Hyperparathyroidism refers to the increased levels of the parathyroid hormone (PTH) in the body. This hormone is secreted from the parathyroid glands, two pairs of which are present on or behind the thyroid gland in the neck.
Primary hyperparathyroidism occurs when there is an inappropriately high secretion of PTH due to increase in the size of the gland, or due to the presence of an adenoma (a non-cancerous tumour of the glandular tissue).
Secondary hyperparathyroidism often occurs because of diseases of the kidney, like chronic renal failure, or disturbances in the gastrointestinal tract, like malabsorption. Vitamin D deficiency rickets can also lead to parathyroid hyperplasia. Hence, in secondary hyperparathyroidism, the underlying cause is not in the parathyroid gland, but elsewhere.
The tertiary type is seen mostly after renal transplantation.
Primary hyperparathyroidism is commonly seen women, especially those who are middle-aged. Women are three times more likely to be after by this condition than men. While some people may remain asymptomatic, others may present with a number of signs and symptoms. An increase in the levels of the parathyroid hormones can lead to decalcification of the bone, that further causes bone pain.
There may also be multiple cysts or pseudo-tumours seen in the jaw, skull or the fingers. The incidence of osteoporosis and pathological bone fractures (caused by an underlying disease and not external trauma) also increases. Racquet nails are also suggestive of bone resorption.
Due to raised levels of calcium in the blood, renal stones can develop in the kidney, which are commonly multiple. Recurrence of these stones is common, and there are often made up of calcium or oxalate. Calcification of the blood vessels in the kidney can lead to renal hypertension.
Increased levels of calcium can also stimulate gastrin, (a peptide hormone that regulates the secretion of gastric acid and influences gastric motility) which may cause peptic ulceration. Such high levels of calcium may also lead to acute pancreatitis and gallstone disease.
Serum calcium, serum PTH and serum phosphate levels are often advised to identify this condition. The bone density may be assessed and vitamin D levels can also be checked. The X-ray of the skull shows a characteristic salt-and-pepper appearance.
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Surgical removal of the gland may be required in some cases, and the a part of the thyroid gland may also need to be removed if the cause is cancerous. Good hydration and regular exercise are also advised.
FAQs about hyperparathyroidism:
1. What is hyperparathyroidism?
Hyperparathyroidism is an increased level of parathyroid hormone (PTH) in the body, secreted from the parathyroid glands located near the thyroid gland.
2. What are the types of hyperparathyroidism?
There are three types: primary, secondary, and tertiary hyperparathyroidism. Primary is caused by an increase in gland size or adenoma, secondary is due to kidney or gastrointestinal diseases, and tertiary is seen mostly after renal transplantation.
3. Who is most affected by primary hyperparathyroidism?
Primary hyperparathyroidism commonly affects middle-aged women, who are three times more likely to develop the condition than men.
4. What are the symptoms of hyperparathyroidism?
Symptoms include bone pain, multiple cysts or pseudo-tumours in the jaw, skull, or fingers, osteoporosis, pathological bone fractures, racquet nails, renal stones, renal hypertension, peptic ulceration, acute pancreatitis, and gallstone disease.
5. How is hyperparathyroidism diagnosed?
Diagnosis involves checking serum calcium, serum PTH, and serum phosphate levels, assessing bone density, vitamin D levels, and a characteristic salt-and-pepper appearance on the X-ray of the skull.
6. What are the treatment options for hyperparathyroidism?
Treatment options include surgical removal of the gland, good hydration, and regular exercise. In some cases, part of the thyroid gland may also need to be removed if the cause is cancerous.
Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.
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