Hyperparathyroidism (overactive parathyroid glands)

The designation Hyperparathyroidism describes a Overactive parathyroid glands. This means that the patient's parathyroid is producing too much of the parathyroid hormone.

What is hyperparathyroidism?

A primary Hyperparathyroidism often shows no symptoms in the person affected, so that the disease is often only discovered by chance during a blood test. The concentration of calcium in the blood is usually significantly increased.
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Hyperparathyroidism (overactive parathyroid glands) is an overactive parathyroid gland, so that too much of the parathyroid hormone is produced. This hormone is responsible for regulating the phosphate and calcium balance in the body.

If the organism has a high proportion of the parathyroid hormone, the calcium level in the blood increases. Many of the patients feel no discomfort, so that hyperparathyroidism is usually discovered by the doctor only by chance. However, some people may experience symptoms including gastrointestinal complications, muscle weakness, loss of appetite, and high blood pressure.

Overactive parathyroid glands are diagnosed significantly more often in women than in men. Around two thirds of all those affected are female. The disease can occur at any age. However, hyperparathyroidism mainly occurs after the age of 40.

causes

For one Hyperparathyroidism there are different causes. Primary hyperparathyroidism develops when diseases of the parathyroid gland itself are the cause. However, if other diseases are responsible for the overactive parathyroid gland, it is referred to as secondary hyperparathyroidism.

The most common causes of this disease are generally diseases of the parathyroid gland. Usually benign tumors in the parathyroid gland, which produce hormones, are found in those affected. These include in particular parietal adenomas. If there is secondary hyperparathyroidism, this is usually due to diseases that lower the calcium level in the bloodstream.

This can be, for example, a reduced calcium intake due to one-sided food intake or a lack of vitamin D. In contrast to the primary form of hyperparathyroidism (overactive parathyroid glands), the calcium value in secondary hyperparathyroidism is lower and not increased.

Symptoms, ailments & signs

In many cases, a routine blood test will reveal an elevated calcium level, which is an initial indication of the presence of hyperparathyroidism. Symptoms of this so-called asymptomatic overactive parathyroid gland do not yet occur.

If the hormonal disorder remains undetected, the excess calcium in the blood can manifest itself through a number of symptoms: The first noticeable signs of hyperparathyroidism can be intense thirst and increased urine output, often accompanied by loss of appetite, nausea, vomiting, constipation and weight loss. High blood pressure, cardiac arrhythmias, and chronic fatigue are also occasionally due to increased calcium levels.

Many of those affected suffer from kidney stones, which can subsequently trigger very painful kidney colic. Kidney stones should also be considered in the case of recurring urinary tract infections that are accompanied by back pain and pain in the upper abdomen.

In the further course of the disease, the bone metabolism is often affected: Those affected report joint and bone pain, which is often misinterpreted as rheumatic complaints. An x-ray shows changes in the sense of osteoporosis (bone loss), with the risk of a bone fracture even with low stress. Calcification of blood vessels and muscles due to the increased calcium and phosphate concentration in the blood is also possible. Those affected rarely develop psychiatric illnesses such as depression, psychosis or dementia as part of hyperparathyroidism.

Diagnosis & course

Examination of the thyroid gland.

A primary Hyperparathyroidism often shows no symptoms in the person affected, so that the disease is often only discovered by chance during a blood test. The concentration of calcium in the blood is usually significantly increased.

But even with the primary form of this disorder, there does not have to be an increase in the calcium level. For example, a simultaneous lack of vitamin D or kidney failure can regulate the calcium level, even though the parathyroid gland is overactive. Doctors use different imaging techniques to determine the cause of hyperparathyroidism. This includes, among other things, the ultrasound examination and a scintigraphy.

In some cases, cross-sectional imaging techniques are also used, including magnetic resonance imaging (MRI) and computed tomography (CT).

The course of the disease depends on the cause. The prognosis for primary hyperparathyroidism is good if surgical treatment is possible. If there are no other side effects, the affected person is symptom-free after the operation because of his hyperparathyroidism.

Complications

Hyperparathyroidism causes various complaints. The affected person suffers primarily from nausea and vomiting. Furthermore, there is an increased thirst and thus an increased urination of the patient. Loss of appetite can also occur, leading to underweight or deficiency symptoms. In the worst case, hyperparathyroidism leads to renal insufficiency.

In this case, the affected person then has to rely on a kidney transplant or dialysis in order to continue to survive. Hyperparathyroidism often leads to psychological upset and complaints, so that psychological treatment is necessary in most cases. This disease is usually treated with surgery, without any particular complications or other complaints.

The symptoms can thus be alleviated or even completely removed. Whether life expectancy has been reduced by the disease depends to a large extent on the severity and duration of the hyperparathyroidism. In some cases, the disease leads to increased bone fragility. This can also be prevented through treatment.

When should you go to the doctor?

A doctor's visit is necessary as soon as symptoms such as nausea, vomiting or dizziness develop. Any abnormalities when using the toilet must be observed. If they last for several days, they should be examined more closely. If you experience unusual bowel noises, flatulence, digestive problems, constipation or diarrhea, you need to see a doctor. If the symptoms persist or if they increase in intensity, a doctor must be consulted.

