Hyperparathyroidism

About Hyperparathyroidism

Your endocrine system is a set of organs and glands that produce hormones, which your tissues use to send signals to each other. Most individuals have four parathyroid glands, which are found in your neck and produce a hormone known as parathyroid hormone (PTH), an important regulator of calcium in our bodies. PTH maintains normal blood calcium levels via three mechanisms: signaling to bones to release their calcium stores into the blood, increasing intestinal uptake of calcium from food, and improving kidney retention of calcium that would otherwise be excreted in the urine.

When the parathyroid glands are overactive, excessive PTH may lead to a loss of bone density due to the bones releasing too much calcium. Too much calcium in the blood can lead to increased calcium excretion by the kidneys, which can lead to the formation of kidney stones. Elevated blood calcium is also thought to play a role in certain cardiovascular conditions. While some people with this condition do not develop symptoms, the majority of patients will ultimately develop manifestations of this disease process.

Types of Hyperparathyroidism

Hyperparathyroidism is classified based on your condition’s underlying cause.

Types of hyperparathyroidism include:

• Primary hyperparathyroidism*: A type of hyperparathyroidism unrelated to any preexisting medical condition, usually caused by a noncancerous tumor known as an adenoma that forms on the parathyroid
• Secondary hyperparathyroidism: A type of hyperparathyroidism resulting from a condition, such as kidney failure, that is associated with insufficient levels of calcium in the bloodstream, causing the parathyroid gland to overproduce PTH to compensate
• Tertiary hyperparathyroidism: A type of hyperparathyroidism that occurs in patients with chronic renal failure following a renal transplant

* In rare cases, primary hyperparathyroidism is caused by a cancerous tumor.

Symptoms of Hyperparathyroidism

Symptoms of hyperparathyroidism can vary. When symptoms do occur, they’re the result of damage or dysfunction in other organs or tissues.

Symptoms of hyperparathyroidism may include:

• Confusion
• Constipation
• Decreased appetite
• Depression
• Fatigue
• Kidney disease
• Kidney stones
• Increased thirst and urination
• Muscle weakness
• Nausea or vomiting
• Osteoporosis
• Pain in the bones and joints

Risk Factors for Hyperparathyroidism

Certain people are at greater risk for developing primary and secondary hyperparathyroidism.

Risk factors for hyperparathyroidism may include:

• Age: Primary hyperparathyroidism onset is most common in individuals between the ages of 50 and 60.
• Family history: Research suggests hyperparathyroidism may be more common in individuals of African American descent.
• Sex: Female patients are more likely than male patients to develop primary hyperparathyroidism.

Risk factors for secondary hyperparathyroidism include:

• Age: The risk of developing secondary hyperparathyroidism increases with age.
• Comorbid conditions: Secondary hyperparathyroidism is most often associated with vitamin D deficiency and chronic kidney disease.

Treating Hyperparathyroidism at UT Health Austin

Hyperparathyroidism treatment begins with a consultation with either an endocrinologist or endocrine surgeon. Once a patient meets surgical criteria, a surgeon can remove one or more overactive parathyroid glands. Other patients may be prescribed a medication known as cinacalcet that reduces the amount of PTH produced by the parathyroid gland. Your care team will work with you to determine the best course of treatment.

Care Team Approach

At UT Health Austin, we take a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines caring for you in one place to avoid having to schedule multiple appointments with providers at locations all over the city. The Surgical Oncology Clinic team includes a fellowship-trained endocrine surgeon who specializes in diagnosing and treating cancerous and noncancerous conditions that affect the thyroid, parathyroid, and adrenal glands. Whether your endocrine condition is cancerous or not, the Surgical Oncology team works closely with your referring provider and the Livestrong Cancer Institutes to provide integrated, whole-person care.

Through our Multidisciplinary Case Conferences, we collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve your treatment. We focus on applying advanced surgical techniques, including minimally invasive approaches, and nonsurgical treatments such as radiofrequency ablation. These procedures are offered with comprehensive attention to your complex needs, including medication management, nutrition, physical therapy, psychosocial wellbeing, and financial support. Advanced imaging and lab testing are also available on-site if needed.

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