Hyperparathyroidism
Hyperparathyroidism Causes
Primary hyperparathyroidism, the first class of hyperparathyroidism, is brought about by the hyperfunction of the parathyroid glands themselves. PTH is oversecreted as a result of hyperplasia, adenoma, or carcinoma of the parathyroid glands. Meanwhile, secondary hyperparathyroidism results when the parathyroid glands react to a hypocalcemia caused by a factor other than a parathyroid pathology. For example, chronic renal failure may trigger this condition. Lastly, tertiary hyperparathyroidism is caused by the excessive secretion of PTH following an extended period of secondary hyperparathyroidism that results in hypercalcemia.
Hyperparathyroidism Definition
Hyperparathyroidism is a condition characterized by an over activity of the parathyroid glands, often caused by an overproduction of the parathyroid hormone (PTH). PTH regulates and helps maintain the levels of calcium and phosphate in the body. When one or more of the parathyroid glands becomes over-active, calcium levels are elevated while phosphate levels drop.
Hyperparathyroidism Diagnosis
A PTH immunoassay is the gold standard in hyperparathyroidism diagnosis. If elevated PTH levels are confirmed, the next steps in diagnosis is screening for serum calcium levels. This is to determine if the origins of the condition are either primary or secondary.
Hyperparathyroidism Symptoms and Signs
Several hyperthyroidism patients may be asymptomatic, and in such cases, diagnosis can only be made with a coincidental discovery of hypercalcemia. Symptomatic hyperparathyroidism, on the other hand, presents with a variety of symptoms, most of which are closely correlated with elevated calcium levels in the blood. Most of these symptoms have neurological origins; the most common of which being fatigue and exhaustion. Other hallmark signs include memory problems, a distinct lack of energy, difficulty concentrating, depression, and even problems with sleeping. Hyperthyroidism may also manifest through kidney stones and pain in the skeletal system (often bone pain that results from osteoporosis). In pop culture, hyperparathyroidism symptoms have been summed up in the following line: "moans, groans, stones, bones, and psychiatric overtones". ?Moans? roughly translates to not feeling well; ?groans? often means abdominal pain; ?stones? indicate kidney problems; ?bones? literally means pain in the bones; and finally, ?psychiatric overtones? refer to lethargy, memory problems, fatigue, and depression. Other demonstrated symptoms include headaches, gastroesophageal reflux, low libido, thinning hair, hypertension, and heart palpitations. Others have also complained of an increase in thirst, stomach ulcers, nausea, and appetite loss.
Hyperparathyroidism Treatment
In hyperparathyroidism, the first priority for treatment is managing hypercalcemia, especially if affected symptomatic individuals require surgery to remove the parathyroid tumor. Because recent findings suggest that the disease will gradually worsen and progress, experts now recommend that all hyperthyroidism patients should be evaluated for surgery. If surgery is not an option, calcium levels, bone density, and the presence of kidney stones must be monitored closely.