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Hyperparathyroidism is an endocrine disorder, which is caused by parathyroid glands overproduction and further results in parathyroid hormone (PTH) excess. This hormone is primarily responsible for calcium regulation. Its abnormal level leads to several complications and the most popular consequence is osteoporosis. There are 2 major types of hyperparathyroidism, primary and secondary, and each one of them has different set of symptoms and signs. The most common ones are associated with hypercalcemia, and include e.g. fatigue, bone pain, loss of appetite, constipation, weakness and depression. In some cases, treatment is unnecessary, however if needed, the most popular method include surgery of parathyroid glands.
Parathyroid glands are four small organs attached to the thyroid. Although they bear similar name and both belong to endocrine system, their task is completely different. Those small glands are responsible for parathyroid hormone (PTH) production rather than thyroid hormones production. PTH is responsible for calcium and phosphate regulation, as well as for vitamin D synthesis. Its abnormal level leads to several dangerous consequences, such as osteoporosis, vitamin D deficiency and kidney stones. This type of disease is the third most prevalent endocrine disorder worldwide.
The disease can be divided into:
- Primary hyperparathyroidism – triggered by internal parathyroid disorder, which is frequently caused by benign tumor, and leads to a hypercalcemia.
- Secondary hyperparathyroidism – occurs as a result of a condition, which is not associated with parathyroid glands. This type of ailment is characterized by hypocalcemia.
- Tertiary hyperparathyroidism – often appears as a result of the secondary type. Although calcium levels has become appropriate, parathyroid glands are no more able to recognize those levels and decrease PTH production. This type of the disease results in hypercalcemia.
Hyperparathyroidism causes and symptoms
In majority of the incidents, primary hyperparathyroidism is caused by either parathyroid adenoma or hyperplasia (gland enlargement). It might also be triggered by parathyroid carcinoma, which is a malignant tumor, but those cases are very rare. On the other hand, secondary type may appear as a result of kidney disorders or vitamin D insufficiency.
Symptoms and signs are different for each type of the disease and they are often non-specific. Their intensity ranges from mild to severe depending on hyperparathyroidism progress and organism’s abilities. What is more, they tend to be barely noticeable or very mild in early stages.
In case of primary type, symptoms are unnoticeable in approximately half of the incidents, but if they eventually appear, they include:
- Bone pain
- Loss of appetite
Whereas symptoms and signs for secondary hyperparathyroidism include:
- Bone or joint pain
- Limb deformation (rickets)
- Swollen joints
- Bone weakness (easy fractures)
Symptoms for tertiary type are the same as for primary type, since they are both associated with hypercalcemia.
Diagnosis and treatment
This type of endocrine disorder is often diagnosed accidentally during routine examinations, since this type of condition do not manifests specific symptoms or they remain unnoticed. In order to reveal the disease, a specialist will check PTH and calcium levels. Raised PTH indicates hyperparathyroidism, whereas calcium levels are determining exact type. Primary and tertiary types have elevated calcium levels, but secondary type has decreased or normal calcium levels.
For primary hyperparathyroidism, treatment is sometimes unnecessary. However if needed, parathyroid surgery is the most common method, which has a high success rate. Other treatment methods include hormone replacement therapy and calcimimetics, calcium or vitamin D intake.