January 16, 2018

Hyperparathyroidism occurs when 1 or more of your parathyroid glands are overactive. You have 4 of these tiny glands. Each one is about the size of a grain of rice. They are found in your neck, next to the thyroid gland. They keep the amount of calcium in your blood in a normal range. If these glands are overactive, they make too much parathyroid hormone (PTH). That raises the level of calcium in your blood.

PTH causes calcium to be released from your bones. This loss of calcium from the bones can lead to weak, brittle bones (osteopenia and osteoporosis), and bone fractures. When the blood with this high calcium goes through the kidneys, the calcium may be filtered into the urine. That can lead to kidney stones.

Hyperparathyroidism most often happens when one of your parathyroid glands gets larger or has a tumor on it. The gland then makes too much parathyroid hormone. Most people with this problem have 1 abnormal gland. Some people may have 2 abnormal glands. A small number of people have 4 abnormal glands. Having 4 abnormal glands is rare. It is often a genetic problem.

You may be more likely to have hyperparathyroidism if:

  • You are a woman who has already gone through menopause
  • You have a family history of related conditions
  • You have had radiation therapy on your head and neck
  • You have taken lithium, a medicine used to treat bipolar disorder

Each person may have symptoms in a different way. But these are the most common symptoms and signs:

  • Joint aches and pains
  • Depression
  • Belly (abdominal) pain
  • Gastroesophageal reflux disease (GERD)
  • Peptic ulcer disease
  • Pancreatitis
  • Tiredness
  • Urinating more than normal
  • Confusion
  • Muscle weakness
  • Osteoporosis
  • Kidney stones

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

A blood test can often find hyperparathyroidism. It can spot high levels of calcium and parathyroid hormone. You may also need a urine test. This can measure the calcium in your urine over 24 hours.

Your healthcare provider will figure out the best treatment for you based on:

  • Your age, overall health, and past health
  • How sick you are
  • How well you can handle certain medicines, treatments, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment options include:

Surgery. If your case is more severe, your parathyroid gland may need to be removed. Before surgery, you may have an imaging test to find out which gland is abnormal. You may have an ultrasound of the neck. Knowing which gland is abnormal will shorten the surgery. It will also allow the surgeon to make a smaller cut (incision) right over the abnormal gland.

No surgery. You may not need treatment if you have a mild case. But your healthcare provider will watch your condition to make sure it doesn’t get worse.

Medicines. Ask your healthcare provider about new medicines that may be available.

You will likely need to have your calcium levels and bone density checked from time to time. Your healthcare provider will then be able to make sure your problem is under control.

Tell your healthcare provider if your symptoms get worse or you have new symptoms.
  • Hyperparathyroidism happens when 1 or more of your parathyroid glands are overactive. The glands make too much parathyroid hormone. That raises the level of calcium in your blood. It then lowers the calcium in your bones.
  • It most often happens when a parathyroid gland gets larger or has a tumor on it.
  • The loss of calcium from the bones can lead to weak, brittle bones (osteopenia and osteoporosis), and bone fractures.
  • A routine blood test can spot high levels of calcium.
  • The most common treatment is surgery. The abnormal gland is removed.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.



January 16, 2018


Patient information: Primary hyperparathyroidism (Beyond the Basics). UpToDate., Primary hyperparathyroidism: Diagnosis, differential diagnosis, and evaluation. UpToDate., Primary hyperparathyroidism: Clinical manifestations. UpToDate., Primary hyperparathyroidism: Management. UpToDate., Pathogenesis and etiology of primary hyperparathyroidism. UpToDate., Primary hyperparathyroidism. Endotext.

Reviewed By:  

Hurd, Robert, MD , Freeborn, Donna, PhD, CNM, FNP