If there is loss of appetite or weight, a medical evaluation should be performed. If the person concerned suffers from frequent urination, this is a warning from the organism. A doctor should be consulted as further illnesses can occur. If there are problems with the heart rhythm, changes in the usual performance or vegetative abnormalities, a doctor's visit is necessary. In the event of sweating, insomnia, bone pain or swelling, a control visit should take place.

If there are problems with the spine or pain in the limbs, it is advisable to consult a doctor. Consult a doctor if you have emotional problems, mood swings, depressive behavioral traits or a loss of wellbeing. Irregular heartbeat, high blood pressure or feelings of internal heat should be monitored and examined. Failure to receive medical care can lead to sudden bone fractures that require treatment.

Doctors & therapists in your area

Treatment & Therapy

Treating a Hyperparathyroidism aims to regulate the level of calcium in the bloodstream. If primary hyperparathyroidism is present, surgery is one of the typical measures of therapy.

During this surgical procedure, the doctor removes the affected parathyroid gland or the identified epithelial cells. If all four parathyroid glands are enlarged, the surgeon usually has to remove the entire organ. Subsequently, parts of the parathyroid gland are transplanted to another region in the body. This is usually done in the arm muscles.

This can effectively prevent a deficiency in hormones. If surgery is not possible or necessary as a treatment method for hyperparathyroidism, the doctor will resort to a conservative therapeutic method. Above all, this includes adequate fluid intake and separate intake of vitamin D.

For women who have already passed the menopause, an intake of biophosphonates can also be helpful. This prevents increased bone fragility. In some cases, therapy with the active ingredient cinacalcet is also necessary to relieve the person concerned of their symptoms. If there is secondary hyperparathyroidism (overactive parathyroid gland), the primary disease is treated.

Outlook & forecast

The prognosis of the disease is very favorable if it is diagnosed early. Treatment is often not necessary. Monitoring of the health functions is initiated and checked at regular intervals.

In some cases, surgery is done. Since this is always associated with risks, complications and sequelae can arise. This worsens the otherwise good prognosis. If the operation is successful, the patient is usually discharged from treatment as symptom-free. Nevertheless, regular check-ups are also necessary here in order to identify and treat possible disorders or changes at an early stage.

The living conditions usually do not have to be changed, as there are no impairments afterwards. If complications arise during the procedure, these must be assessed and recorded individually. The further treatment plan depends on the damage or injury that has occurred. A generally valid statement cannot be made.

If the disease is severe, kidney failure can occur. This course only occurs in exceptional cases, but is life-threatening. It is an acute condition that requires immediate intensive care. If the inability to function of the kidney cannot be adequately treated in good time, the patient dies prematurely. If the patient survives, permanent impairment of kidney function can occur and further secondary diseases are possible.

prevention

So far, there are no known measures that could Hyperparathyroidism could prevent. However, protection against very serious complications in the primary form of hyperparathyroidism is surgical removal of the affected parathyroid.

Aftercare

For hyperparathyroidism, the method of follow-up depends on whether the disease was treated conservatively or through surgery. In both cases, there is close monitoring of health in order to identify any relapses quickly.

As part of conservative therapy and follow-up treatment, patients need to consume plenty of fluids and vitamin D. This can alleviate the symptoms associated with overactive parathyroid glands. Frequent exposure to the fresh air is also helpful. Outside, sunlight stimulates the production of vitamin D. After a detailed medical consultation, those affected can take dietary supplements to support the vitamin balance.

However, patients should not take this additional intake of vitamin D without consulting their doctor. With this method, secondary diseases such as osteoporosis can be avoided or at least postponed. With a regular blood test, the doctor determines whether any adjustments are necessary for the health status or the balanced vitamin balance.

Depending on the situation, nutritional advice can help stabilize calcium levels. For patients, this means above all that they have to drink a lot and only consume dairy products and legumes in small quantities. In self-help groups they can exchange ideas about their problems and the recommended change in life.

You can do that yourself

The overactive parathyroid gland is often associated with a vitamin D deficiency. Therefore, those affected benefit from being outdoors regularly. The production of the vitamin is promoted by sunlight. In consultation with the attending physician, dietary supplements also help to keep the vitamin balance in balance. In this way, patients can prevent long-term effects such as osteoporosis from developing. It should be said that regular blood tests are required. In this way, you can always react directly to the current vitamin status.

Nutritional advice is also recommended. Since in most cases of hyperparathyroidism there is an increased calcium level, a diet low in calcium is advisable. This includes the moderate consumption of dairy products and legumes. Patients should also drink a lot to increase calcium excretion. Choose a mineral water with a low calcium content.

There are also support groups for people with hyperparathyroidism. Here, those affected have the opportunity to exchange ideas. Such regular meetings with other patients often help people cope better with the condition. A visit to a naturopath is often worthwhile. This recognizes regulatory disorders of the vitamin balance and can contribute to a higher quality of life with natural methods. The accompanying symptoms such as tiredness are also treated with Schüssler salts, globules or herbal remedies.