There are two primary forms of hyperparathyroidism: primary and secondary. Primary hyperparathyroidism occurs when the parathyroid glands function independently of the body’s calcium levels, often due to a benign tumor (adenoma) or, less commonly, hyperplasia (enlargement) of the glands. Secondary hyperparathyroidism develops as a compensatory response to chronic low calcium levels, frequently seen in patients with kidney disease or long-term vitamin D deficiency. Tertiary hyperparathyroidism is a rare form that arises when secondary hyperparathyroidism becomes autonomous over time.
Symptoms of hyperparathyroidism can vary widely and may include fatigue, weakness, depression, bone pain, frequent fractures, kidney stones, nausea, vomiting, and an increased risk of hypertension. In some cases, the condition may be asymptomatic and detected incidentally during blood tests showing elevated calcium levels. Chronic hyperparathyroidism can lead to complications such as osteoporosis, kidney damage, and cardiovascular issues.
Diagnosis typically involves blood tests to measure calcium, PTH, and phosphate levels, along with imaging studies like ultrasound, CT scans, or MRI to identify abnormalities in the parathyroid glands. Treatment depends on the severity and type of hyperparathyroidism. Mild cases may be managed with monitoring and lifestyle adjustments, while more severe cases may require surgical removal of the affected gland(s), known as parathyroidectomy. In some instances, medications like cinacalcet may be used to lower PTH levels.
Prognosis is generally good with appropriate treatment, particularly for primary hyperparathyroidism. Early detection and intervention can prevent long-term complications and improve quality of life. Regular follow-up is essential for monitoring calcium levels and overall health, especially in patients with chronic kidney disease or other predisposing conditions.