What Is Hyperparathyroidism? Symptoms & Treatment Options

Hyperparathyroidism is not a condition most people recognize right away. Many discover it only after a routine blood test shows elevated calcium or when vague symptoms like fatigue, joint pain, or frequent urination start interfering with daily life. These signs are easy to dismiss, which is why the condition often goes undetected for years.

At its core, hyperparathyroidism is a hormone imbalance that quietly affects bones, kidneys, muscles, and even mental clarity. When left unchecked, the impact builds over time. Knowing hyperparathyroidism's causes, effects, and treatment can help avoid long-term issues.

What Is Hyperparathyroidism?

Hyperparathyroidism is a condition in which the parathyroid glands produce excessive parathyroid hormone. This hormone regulates calcium and phosphorus balance in the body. When parathyroid hormone levels rise abnormally, calcium is released from bones into the bloodstream, absorbed more aggressively from food, and conserved by the kidneys. Over time, this abnormality disrupts bone strength, kidney function, and neuromuscular stability.

Types of Hyperparathyroidism

There are three main types of hyperparathyroidism. Each type has different causes and may need different treatments.

Primary Hyperparathyroidism

This occurs when one or more parathyroid glands become overactive on their own. It is the most common type and is usually caused by a non-cancerous growth or enlargement of the gland.

Secondary Hyperparathyroidism

This type develops when calcium levels in the body are low, often due to kidney disease or a lack of vitamin D. The parathyroid glands produce more hormone to try to restore balance.

Tertiary Hyperparathyroidism

This happens when the parathyroid glands stay overactive even after the original cause of secondary hyperparathyroidism has been treated, such as following a kidney transplant.

Symptoms of Hyperparathyroidism

Symptoms of hyperparathyroidism may be mild at first or go unnoticed. Over time, however, the condition can cause changes that affect daily life. Common symptoms include:

• Persistent tiredness and fatigue that does not improve with rest. This is often one of the earliest symptoms.

• Bone or joint pain, especially in the arms, legs, or lower back, caused by calcium being pulled from the bones.

• Kidney stones can cause sharp pain in the side or back and happen when there is too much calcium in the urine.

• Muscle weakness or aches, making everyday activities more difficult.

• High calcium levels, which affect the digestive system, are linked to symptoms such as abdominal pain, nausea, or loss of appetite.

• Mood changes, including depression, irritability, or difficulty concentrating, due to altered calcium levels affecting brain function.

• Excessive thirst and frequent urination, particularly in people with secondary hyperparathyroidism where kidney function is already impaired.

Causes of Hyperparathyroidism

The causes of hyperparathyroidism depend on the type of condition. Identifying the underlying cause helps guide the most effective treatment.

Causes of Primary Hyperparathyroidism

• A non-cancerous tumor (adenoma) in one of the parathyroid glands, which is the most common cause.

• Enlargement (hyperplasia) of two or more parathyroid glands.

• Parathyroid cancer, which is rare.

• Inherited genetic conditions, such as multiple endocrine neoplasia (MEN) syndromes.

• Previous radiation exposure to the neck, which can damage the parathyroid glands.

Causes of Secondary Hyperparathyroidism

• Chronic kidney disease, the most common cause, disrupts calcium and phosphate balance.

• Severe vitamin D deficiency, reducing calcium absorption from food.

• Low blood calcium levels due to poor diet or intestinal absorption problems.

• Certain medications, such as anticonvulsants or phosphate-binding drugs.

• Gastrointestinal disorders, including celiac disease, that reduce calcium and vitamin D absorption.

Causes of Tertiary Hyperparathyroidism

• Long-standing secondary hyperparathyroidism that continues even after treatment.

• Failed kidney transplantation, where overactive parathyroid glands do not return to normal.

• Permanent enlargement of the parathyroid glands due to prolonged overstimulation.

• Delayed correction of calcium imbalance after long-term dialysis.

• Rare cases where parathyroid gland changes become irreversible, even after the original cause is treated.

Risk & Complications of Hyperparathyroidism

Untreated hyperparathyroidism carries real consequences. Persistent hormone imbalance leads to progressive bone loss, increased fracture risk, kidney damage, and cardiovascular strain. Cognitive and mood disturbances can worsen quality of life. Over time, these complications become harder to reverse, even after treatment.

How Is Hyperparathyroidism Diagnosed?

Diagnosis relies on laboratory evaluation rather than symptoms alone. Elevated blood calcium levels combined with inappropriately high parathyroid hormone levels confirm suspicion. Additional tests assess kidney function, vitamin D status, and bone density. Imaging is used selectively to locate abnormal glands, not to establish the diagnosis itself. Misdiagnosis often occurs when calcium levels are evaluated without hormonal context.

How Is Hyperparathyroidism Treated?

Treatment depends on the type of hyperparathyroidism and how severe it is. Not everyone needs surgery, and your doctor will decide the best option based on your condition.

Primary Hyperparathyroidism

Mild cases may only need regular monitoring of calcium levels and bone health. If symptoms or complications develop, surgery to remove the overactive parathyroid gland may be recommended. Surgery is usually very effective and often provides a long-term solution.

Secondary Hyperparathyroidism

Treatment focuses on managing the underlying cause, such as kidney disease or vitamin D deficiency. This may include vitamin D supplements, medications to control phosphate levels, and dietary changes. People on dialysis may need additional medicines to control hormone levels.

Tertiary Hyperparathyroidism

When hormone levels remain high despite treatment, especially after a kidney transplant, surgery is often required. If surgery is not possible, medications may be used to help control calcium and phosphorus levels.

Key Takeaways on Hyperparathyroidism

Hyperparathyroidism is a progressive endocrine disorder that can quietly damage bones, kidneys, and cardiovascular health if left untreated. Early diagnosis and type-specific treatment are critical to preventing irreversible complications such as osteoporosis, kidney stones, and long-term calcium imbalance.

The team at Arden JR Surgery, including experienced oncologists, provides structured evaluation and evidence-based care for hyperparathyroidism.

If you need specialist assessment or treatment guidance, you're here to schedule a consultation.