From the Guidelines
Hyperparathyroidism symptoms include bone pain, kidney stones, excessive urination, abdominal pain, nausea, vomiting, constipation, fatigue, depression, memory problems, and muscle weakness, as a result of elevated parathyroid hormone levels pulling calcium from bones and increasing calcium absorption from food, affecting multiple body systems 1.
Symptoms of Hyperparathyroidism
The symptoms of hyperparathyroidism are diverse and occur due to the overproduction of parathyroid hormone, which raises blood calcium levels. These symptoms can be categorized into several groups, including:
- Bone-related symptoms: bone pain, bone demineralization, fractures
- Kidney-related symptoms: kidney stones, nephrocalcinosis
- Gastrointestinal symptoms: abdominal pain, nausea, vomiting, constipation
- Neurological and psychological symptoms: fatigue, depression, memory problems, muscle weakness
Asymptomatic Cases
Many patients with hyperparathyroidism are asymptomatic, with the condition discovered during routine blood tests showing elevated calcium levels 1.
Severe Cases
Severe cases of hyperparathyroidism may present with more pronounced symptoms like significant bone loss, kidney damage, or cognitive impairment. The classic description of hyperparathyroidism symptoms is "bones, stones, abdominal groans, and psychic moans," referring to the major symptom categories 1.
Importance of Medical Evaluation
If you experience these symptoms, especially with a family history of endocrine disorders, it is essential to seek medical evaluation as treatment options range from monitoring to surgical removal of the affected gland(s) 1.
From the FDA Drug Label
In a randomized double-blind, placebo-controlled study of 67 patients with primary hyperparathyroidism for whom parathyroidectomy would be indicated on the basis of serum calcium levels, but who are unable to undergo surgery, the most common adverse reactions are listed in Table 4.
Table 4 Adverse Reactions Occurring in ≥ 10% of Subjects in a Double-Blind, Placebo-Controlled Study in Patients with Primary Hyperparathyroidism Adverse Reaction Placebo (n = 34) n (%) Cinacalcet (n = 33) n (%) Nausea 6 (18) 10 (30) Muscle spasms 0 (0) 6 (18) Headache 2 (6) 4 (12) Back pain 2 (6) 4 (12)
The symptoms of hyperparathyroidism may include:
- Nausea
- Muscle spasms
- Headache
- Back pain 2
From the Research
Symptoms of Hyperparathyroidism
The symptoms of hyperparathyroidism, a condition characterized by high parathyroid levels, can vary depending on the severity of the condition.
- Mild hyperparathyroidism is usually asymptomatic but may be associated with constitutional symptoms such as:
- Fatigue
- Constipation
- Severe hyperparathyroidism can cause:
- Long-term effects of hyperparathyroidism can include:
- Renal calculi
- Osteoporosis
- Nephrolithiasis
Diagnosis and Treatment
Hyperparathyroidism is typically diagnosed through serum intact parathyroid hormone (PTH) tests, which distinguish PTH-dependent from PTH-independent causes 3.
- Treatment of hyperparathyroidism depends on the underlying cause and severity of the condition.
- For primary hyperparathyroidism, treatment options include:
- Parathyroidectomy
- Observation with monitoring
- Calcium supplementation for patients with low calcium intake 5
- For severe hypercalcemia, treatment typically involves:
Management and Prognosis
The prognosis for asymptomatic primary hyperparathyroidism is excellent with either medical or surgical management 3.
- Cinacalcet, a calcimimetic drug, has been shown to be effective in reducing plasma PTH and calcium levels in patients with primary hyperparathyroidism 6, 7.
- Long-term treatment with cinacalcet has been found to be well-tolerated and effective in maintaining normocalcemia and reducing plasma PTH levels 7.