From the Guidelines
The main symptoms of primary hyperparathyroidism (PHPT) include bone demineralization, fractures, nephrolithiasis, nephrocalcinosis, muscle weakness, and neurocognitive disorders, although many cases are asymptomatic, particularly in countries where routine biochemical screening is common 1.
Symptoms of Hyperparathyroidism
The symptoms of PHPT can vary widely among individuals, with some patients experiencing no symptoms at all, while others may present with a range of symptoms related to target organ involvement. According to the most recent evidence, common symptoms include:
- Bone demineralization
- Fractures
- Nephrolithiasis (kidney stones)
- Nephrocalcinosis (calcium deposits in the kidneys)
- Muscle weakness
- Neurocognitive disorders
Asymptomatic Presentation
It's worth noting that in countries where routine biochemical screening is common, such as the United States, Canada, and most of Europe, PHPT often presents as an asymptomatic disorder 1. This highlights the importance of regular health check-ups and screenings to detect and manage the condition early on.
Severity of Symptoms
The severity of symptoms in PHPT can correlate with the degree of hypercalcemia, with more severe calcium elevation leading to more pronounced symptoms. However, the presence and severity of symptoms can vary significantly among individuals, and some patients may remain asymptomatic despite elevated calcium levels 1.
Importance of Early Detection and Treatment
Given the potential negative effects of long-term hypercalcemia, early detection and treatment of PHPT are crucial to prevent complications and improve quality of life. Treatment options range from monitoring to surgical removal of the affected parathyroid gland, and the choice of treatment depends on various factors, including the severity of symptoms, calcium levels, and overall health status 1.
From the Research
Main Symptoms of Hyperparathyroidism
The main symptoms of primary hyperparathyroidism (PHPT) can be varied and affect multiple organ systems. Some of the common symptoms include:
- Bone loss, which can lead to skeletal fragility and increased risk of fractures 2, 3, 4, 5
- Kidney stones, which can cause severe pain and other complications 2, 6, 3, 4
- Declining renal function, which can lead to chronic kidney disease and other renal problems 2, 6, 4
- Neurocognitive symptoms, such as weakness, malaise, fatigue, and mood disturbances 6, 3, 5
- Gastrointestinal symptoms, such as nausea, vomiting, and abdominal pain 3
- Musculoskeletal symptoms, such as muscle weakness and bone pain 2, 3
- Cardiovascular symptoms, such as hypertension and cardiac arrhythmias 6, 3
Asymptomatic Primary Hyperparathyroidism
It's worth noting that many cases of PHPT are asymptomatic, meaning that patients do not exhibit any noticeable symptoms 2, 6, 3, 4, 5. In these cases, the disease is often discovered incidentally during routine laboratory tests. Despite the lack of symptoms, asymptomatic PHPT can still lead to long-term complications, such as bone loss and kidney damage.
Variants of Primary Hyperparathyroidism
There are also variants of PHPT, including normocalcemic and normohormonal variants, as well as syndromic forms of the disease 2. These variants can present with different symptoms and may require different treatment approaches. Additionally, some patients may have a variant of PHPT with normal serum calcium levels but elevated parathyroid hormone levels 4.