COVID-19 Update

Due to interest in the COVID-19 vaccines, we are experiencing an extremely high call volume. Please understand that our phone lines must be clear for urgent medical care needs. We are unable to accept phone calls to schedule COVID-19 vaccinations at this time. When this changes, we will update this website. Our vaccine supply remains limited. Read all COVID-19 Vaccine Information.

Patient Care Options | Visitor Guidelines | Coronavirus Information | Self-Checker | Get Email Alerts


Primary Hyperparathyroidism

What is primary hyperparathyroidism?

Your parathyroid glands produce parathyroid hormone (PTH). Primary hyperparathyroidism is a condition in which one or more of the parathyroid glands makes too much PTH. This can lead to the loss of bone tissue. This condition is more common in women than in men.

A job of PTH is to keep blood calcium levels from going too low. It does this by releasing calcium from bones. The hormone also conserves calcium that would be given off by the kidneys. It also increases how much calcium is absorbed from food. When the hormone overacts, there is a rise in the blood calcium level. Too much PTH causes too much calcium to be released from bone.

When there is a benign tumor in a parathyroid gland, it is called a parathyroid adenoma. When more than one gland becomes enlarged, it is called parathyroid hyperplasia. Both of these conditions are noncancerous (benign).

What causes primary hyperparathyroidism?

In some cases, no cause can be found. Some known causes include noncancerous (benign) tumors on the parathyroid glands, or enlargement of the glands.

What are the symptoms of primary hyperparathyroidism?

These are the most common symptoms of primary hyperparathyroidism. However, each person may experience symptoms differently. Symptoms of too much calcium in the blood may include:

  • Constipation

  • Frequent urination

  • Increased thirst

  • Joint pain

  • Kidney pain (due to the presence of kidney stones)

  • Lethargy and fatigue

  • Loss of appetite

  • Muscle weakness

Other serious symptoms may include:

  • Abdominal pain

  • Depression

  • Memory loss

  • Nausea

  • Vomiting

The symptoms of primary hyperparathyroidism may look like other medical problems. Always talk with your healthcare provider for a diagnosis.

How is primary hyperparathyroidism diagnosed?

The condition may not have any symptoms or complications. Sometimes this problem is found during a routine blood test as part of a physical exam.

To diagnose primary hyperparathyroidism, you may have a dual X-ray absorptiometry. This test is also called bone densitometry. It is done to determine bone density and to reveal loss of bone tissue. It is also used to help your healthcare provider to keep an eye on the condition.

How is primary hyperparathyroidism treated?

Specific treatment for primary hyperparathyroidism will be decided by your healthcare provider based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medicines, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Surgery to remove the affected gland may be needed. Treatment may include regular bone densitometry testing to reveal loss of bone tissue. Testing can also help decide if surgery may be needed.

Key points about primary hyperparathyroidism

Primary hyperparathyroidism is a condition in which one or more of the parathyroid glands makes too much hormone. This can lead to the loss of bone tissue.

  • It is more common in women than in men.

  • Some known causes include benign tumors on the parathyroid glands or enlargement of the glands.

  • Symptoms include loss of appetite, increased thirst, frequent urination, lethargy and fatigue, muscle weakness, joint pain, constipation, and kidney pain

  • It is sometimes found during a routine blood test as part of a physical exam.

  • Treatment may include regular bone densitometry testing to reveal loss of bone tissue and to decide if surgery may be needed.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your healthcare provider if you have questions.


Neck Surgery’s Scarless Alternative

More than a year after her initial sore throat, Gwen met with head and neck surgeon Jonathon Russell, at Johns Hopkins to discuss a thyroidectomy. When she explained her symptoms, such as low bone density, fatigue and kidney stones, Russell ordered additional tests. “Her symptoms were not consistent with that I would have expected,” he recalls. The test revealed abnormally high calcium, vitamin D and parathyroid hormone levels in her blood.

Russell formally diagnosed Gwen with hyperparathyroidism caused by a parathyroid nodule.

Request an Appointment

Find a Doctor
Find a Doctor