Understanding Hyperparathyroidism in Simple Terms
Hyperparathyroidism is a condition where small glands in your neck (parathyroid glands) produce too much of a hormone that controls calcium levels in your blood, causing your blood calcium to become too high. 1
What Are the Parathyroid Glands?
You have four tiny parathyroid glands located in your neck, near your thyroid gland. These glands produce parathyroid hormone (PTH), which acts like a thermostat for calcium in your body. 2
How Does This Hormone Normally Work?
Think of PTH as a calcium manager with three main jobs:
- In your bones: It releases calcium stored in your bones into your bloodstream
- In your kidneys: It tells your kidneys to hold onto calcium instead of losing it in urine, while getting rid of phosphate
- In your intestines: It helps your body absorb more calcium from food by activating vitamin D 2
What Goes Wrong in Hyperparathyroidism?
In most cases (95%), one of these glands develops a benign (non-cancerous) growth called an adenoma that acts like a broken thermostat—it keeps producing PTH even when calcium levels are already high enough. 2 Less commonly, all four glands become enlarged and overactive.
The result is too much calcium in your blood (hypercalcemia), which happens because:
- Your bones release more calcium than they should
- Your intestines absorb more calcium from food
- Your kidneys hold onto calcium instead of eliminating it properly 2
Who Gets This Condition?
This is actually quite common—it's the third most common hormone disorder. 1, 3 It affects:
- Women much more than men (about 75% of cases are women)
- Mostly people after menopause
- More people as they get older 1
What Problems Does It Cause?
Kidney Problems
The excess calcium can form kidney stones or damage kidney tissue (nephrocalcinosis). Many people don't feel symptoms until they pass a painful kidney stone. 1
Bone Problems
Your bones become weak (osteoporosis) because calcium is constantly being pulled out of them. This increases your risk of fractures, even from minor falls. 1, 2
Other Effects
When calcium gets very high, you might experience:
- Fatigue and weakness
- Loss of appetite
- Nausea
- Constipation
- Confusion or memory problems
- Excessive thirst and urination 4, 5
However, many people today have no symptoms at all and are only diagnosed when routine blood work shows high calcium levels. 1, 6
How Is It Diagnosed?
Doctors look for a specific pattern in blood tests:
- High calcium levels in your blood
- High or "inappropriately normal" PTH levels (the PTH should be low if calcium is high, but instead it's elevated or normal)
- Often high calcium in urine
- Low phosphate in blood 1
What's the Treatment?
Surgery to remove the overactive parathyroid gland(s) is the only cure and is recommended if you have: 1
- Kidney stones or kidney damage
- Weak bones (osteoporosis) or fractures
- Calcium levels significantly above normal
- Reduced kidney function
- High amounts of calcium in your urine
If surgery isn't done or isn't possible, doctors monitor you closely and may use medications to protect your bones or lower calcium levels. 1
Important Distinctions
There are different types of hyperparathyroidism:
- Primary: The parathyroid glands themselves are the problem (what we've been discussing)
- Secondary: The glands work overtime because of another condition, like kidney disease or vitamin D deficiency
- Tertiary: Long-standing secondary hyperparathyroidism where the glands become autonomous 3, 5, 7
The key takeaway: Hyperparathyroidism is a treatable condition where your body's calcium control system malfunctions, leading to too much calcium in your blood, which can damage your bones and kidneys if left untreated.