Hyperparathyroidism: symptoms, diagnosis and treatments
Hyperparathyroidism, as its name suggests, is a condition that consists of an increase in parathyroid hormone in the blood. Parathyroid hormone is also called parathyroid hormone (PTH).
This hormone is responsible for regulating calcium levels in the blood. It is produced in the parathyroid glands, which are found in the neck, next to the thyroid. They are four small glands.
Hyperparathyroidism is a common condition that, in many cases, requires treatment. In this article We explain what it consists of, why it occurs and what should be done about it.
What is hyperparathyroidism?
Hyperparathyroidism, as we have pointed out in the introduction, is a pathology that consists of an increase in parathyroid hormone in the blood. This hormone is synthesized in the parathyroid glands, that lie behind the thyroid.
The role of parathyroid hormone is to regulate calcium levels in the blood. Calcium is a fundamental mineral for the proper functioning of the body. It is involved in muscle contraction, heart rate, bone structure, and so on.
What happens in hyperparathyroidism is that the increase in parathormone causes that, in turn, calcium levels in the blood are increased. This can lead to numerous symptoms and health problems that we will explain later.
According to an article in Medical Writing, there are two main types of hyperparathyroidism. The primary is that in which there is an increase in one or more of the parathyroid glands. That is, the problem is in the glands as such.
On the other hand, secondary hyperparathyroidism is one that occurs as a result of another disease. This disease or situation causes calcium levels in the body to drop. In response to this, the parathyroid glands begin to secrete much more parathyroid hormone than usual.
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Symptoms of hyperparathyroidism
This condition causes calcium levels in the blood to increase. According to experts from the Norman Parathyroid Center, most cases are diagnosed before symptoms appear.
The problem is that, when symptoms appear, it can be very nonspecific. In addition, they can sometimes be very serious and life-threatening. To increase calcium in the blood, parathyroid hormone stimulates its release from the bones.
So, one of the consequences of hyperparathyroidism is osteoporosis. Pain in the bones or joints is also common. Calcium also tends to form kidney stones and increase the urge to urinate.
Many people feel tired, depressed, or forgetful. Similarly, abdominal pain, nausea, and loss of appetite may appear. There may be tachycardia or palpitations.
What can cause it?
Hyperparathyroidism, as we have explained before, can be primary or secondary. In both cases the consequence is an increase in parathyroid hormone. However, they are entities that can have different causes. In the following sections we mention the most relevant ones.
This type is produced by an alteration in one of the four parathyroid glands. As the specialists of Mayo Clinic, the most common cause is adenomas. They are a type of benign tumor in these glands that causes them to increase their activity.
It can also be due to a malignant tumor, although it is somewhat less frequent. In most of these cases, there is usually a genetic disorder that predisposes to suffering from this cancer.
Secondary hyperparathyroidism is one that occurs because something lowers calcium levels in the blood. In response to this, the glands begin to secrete more parathormone in an attempt to balance the calcium concentration.
Calcium levels may be low due to insufficient intake in the diet. Another of the main causes is that it is not absorbed enough at the intestinal level, due to some pathology of said organ.
In the same way, when there is a deficiency of vitamin D, less calcium is absorbed from the intestine. Therefore, it can lead to this pathology. Vitamin D deficiency is seen in patients with chronic kidney failure, or in people who have low sun exposure.
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There are many factors that can increase your risk of hyperparathyroidism. For example, being a woman and having menopause is one of the main ones. Also, as we have just pointed out, having chronic kidney failure, since the kidney plays a fundamental role in the synthesis of vitamin D.
Certain treatments, such as lithium or radiation therapy to the neck, can increase your chances of getting it. Lastly, having a history of certain genetic disorders, such as multiple endocrine neoplasia type I, is a very important risk factor.
Possible complications of hyperparathyroidism
The complications derived from hyperparathyroidism are due to high levels of calcium in the blood. We pointed out earlier that these patients usually suffer from osteoporosis and kidney stones. It can also lead to cardiovascular diseases, such as high blood pressure.
On the other hand, pregnant women are at higher risk of pregnancy complications. When hyperparathyroidism is severe, the newborn may develop hypoparathyroidism right after birth.
How is it diagnosed?
The diagnosis of hyperparathyroidism is usually made before symptoms appear. The fundamental test is the blood test. With this test, you can see how your calcium and parathyroid hormone levels are.
However, that is not enough to find out the cause of the disorder. According to a publication of Barna Clinic, other complementary tests are usually carried out to find out if it is primary or secondary. It also seeks to find out how serious the picture is.
One of them is bone densitometry. The idea is to check for osteoporosis in the patient. The 24-hour urinalysis can be helpful to see how much calcium is excreted in the urine. In addition, it allows you to see how kidney function is, as well as kidney ultrasound or other imaging tests.
Ultrasound is also usually performed at the level of the neck, to try to visualize the glands. However, a specific test is usually used, which consists of explore these glands with sestamibi. It is a radioactive compound that is usually taken up by the glands.
In this way, if any of them are hyperactive, they capture more of the sestamibi. That, using an imaging test such as a CT scan, allows you to easily appreciate the alterations. This is how primary hyperthyroidism is diagnosed.
Available treatments for hyperparathyroidism
Treatment of hyperthyroidism varies depending on the patient's condition. There are cases where expectant management is preferred, based on observation alone. For example, in patients whose calcium levels are not very high. It is also an option if there are no kidney problems, bone density is normal, or there are hardly any symptoms.
However, in many cases treatment is required. The most widely used therapeutic option is surgery. Especially in primary cases. The idea is to remove the affected glands to prevent them from making too much hormone.
It is a simple surgery, which is usually performed under local anesthesia. However, complications can occur, such as damage to the vocal cords or infections. In addition, many patients require subsequent calcium and vitamin D supplementation.
In addition to surgery, there are a number of drugs that can help control hyperthyroidism. They are not a curative option, but they are another alternative. The most used are calcimimetics. They are compounds similar to calcium, which "trick" the gland into not continuing to produce hormones.
Bisphosphonates can also be used. They are drugs used to treat osteoporosis. They prevent the loss of calcium from the bones. The problem is that they often have gastrointestinal side effects, such as nausea and vomiting.
Lifestyle and recommendations
In some cases, hyperparathyroidism can be prevented or its impact reduced. For example, it is advisable to drink plenty of fluids to urinate more. This stimulates renal clearance and reduces the risk of kidney stones.
It is also recommended to maintain an adequate intake of calcium and monitor vitamin D. This is especially important in menopausal women. Vitamin D is activated thanks to sun exposure.
So, Another tip is to exercise regularly outside. For example, walking. In addition, exercise also helps keep your bones stronger. Similarly, you have to avoid tobacco.
What we must remember is that hyperparathyroidism is a relatively common condition. It can happen both primarily as a result of certain situations that lower calcium levels.
As in many cases it does not produce symptoms or they are very nonspecific, it is important to try to go to medical check-ups frequently. It is a problem that may require treatment for avoid serious complications such as cardiovascular disease or osteoporosis.
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