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Am Fam Physician. 2004;69(2):340

What is hyperparathyroidism?

At the front of your neck, behind the thyroid gland, lie the four small parathyroid glands. (Say: pair-ah-thigh-royd) The hormone they make is called parathyroid hormone. This hormone keeps the right levels of calcium and phosphorus in your blood and bones. It also helps your body absorb calcium from food and helps you lose less calcium in urine.

Hyperparathyroidism (also called HPT) is a health problem you get when your parathyroid glands make too much parathyroid hormone. (Say: high-per-pair-ah-thigh-royd-iz-um) Having too much of this hormone can cause hypercalcemia, or too much calcium in your blood. (Say: high-per-kal-see-mee-ah) If this happens, other parts of your body will not work right.

HPT usually is caused by a growth in one of the parathyroid glands. The growth will be too small for you to feel in your neck.

Who gets HPT?

HPT is more common in women and older people. Nothing you eat or do causes HPT. You have about one chance in 1,000 of getting HPT after you are 60 years old.

How do I know I have HPT?

Your doctor may suspect you have HPT if a routine blood test shows that you have a high calcium level. Most people have no symptoms when their calcium level is high. However, it is possible that you might get depressed or feel more tired than usual. Any part of your body might hurt. With more serious HPT, the high calcium level can cause loss of appetite, nausea, vomiting, constipation, or stomach pain.

If you have HPT, you could get kidney stones. Too much calcium in your kidneys might make you thirsty or increase your need to urinate. Losing too much calcium in your urine makes your bones weak. Weak bones break more easily and take longer to heal.

Your doctor will order tests to see if HPT is causing other problems for you. You might have a test to check the density of your bones. You might have an x-ray or an ultrasound exam to check for kidney stones. You might have a urine test to check your risk of forming stones. You might have a special test to locate the abnormal parathyroid gland.

How is HPT treated?

The usual treatment for HPT is surgery to remove the growth in your neck. The growth usually does not come back. Most of your symptoms will stop in the first month after surgery. Right after surgery, your blood calcium level may be too low. This problem can be treated with medicine.

Not all people with HPT need surgery. If you have very few symptoms, you might be watched closely and have tests every six months. You might have surgery if the disease were to get worse. Medicines that lower the calcium level are used in people who can't have surgery.

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