Mayo Clinic: After a routine blood test my doctor called and
said that I have higher than normal levels of calcium in my
blood. He wants me to come back for another appointment to
test for something called primary hyperparathyroidism. What
causes this condition, and is it treatable? I am 60 and always
have been very healthy.
hyperparathyroidism is a condition that affects your
parathyroid glands and the hormone those glands make. The
disorder usually develops because one of the parathyroid
glands is enlarged and makes too much parathyroid hormone (PTH).
In most cases, removing the diseased gland cures
hyperparathyroidism. Sometimes more than one parathyroid gland
is overactive. In that case, more than one of the glands may
body usually has four parathyroid glands. These tiny glands,
each about the size of a grain of rice, are located near your
thyroid gland, a butterfly-shaped structure that sits at the
front and center of your neck. Despite their location and
name, the parathyroid glands have nothing to do with the
thyroid gland. Instead they make PTH, a hormone that tightly
controls the level of calcium in your blood. Calcium is the
most abundant mineral in the human body.
parathyroid glands make too much PTH, the result can be too
much calcium in your blood. Thatís a problem, because,
although your body uses the vast majority of its calcium to
maintain healthy bones, calcium also is critically important
for keeping your nerves, muscles, heart and blood vessels
working the way they should. When you have too much or too
little calcium in your blood, it can lead to problems in all
hyperparathyroidism typically doesnít cause any symptoms,
especially in its early stages. As in your situation, high
levels of calcium often are found on a routine blood test thatís
done for another reason. To confirm the diagnosis, your doctor
likely will run another blood test to recheck your calcium and
to see if the level of PTH in your blood is also too high. If
it is, then you have primary hyperparathyroidism.
primary hyperparathyroidism, the problem comes from within a
parathyroid gland. It could be the result of a noncancerous
enlargement of one of the parathyroid glands, enlargement of
more than one of the parathyroid glands or, rarely, cancer of
a parathyroid gland.
type of the disease, called secondary hyperparathyroidism, can
happen as a result of other medical problems, such as kidney
disorders, digestive disorders or vitamin D deficiency, that
cause your level of blood calcium to drop. Your parathyroid
glands then make extra PTH to try to increase the amount of
calcium in the blood. This is the bodyís protective response
to keep critical minerals, such as calcium and phosphorus, at
a healthy level. If your doctor suspects secondary
hyperparathyroidism, he or she may recommend additional
testing to investigate the possible cause.
may be recommended for those who are young or who have
complications related to primary hyperparathyroidism, such as
osteoporosis or kidney stones. If your disease is
uncomplicated and mild, your doctor may recommend simply
keeping an eye on it with yearly follow-up appointments.
for primary hyperparathyroidism typically involves surgery to
remove the gland thatís abnormal. In about 85 percent of
cases, only one gland is malfunctioning, and removing that
gland cures the disease. If two or three glands are affected,
they also can be removed. The remaining glands pick up the
work of those that are gone. If all four glands are affected,
the surgeon likely will remove only three glands and a portion
of the fourth ó leaving some functioning parathyroid tissue.
secondary hyperparathyroidism is the cause of your elevated
PTH, then effectively treating the underlying medical
condition thatís causing the PTH level to rise usually
improves the hyperparathyroidism.