Hormone

Hyperparathyroidism: Complete Guide

Hyperparathyroidism causes excess parathyroid hormone, leading to high calcium levels that can affect bones, kidneys, and mental wellbeing.

Most common cause
Single benign adenoma (parathyroid gland)
Key tests
Calcium + PTH together
Classic mnemonic
'Bones, stones, groans, and psychiatric overtones'
Treatment
Surgery for symptomatic/significant cases

Symptoms — 'Bones, Stones, Groans, Psychiatric Overtones'

CategorySymptoms
BonesBone pain, osteoporosis, fractures
StonesKidney stones (recurrent)
GroansAbdominal pain, constipation, peptic ulcers, pancreatitis
Psychiatric overtonesDepression, fatigue, poor concentration, confusion

Diagnostic Pattern

TestFinding in Primary Hyperparathyroidism
CalciumElevated
PTHElevated or inappropriately normal (should be suppressed if calcium is high)
Vitamin DOften checked to exclude deficiency as alternative explanation
24-hour urine calciumHelps distinguish from familial hypocalciuric hypercalcaemia (a benign genetic mimic)

Treatment

Parathyroidectomy (surgical removal of the overactive gland) is curative and recommended for symptomatic patients or those meeting specific criteria (significantly high calcium, kidney stones, osteoporosis, age under 50). Mild, asymptomatic cases may be monitored without immediate surgery.
Many Cases Are Found IncidentallyWith calcium now commonly included in routine blood panels, hyperparathyroidism is increasingly diagnosed incidentally in people with mild or no symptoms — decisions about whether to treat mild cases involve weighing surgical risks against long-term monitoring.
Is hyperparathyroidism the same as thyroid disease?
No — despite similar names, the parathyroid glands (four small glands near the thyroid) regulate calcium, while the thyroid gland regulates metabolism through different hormones. They're distinct conditions requiring different tests and treatments.
Can hyperparathyroidism be treated without surgery?
For mild, asymptomatic cases, monitoring without surgery is often appropriate. Medications (cinacalcet) can help control calcium in those unsuitable for surgery, but surgery remains the only curative treatment.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.