What is hyperparathyroidism & its treatment?

Management of Hyperparathyroidism
Primary Hyperparathyroidism
Disorder of one or more than one parathyroid glands increases the secretion of the hormone
called parathyroid which leads to primary hyperparathyroidism. Four parathyroid glands are
positioned in the posterior region of the thyroid gland. The glands are Pea – shaped. Major
causes of primary hyperparathyroidism are the prolonged shortage of calcium and vitamin D,
patients who underwent radiation therapy or exposed to cancer and patients on lithium
medication (Walker, and Silverberg, 2018) Common signs and symptoms of primary
hyperparathyroidism are tiredness, weakness, body pain and depressive mood. Increase
secretion of parathyroid hormone the calcium levels in the blood. The condition is stated as
hypercalcemia which may lead to complications like weakening of bones and kidney stones.
The most common cause of primary hyperparathyroidism is the abnormal growth of the
gland. The parathyroid gland enlarges and increases the hormonal secretion.
Secondary and tertiary Hyperparathyroidism
An abnormally low level of calcium is stated as Secondary Hyperparathyroidism. Patients
with secondary hyperparathyroidism suffer chronic renal failure which may reduce the levels
of vitamin D and calcium. Signs and symptoms of secondary Hyperparathyroidism are
frequent fractures, joint deformities and weakening of bones (Gasparri, Camandona, and
Palestini, 2015). Parathyroid glands increase the secretion of the parathyroid hormone even
after the calcium levels become normal which is stated as Tertiary hyperparathyroidism. It
occurs to patients with renal failure.
Evidence of long-term complication
Patients with hyperparathyroidism may undergo various complications. A study confirms that
70% of people suffered muscle weakness, 54% of the patients had arthralgias, and

hyperemeisis. About 12% of them found to have changes in mental changes. 12% of patients
had peptic ulcer and 2% of them had bone disorder (Ali Rizvi, 2008).
Risks in Hyperparathyroidism
Hyperparathyroidism impacts the functions of the vital organs like heart, blood vessels,
bones, and kidneys. Increased secretion of Parathyroid hormone increases the level of
calcium in the blood. It affects the density of bones and causes weakness in the bones. A
severe complication of Hyperparathyroidism is stated as osteoporosis. Increase calcium levels
in the blood lead to renal stones (Procopio et al. 2014). It also causes calcium deposition in
the blood vessels which may impact the blood flow and leads to hypertension. Calcium
deposition in the blood vessels hardens the blood vessels in the heart which may lead to
coronary artery disease, vascular abnormalities and heart enlargement. Weight gain is one of
the common complications in conditions with hormonal imbalance.
Surgical management
Invasive and non-invasive Para thyroidectomies are the surgical management that is
implemented for the betterment of the patient's condition (Lorenz et al. 2015). If the causative
factor of hyperparathyroidism is the tumour, the surgical removal of the tumour is
recommended.
Non-surgical management
Symptomatic management is implemented to treat patients with less complication. Adequate
hydration is the primary recommendation for patients with Hyperparathyroidism.
Normalizing the calcium level is the recommended Non-surgical treatment for patients with
lower calcium levels. Regular follow –up and monitoring are recommended for pregnant
women with primary Hyperparathyroidism (Takeuchi 2017). Calcium supplement is the
common non- surgical therapy involved in the management of Hyperparathyroidism. A
calcium-rich diet is one of the management that improves the condition and normalise the

calcium level in blood. Calcimimetics is the medication that acts on the parathyroid gland and
maintains the normal level of the hormone. Bisphosphonates are the medication prevents the
bones from losing the calcium. Hormone replacement treatment is implemented for patients
who had menopause and patients suffering from severe osteoporosis.
References
Ali Rizvi, 2008. Complications and Management of Primary Hyperparathyroidism
During Pregnancy – Review. Official Journal of Society of Endocrinology and Metabolism
of Turkey. http://www.turkjem.org/fulltext/complications-and-management-of-primary-
hyperparathyroidism-during-pregnancy-review-3238
Gasparri, G., Camandona, M. and Palestini, N. eds., 2015. Primary, Secondary and Tertiary
Hyperparathyroidism: Diagnostic and Therapeutic Updates. Springer
https://books.google.co.in/books?
hl=en&lr=&id=T8MDCwAAQBAJ&oi=fnd&pg=PR2&dq=secondary+and+tertiary+hyperpa
rathyroidism&ots=oC0teauuHD&sig=DRBA9xiLk_WZoFqgwLqzQYOxcYo&redir_esc=y#
v=onepage&q=secondary%20and%20tertiary%20hyperparathyroidism&f=false
Lorenz, K., Bartsch, D.K., Sancho, J.J., Guigard, S. and Triponez, F., 2015. Surgical
management of secondary hyperparathyroidism in chronic kidney disease—a consensus
report of the European Society of Endocrine Surgeons. Langenbeck's archives of
surgery, 400(8), pp.907-927 https://link.springer.com/article/10.1007/s00423-015-1344-5

Takeuchi, Y., 2017. Surgical and non-surgical management of primary hyperparathyroidism:
How do calcimimetics work?. Clinical calcium, 27(4), pp.553-559
https://europepmc.org/article/med/28336832
Procopio, M., Barale, M., Bertaina, S., Sigrist, S., Mazzetti, R., Loiacono, M., Mengozzi, G.,
Ghigo, E. and Maccario, M., 2014. Cardiovascular risk and metabolic syndrome in primary
hyperparathyroidism and their correlation to different clinical forms. Endocrine, 47(2),
pp.581-589 https://link.springer.com/article/10.1007/s12020-013-0091-z
Walker, M.D. and Silverberg, S.J., 2018. Primary hyperparathyroidism. Nature Reviews
Endocrinology, 14(2), p.115 https://www.nature.com/articles/nrendo.2017.104