Hyperparathyroidism: what happens if left undiagnosed?

Hyperparathyroidism (HPT) occurs when one or more of the four parathyroid glands in the neck become abnormal and produce too much of a hormone called parathyroid hormone (PTH). This leads to loss of calcium from the bones and a higher-than-normal blood calcium level. It can affect anyone but is more common in women than men, and the risk increases the older you get.

We’ve asked consultant surgeon Mr Robert Hardy to explain just how serious the condition is if left undiagnosed and whether, like other conditions of the thyroid, it leads to weight gain.

What are the different types of hyperparathyroidism?

There are three types of HPT – primary, secondary and tertiary:

• Primary HPT is the most common type and can affect anyone. Normally one, but occasionally more, parathyroid glands become abnormal, usually by developing a benign tumour (adenoma).
• Secondary HPT can occur because of a number of diseases, the commonest being kidney failure. In this case, often all four glands will be abnormal.
• Tertiary HPT is a more rare disease and only occurs in people with kidney failure who have had a kidney transplant.
   

What are the symptoms? What happens if left undiagnosed?

It is quite common for HPT to cause a number of symptoms the commonest of which are tiredness, lack of energy, aches and pains in the bones and joints, headaches and excessive thirst.

If left untreated it may lead to osteoporosis (weakening of the bones), kidney problems (including stones) and other less common problems.
 

Does diet cause hyperparathyroidism?

Diet does not cause the problem, and cannot be used to control calcium levels. It is a good idea to keep well hydrated if you have HPT as dehydration can lead the calcium level to rise.
 

Does the condition cause weight fluctuations or gain?

Thyroid problems can cause weight changes but parathyroid problems do not.
 

Is surgery my only option in treating hyperparathyroidism?

There is no medication useful in treating primary HPT. In people who have little in the way of symptoms, mildly elevated calcium levels and no evidence of bone or kidney problems, the options are either to monitor the problem or to consider surgical removal of the abnormal parathyroid gland.
 

In people with symptoms, high calcium levels and/or bone or kidney problems, surgery is usually advised. Symptoms often improve with surgery but are not guaranteed to. In secondary and tertiary HPT there is a medication licensed for treatment, but if this does not work then surgery is advised.

Do not hesitate to book an appointment with Mr Hardy if you’re experiencing any of the symptoms mentioned above.