From the Research
Hyperparathyroidism typically does not cause hyperkalemia (high potassium levels), but it can cause hypomagnesemia (low magnesium levels). In hyperparathyroidism, the parathyroid glands produce excessive parathyroid hormone (PTH), which primarily affects calcium and phosphate metabolism. PTH increases calcium levels in the blood by enhancing bone resorption, increasing calcium reabsorption in the kidneys, and promoting vitamin D activation to increase intestinal calcium absorption. Regarding potassium, PTH has minimal direct effects on potassium regulation, so hyperkalemia is not a characteristic feature of hyperparathyroidism. However, hypomagnesemia can occur in hyperparathyroidism due to increased urinary magnesium excretion. PTH can reduce magnesium reabsorption in the kidneys, leading to increased magnesium loss in urine. Additionally, the chronic hypercalcemia seen in hyperparathyroidism can further impair magnesium reabsorption in the kidneys.
Some studies have investigated the relationship between hyperparathyroidism and electrolyte disturbances. For example, a study published in 2024 found that hypomagnesemia was detected in 23.9% of patients with primary hyperparathyroidism, and these patients had a higher rate of symptomatic disease, including osteoporosis and kidney stones 1. Another study published in 2011 reported a rare case of hyperparathyroid crisis, which presented with extreme hypercalcemia, hypokalemia, and hypomagnesemia, highlighting the potential for multiple electrolyte disturbances in severe cases of hyperparathyroidism 2.
In terms of potassium regulation, some studies have reported hypokalemia (low potassium levels) in patients with hyperparathyroidism, particularly in those with severe hypercalcemia 3, 4. However, hyperkalemia is not a typical feature of hyperparathyroidism.
Overall, patients with hyperparathyroidism should have their magnesium levels monitored, and supplementation may be necessary if levels are low, as hypomagnesemia can be a significant complication of this condition.