Hyperparathyroidism is excessive activity of the hyperthyroid glands. There are three common forms of this condition:

  • Sporadic primary hyperparathyroidism
  • Secondary hyperparathyroidism
  • Hyperparathyroidism related to Multiple Endocrine Neoplasm Syndrome

Of these three types, by far the most common is the first one, sporadic primary hyperparathyroidism (SHPT).

Sporadic Primary Hyperparathyroidism (SHPT)

Signs and symptoms of SHPT may be nonspecific, mild or severe.

The range of signs and symptoms include:

  • Muscle weakness
  • Bone and joint aches and pains
  • Kidney stones
  • Excessive urination
  • Feeling thirsty more than normal
  • Constipation
  • Fragile bones that may easily fracture (osteoporosis)
  • Depression
  • Pancreatitis
  • Stomach ulcers

The diagnosis of primary hyperparathyroidism is made by blood tests.  Calcium and parathyroid hormone (PTH) are measured.

The most common cause of SHPT is the development of a benign tumor (adenoma) involving one of the parathyroid glands. This overactive parathyroid gland is not cancerous; however, it induces high levels of calcium in the blood due to an overproduction of PTH that can cause a variety of health problems.

  • In 95% of cases, there is a single adenoma.
  • In 2% of cases, there will be 2 adenomas (double adenoma).
  • Occasionally all four glands are overactive, a condition called parathyroid hyperplasia / multi-gland disease (3% of cases).

Cancer of the parathyroid glands is very rare (less than 1% of cases).

No imaging studies are necessary to make the diagnosis of HPT. However, these tests help the surgeon to preoperatively localize the offending gland or glands and allows him/her to perform a targeted, minimally invasive parathyroidectomy.  A combination of two imaging tests to locate the parathyroid gland or glands before parathyroidectomy can be performed:

  • Ultrasound — a small device held on the skin of your neck
  • Sestamibi scan — a mild, safe radioactive agent is injected into a vein, and an X-ray image of the head, neck, and chest is taken

Surgical removal of the abnormal parathyroid gland(s) or parathyroidectomy is the treatment for PHPT. A surgeon will remove one or more of the glands that are abnormal. If all four glands are abnormal, three glands and a portion of the fourth gland are removed, leaving some functioning parathyroid tissue in the neck (subtotal parathyroidectomy).

This information is provided by the Department of Surgery at the University of Colorado School of Medicine. It is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.