Parathyroid Disorders

What are parathyroid disorders?

Disorders of the parathyroid glands most commonly present with abnormalities of serum calcium. Patients with primary hyperparathyroidism (the most common cause of hyercalcemia in outpatients) are often asymptomatic or may have bone disease, nephrolithiasis, or neuromuscular symptoms. Patients with chronic kidney disease may develop secondary hyerparathyroidism with resultant chronic kidney disease-mineral and bone disorder.

What are the risk factors for parathyroid disorders?

Risk factors for primary hyperparathyroidism include:

• History of neck radiation.
• Age older than 50 years old.
• Sex, women are twice as likely as men to develop primary hyperparathyroidism.

Risk factors for secondary hyperparathyroidism include:

• Most commonly occurs because of decreased levels of 1,25-dihydroxyvitamin D, hyperphosphatemia, and hypocalcemia in the setting of chronic kidney disease.
• Other causes include vitamin D deficiency secondary to low dietary intake, lack of sun exposure, malabsorption, liver disease, and other chronic illnesses.

What are the symptoms of parathyroid disorders?

Symptoms may be so mild and nonspecific that they don’t seem at all related to parathyroid function, or they may be severe. The range of signs and symptoms include:

• Fragile bones that easily fracture (osteoporosis).
• Kidney stones.
• Excessive urination.
• Abdominal pain.
• Tiring easily or weakness.
• Depression or forgetfulness.
• Bone and joint pain.
• Frequent complaints of illness with no apparent cause.
• Nausea, vomiting or loss of appetite.

How are parathyroid disorders diagnosed?

Evaluation of patients with abnormal serum calcium levels may include:

• Physical exam and history.
• Laboratory tests, including repeat measurement of serum calcium levels, measurement of creatinine, magnesium, vitamin D, and parathyroid hormone levels.

How are parathyroid disorders treated?

The treatment for symptomatic primary hyperparathyroidism may involve parathyroidectomy or close monitoring by an endocrinologist.

When should I contact my healthcare provider?

See your provider if you have any signs or symptoms of hyperparathyroidism. These symptoms could be caused by any number of disorders, including some with serious complications. It’s important to get a prompt, accurate diagnosis and appropriate treatment.