Hyperparathyroidism is a condition that occurs when one or more of the parathyroid glands in the neck become overactive, producing too much parathyroid hormone (PTH). This hormone regulates calcium levels in the blood and bones. When there is too much PTH, calcium levels can rise excessively, potentially leading to health problems such as fatigue, kidney stones, brittle bones and mood changes.
What Is Hyperparathyroidism
Hyperparathyroidism is a condition where one or more parathyroid glands produce too much parathyroid hormone (PTH), disrupting calcium and phosphate balance. This can lead to weakened bones, kidney stones, fatigue and other metabolic issues. It is typically discovered through elevated calcium levels in routine blood tests before symptoms appear.
Primary Hyperparathyroidism
Primary hyperparathyroidism occurs when a parathyroid gland becomes overactive due to a benign tumour or enlargement. It leads to excessive PTH production regardless of calcium levels. This is the most common form and typically affects adults over 50, especially women. Surgery is often the preferred treatment to remove the affected gland.
Secondary Hyperparathyroidism
Secondary hyperparathyroidism develops when low calcium levels trigger the parathyroid glands to overproduce PTH. This often results from vitamin D deficiency or chronic kidney disease. The glands respond appropriately to the body’s needs, but long-term overactivity can still cause complications. Treating the underlying condition usually helps correct the hormone imbalance.
Tertiary Hyperparathyroidism
Tertiary hyperparathyroidism usually follows long-standing secondary hyperparathyroidism, especially in chronic kidney disease patients after kidney transplantation. The glands become permanently overactive, producing high PTH even when calcium levels are normal or high. This form may require surgical removal of some or all parathyroid glands to control the condition effectively.
Parathyroid Adenomas
Parathyroid adenomas are non-cancerous tumours of a single parathyroid gland and are the most common cause of primary hyperparathyroidism. These adenomas lead to excessive PTH secretion, raising blood calcium levels. Although benign, they can cause serious symptoms and are often treated through minimally invasive surgery to remove the affected gland.
Parathyroid Hyperplasia
Parathyroid hyperplasia involves the enlargement of two or more parathyroid glands and causes elevated PTH production. Unlike adenomas, which usually affect only one gland, hyperplasia involves multiple glands. This condition may be genetic and sometimes requires surgery to remove all but one gland or partial removal of each affected gland.
Parathyroid Carcinoma
Parathyroid cancer is an extremely rare cause of hyperparathyroidism. It results in very high calcium and PTH levels and presents with more severe symptoms. Diagnosis is often made post-surgery, as it closely resembles benign conditions. Treatment involves the complete removal of the tumour, and recurrence monitoring is crucial after surgery.
Genetic Conditions and Inherited Syndromes
Inherited syndromes such as Multiple Endocrine Neoplasia types 1 and 2 (MEN1 and MEN2) can cause hyperparathyroidism. These genetic conditions involve tumours in various endocrine glands, including the parathyroids. People with a family history may need genetic screening and long-term follow-up to manage risks and detect early gland overactivity.
Calcium and Vitamin D Imbalance
Imbalances in calcium and vitamin D can play a role in the development or worsening of hyperparathyroidism. A lack of vitamin D may drive secondary hyperparathyroidism, while high calcium levels are often a result of primary disease. Nutritional assessment and correction of these levels are essential for accurate diagnosis.
Environmental and Lifestyle Risk Factors
While genetic and biological causes are primary drivers, some lifestyle and environmental factors may influence the condition. Prolonged lithium therapy, radiation exposure to the neck, and long-term vitamin D deficiency may increase the risk of hyperparathyroidism. Regular health screenings help detect such issues before complications arise.
Conclusion
Hyperparathyroidism is a condition that requires proper understanding and medical evaluation. Whether it is caused by a benign tumour, vitamin D deficiency or kidney issues, the effects on calcium balance can impact your long-term health. Recognising the symptoms early and knowing when to seek help can make a significant difference.
