management of osteoporosis and kidney stones.

Hyperparathyroidism NEET MCQs (With Answers & Explanations)

Important questions asked in NEET from this topic are:

• Functions of parathyroid gland

• Types of hyperparathyroidism

Practice Questions for NEET

Q1. The blood calcium level is lowered by the deficiency of

1. Thyroxine

2. Calcitonin

3. Parathormone

4. Both 1 and 2

Correct answer: 3) Parathormone

Explanation:

The parathyroid glands secrete a peptide hormone called parathyroid hormone (PTH), which plays a crucial role in regulating calcium levels in the blood. The secretion of PTH is primarily controlled by the circulating levels of calcium ions. When blood calcium levels drop, the parathyroid glands increase the release of PTH to stimulate the release of calcium from bones, increase calcium reabsorption by the kidneys, and promote the activation of vitamin D, which enhances calcium absorption from the intestines. Conversely, when calcium levels rise, the secretion of PTH is reduced, maintaining a balanced calcium concentration in the body.

Hence the correct answer is option 3) Parathormone.

Q2. Tetany is caused by

1. Hyperparathyroidism

2. Hypoparathyroidism

3. Hypothyroidism

4. Hyperthyroidism

Correct answer: 2) Hypoparathyroidism

Explanation:

The clinical complications associated with hypoparathyroidism can result in a disorder termed parathyroid tetany or hypocalcemic tetany, characterized by involuntary muscle contractions that can be distressing and potentially dangerous. Proper diagnosis and management of this condition are essential to restore calcium balance and reduce symptoms.

Hence, the correct option is 2) Hypoparathyroidism

Q3. Which of the following hormones can play a significant role in osteoporosis?

1. Estrogen and Parathyroid hormone

2. Progesterone and Aldosterone

3. Aldosterone and Prolactin

4. Parathyroid hormone and Prolactin

Correct answer: 1) Estrogen and Parathyroid hormone

Explanation:

Estrogen: By preventing bone resorption, or breakdown, this hormone aids in maintaining bone density. Osteoporosis is a disorder in which bones become weak and can be exacerbated by a reduction in estrogen levels, such as occurs after menopause.

Parathyroid hormone (PTH): PTH affects bone metabolism and controls blood calcium levels. Increased bone resorption brought on by high PTH levels can erode bones even more and exacerbate osteoporosis. PTH promotes bone breakdown to release calcium into the bloodstream when blood calcium levels are low.

Hence, the correct answer is option 1)Estrogen and Parathyroid hormone.

Also Read:

• MCQs on Parathyroid Gland

• Pancreas

• Hormone Receptors

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