Diseases of the parathyroid glands - Part 2 hyperparathyroidism

on Wed 5 Oct

As previously explained the 4 parathyroid glands are situated in the neck behind the thyroid. Each the size of a rice grain they produce parathyroid hormone (PTH) which plays a significant part in maintaining the correct levels of calcium, phosphorus and vitamin D within the body.


About Hyperparathyroidism

When this condition is present too much PTH is produced leading to rising blood calcium levels and low blood phosphate levels. The main cause of primary hyperthyroidism is a benign (non-cancerous) tumour growing on one of the parathyroid glands (An adenoma) whilst secondary hyperparathyroidism is caused by kidney failure or lack of Vitamin D which lowers calcium levels.


As initial symptoms are mild and non-specific the condition is often only picked up when having a blood test for another treatment - about 80% of patients are found in this way.


The classic symptoms are colloquially described as “bones, stones, abdominal moans and groans” and include:


  • Fatigue
  • Abnormal thirst
  • Excessive dilute urine
  • Nausea and lack of appetite
  • Stomach pain
  • Constipation
  • Weakness
  • Anorexia
  • Mild depression
  • Mild cognitive or neuromuscular dysfunction


Left untreated, patients can present with kidney stones, bone pain and fractures, peptic ulcers or renal damage and they may have decreased bone density in areas like the forearm or hip. In severe cases high calcium levels can lead to coma.  


Treatment of Hyperparathyroidism

Primary hyperparathyroidism can only be treated by the removal of the adenoma.


Secondary hyperparathyroidism due to vitamin D deficiency is treated with high-dose vitamin D (colecalciferol) supplementation. If due to chronic kidney disease it can also be treated by Cinacalcet which is a drug which mimics the action of calcium on tissues reducing parathyroid hormone levels and thus calcium levels.


There is now increasing use of this drug in patients with severe and refractory primary hyperparathyroidism if they are not well enough to undergo surgery.


All patients with hyperparathyroidism should avoid a high calcium diet and should drink plenty of water to maintain hydration. Vitamin D requirements are increased in hyperparathyroidism and should be continued.


If you would like to see me discussing this condition on a video please click here


Please see the first part of this post which discusses Hypoparathyroidism (click here)


Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.


As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link.



acanthosis nigricans Acromegaly Addison's disease adolescent diabetes problems adolescent thyroid problems Adrenal crisis adrenal fatigue Adrenal glands Anovulation artificial pancreas Autoimmune Thyroiditis Bariatric Surgery blood glucose levels blood pressure breastfeeding CAH Charcot foot cholesterol CHT coffee cold and flu medications Conception Congenital adrenal hyperplasia congenital hypothyroidism Consultant Endocrinologist London coronavirus cortisol covid-19 Cushing's disease Cushing's syndrome Depression Diabetes diabetes and bone health diabetes and heart health diabetes and oral health diabetes and parkinsons diabetes and sexual dysfunction diabetes and skin conditions diabetes and thrush diabetes in China diabetes insipidus diabetes latest diabetic ketoacidosis diabetic neuropathy Diabetic prevalence diabetic retinopathy diet for diabetes diet for obesity Disability Act Down's Syndrome Dr Mark Vanderpump e-consulting endocrine system fertility folic acid Freestyle Libre frozen shoulder and thyroid Fruit sugars gestational diabetes Gigantism Glucose Monitoring Glucose Tolerance Test gluten free Goitre Graves Disease Graves Orbitopathy guthrie test hair loss Hashimoto's Disease healthcare services hearing loss Heart Disease heel prick test Hepatitis C Hormones - most important how to lose weight hyperparathyroidism Hypersecretion Hyperthyroidism hyperthyroidism and respiratory problems Hypocalcaemia Hypogonadism hypoparathyroidism hypophysitis Hyposecretion Hypothyroidism hypothyroidism and respiratory problems IFG IGT immunotherapy side effects Impaired Fasting Glucose Impaired Glucose Tolerance Insulin Resistance Iodine IR iron Labour and birth late onset hypogonadism Levothyroxine Long Covid losing weight Low testosterone Mark Vanderpump MEN1 MEN2 menopause metabolic syndrome mood changes morning sickness Multiple endocrine neoplasia neuroendocrine tumour neuropathy Obesity obstructive sleep apnoea older patients online doctor OSA Osteoporosis overactive thyroid ozempic Pancreas Pancreatic Cancer Pancreatic Diabetes parathyroid glands Patient Resources Patient Support Groups PCOS PCOS and acne PCOS and fertility PCOS and Insulin PCOS diet Phaeochromocytomas Pituitary Gland POF Polycystic Ovary Syndrome Post menopause thyroid problem Post pregnancy thyroid problem postnatal diabetes medication postnatal thyroid medication Prader-Willi Syndrome pre-eclampsia prediabetes pregnancy Pregnancy and Diabetes Pregnancy and Thyroid Disease Premature Ovarian Failure prolactinomas PTH puberty Radioactive Iodine RAI resistant hypertension semaglutide Sheehan's Syndrome Skin tags sleep and diabetes sleep and obesity soy Soya steroid dependent subacute thyroiditis T4 Tara Palmer Tomkinson testosterone Tetany The endocrine system Thyroid thyroid and menstruation thyroid cancer Thyroid disease in children thyroid nodules Thyroid Storm thyroid tests Thyroiditis Thyrotoxic Periodic Paralysis Thyroxine TSH levels TSH Testing tumours Type 1 diabetes Type 2 Diabetes Type 3 diabetes underactive thyroid Vitamin B complex Vitamin D Waist circumference weight gain weightloss

Please get in touch

Phone: 07565 978310

Contact form