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

What Is Hyperparathyroidism?

Hyperparathyroidism is one of the parathyroid gland disorders, wherein too much parathyroid hormone is produced, which causes high calcium levels in the blood. An imbalance like this is most likely to lead to bone weakening and neurological problems, in addition to causing 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.

The parathyroid glands are small, four in number and are located at the back of the thyroid gland in the neck. These glands, via the secretion of PTH, play a crucial role in the homeostasis of the concentration of calcium in the blood. The explanation for this is that PTH raises calcium by stimulating bone resorption, increases its absorption in the gut, and reduces its excretion in the kidneys. The properly functioning parathyroid glands are important for overall metabolic balance given maintaining the correct level of calcium.

Types Of Hyperparathyroidism

The types of hyperparathyroidism are:

Primary Hyperparathyroidism

• Causes: Adenomas, that is, benign tumours; hyperplasia, which is an enlargement of the glands; carcinoma, rarely.

• The excess secretion of PTH will lead to high blood calcium levels, which have far-reaching effects on the body.

Secondary Hyperparathyroidism

• Causes: Chronic renal failure and vitamin D deficiency

• It involves compensatory overproduction of PTH as a result of low calcium levels or impaired kidney function.

Tertiary Hyperparathyroidism

• Causes: Prolonged secondary hyperparathyroidism, typically in the setting of chronic kidney disease.

• Pathophysiology: Autonomous overproduction of PTH despite correction of the underlying cause.

Causes And Risk Factors

The causes and risk factors associated with hyperparathyroidism are:

Genetic Factors

• Familial links: Family history of hyperparathyroidism.

• Inherited conditions: Multiple Endocrine Neoplasia syndromes, which involve multiple endocrine glands.

Environmental And Lifestyle Factors

• Diet: Inadequate dietary intake of calcium or vitamin D.

• Radiation exposure: Prior radiation therapy to the neck.

• Other contributing factors: 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, and symptoms review.

• Assessment of the signs of hypercalcemia.

Laboratory Tests

• Serum calcium and PTH levels: Elevated in hyperparathyroidism.

• Other relevant blood tests: Phosphorus, vitamin D levels, and renal function tests.

Imaging Techniques

• Ultrasound: To visualise the parathyroid glands.

• Sestamibi scan: To identify overactive glands.

• CT/MRI: Imaging details in complicated cases.

Treatment Options

The treatment options for hyperparathyroidism are given below:

Surgical Treatments

• Parathyroidectomy: Excision of the overactive glands; indicated in severe cases or symptomatic patients with complications.

Non-Surgical Treatments

• Medications: Calcimimetics, for example, cinacalcet and bisphosphonates.

• Lifestyle modifications: Dietary alterations and increased fluid intake; monitoring of calcium and vitamin D intake.

Prevention And Management

The details are given below:

Preventive Measures

• An adequate intake of both calcium and vitamin D.

• Lifestyle modifications include regular exercise, avoidance of smoking, and excessive alcohol intake.

Long-Term Management

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

• Management of complications such as osteoporosis and kidney stones.

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