Hyperparathyroidism

Hyperparathyroidism is a medical condition where the parathyroid glands produce an excessive amount of parathyroid hormone (PTH). This hormonal imbalance results in various symptoms, including bone pain, fatigue, kidney stones, nausea, depression, and increased urination. Treatment for hyperparathyroidism often includes medications like calcimimetics, which help regulate calcium levels, and vitamin D analogues to maintain bone health.

Causes

Hyperparathyroidism occurs when one or more parathyroid glands in the neck secrete too much parathyroid hormone (PTH). The condition is classified into two primary types based on its causes:

• Primary Hyperparathyroidism: Typically caused by a benign tumor called an adenoma on a parathyroid gland. Less commonly, it may result from enlarged glands or malignant tumors.

• Secondary Hyperparathyroidism: Often linked to low calcium levels due to chronic kidney disease, vitamin D deficiency, or post-surgical complications. In response, the parathyroid glands increase PTH production, which can pose long-term health risks.

Symptoms

The symptoms of hyperparathyroidism can vary, and may initially be subtle:

• Increased urination

• Persistent thirst

• Fatigue and feeling weak

• Joint or bone pain

• Digestive issues, including nausea, vomiting, loss of appetite, and constipation

• Depression and difficulty concentrating

• Itchy skin

Often, individuals discover the condition through routine blood tests that show elevated calcium levels. Early consultation with a healthcare professional is vital to prevent further complications.

Diagnosis

Hyperparathyroidism is often detected through routine blood tests showing elevated calcium levels. For confirmation, healthcare providers check for high levels of parathyroid hormone in the blood. Additional tests, such as bone mineral density tests and 24-hour urine tests, assess bone health and kidney function, respectively. Imaging studies, like ultrasounds or sestamibi scans, may identify abnormalities in the parathyroid glands, especially if surgery is being considered. These evaluations guide treatment planning.

Treatments

Managing hyperparathyroidism involves controlling high calcium levels:

• Surgery: The most effective treatment for primary hyperparathyroidism, particularly when associated with adenomas.

• Medications: For patients unsuitable for surgery, medications like calcimimetics can decrease PTH production. Bisphosphonates and hormone replacement therapy may also be used to maintain bone health.

• Lifestyle Changes: Staying hydrated, managing calcium and vitamin D intake, and engaging in physical activity support health management.

Medications

If surgery isn't an option, these medications may help manage the condition:

• Cinacalcet: A calcimimetic that reduces PTH production by tricking the parathyroid glands into sensing higher blood calcium.

• Bisphosphonates: Help prevent osteoporosis-related bone loss by inhibiting bone breakdown.

• Hormone Replacement Therapy: Supports bone health in postmenopausal women, but doesn't address the parathyroid dysfunction cause.

These treatments are crucial for managing symptoms and preventing complications, so following healthcare advice is essential.

Prevention

Consider these preventive steps:

• Manage Underlying Conditions: Address conditions that may lead to secondary hyperparathyroidism.

• Dietary Management: Ensure adequate calcium and vitamin D intake.

• Monitor Kidney Health: Especially important for those with chronic kidney disease.

• Exercise: Regular physical activity promotes bone and kidney health.

• Hydration: Supports overall health and prevents complications.