Hyperparathyroidism
Hyperparathyroidism is an excess of parathyroid hormone produced by the parathyroid glands.
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Medicines commonly prescribed for Hyperparathyroidism
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 90 mgActive substance: cinacalcetManufacturer: Sandoz Farmaceutica S.A.Prescription requiredDosage form: TABLET, 30 mgActive substance: cinacalcetManufacturer: Laboratorio Stada S.L.Prescription requiredDosage form: TABLET, 30 mgActive substance: cinacalcetManufacturer: Zentiva K.S.Prescription required
Hyperparathyroidism is an excess of parathyroid hormone produced by the parathyroid glands. This hormone controls calcium, and when there is too much of it, calcium is drawn out of the bones into the blood. It is often picked up by chance on a blood test, while there are still barely any complaints. That is good news: caught early, hyperparathyroidism is simple to treat and the treatment is definitive.
Types
- primary — the problem is in the glands themselves, almost always a benign adenoma of one of them. Blood calcium is high;
- secondary — the glands overwork in response to low calcium or vitamin D deficiency, most often in chronic kidney disease. Calcium is normal or low;
- tertiary — prolonged overactivity becomes autonomous, usually in advanced kidney disease.
Symptoms
The classic description is "bones, stones, abdominal groans and psychic moans". It is a convenient way to remember where to look.
- bones: bone and joint pain, reduced bone density, fractures from minor injury;
- stones: kidney stones, passing urine often, intense thirst;
- abdomen: nausea, loss of appetite, constipation, abdominal pain, sometimes pancreatitis or peptic ulcer;
- mood and mind: low mood, anxiety, irritability, poor concentration, forgetfulness — symptoms usually blamed on age or stress;
- general: muscle weakness, fatigue, itchy skin.
With mildly raised calcium there may be no symptoms at all.
When to see a doctor
- a blood test has shown raised calcium — reason enough to investigate even without symptoms;
- you have had kidney stones, particularly more than once;
- you have had a fracture after a minor injury, or have been diagnosed with osteoporosis;
- you have constant thirst, pass urine often and feel weak;
- you have developed bone pain;
- your mood, memory or concentration have worsened without a clear reason.
Urgent care is needed if calcium rises sharply: increasing confusion, severe nausea and vomiting, marked weakness, heart rhythm disturbance or a sharp drop in urine output. This is a hypercalcaemic crisis.
How it is investigated
The basis is blood tests: calcium (total and ionised), parathyroid hormone, vitamin D, phosphate, creatinine, alkaline phosphatase and magnesium. A combination of high calcium with high — or even "normal" — parathyroid hormone already points to the primary form.
Then the consequences are assessed and the source located: urinary calcium, kidney ultrasound or CT for stones, bone density scanning, neck ultrasound and parathyroid scintigraphy before surgery.
What to bring to the appointment: all previous test results that include calcium, even from years ago — the trend helps establish how long this has been going on. Also a list of medicines and supplements: thiazide diuretics, lithium and high doses of vitamin D or calcium all affect the result.
Treatment
- surgery — removal of the parathyroid adenoma. This is the only curative treatment for the primary form; the operation is small and calcium normalises afterwards;
- monitoring — for mild disease in older people without complications, with checks on calcium, kidney function and bone density;
- medication that reduces parathyroid hormone production, when surgery is not possible;
- osteoporosis treatment;
- for the secondary form — replacing vitamin D, adjusting dietary phosphate and treating the underlying kidney disease;
- reviewing medicines that themselves raise calcium.
What you can do
- drink enough water — it lowers the risk of kidney stones;
- do not cut dietary calcium on your own initiative: a sharp restriction can worsen bone health. Discuss the amount with your doctor;
- do not take high-dose vitamin D or calcium supplements without advice;
- keep up weight-bearing physical activity;
- stop smoking and limit alcohol;
- discuss any diuretics you take with your doctor;
- have your follow-up tests on time, even when you feel well.
Risks if left untreated
A prolonged excess of parathyroid hormone leads to osteoporosis and fractures, kidney stones and declining kidney function, pancreatitis, persistent changes in mood and memory, and increased cardiovascular risk.
Common questions
Is it cancer? No. It is almost always a benign adenoma; parathyroid cancer is very rare.
Can surgery be avoided? Sometimes, in mild cases under monitoring. But where there are stones, osteoporosis or symptoms, surgery gives the best outcome.
Will I need hormones after the operation? Usually not: the remaining glands take over. Calcium is monitored for the first few days and calcium and vitamin D are sometimes prescribed briefly.
Why is my calcium high if I feel nothing? That is common. It does not mean the condition is harmless — the effects on bones and kidneys accumulate silently.
Online consultation
In an online consultation the doctor reviews the trend in your calcium and parathyroid hormone, checks the influence of medicines and supplements, explains which tests are needed to assess your bones and kidneys, and helps you understand whether your case is one for monitoring or for surgery.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Jul 30, 2026
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Discuss your symptoms and possible next steps for Hyperparathyroidism with a doctor online.
