There are four parathyroid glands, located behind the two lobes of the thyroid gland. The parathyroid glands produce the hormone that regulates blood levels of calcium and phosphate, minerals necessary for strong bones and teeth. Primary hyperparathyroidism is characterized by an overproduction of parathyroid hormone, which, in turn, results in an elevation of calcium levels in the blood.

Signs and Symptoms

At least 50% of patients with primary hyperparathyroidism have no symptoms, and approximately 1% of cases go undiagnosed. When symptoms do occur, they are generally attributable to persistently high levels of calcium and may include:

What Causes It?

Primary hyperparathyroidism may develop as a result of one of the following conditions:

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing primary hyperparathyroidism:

What to Expect at Your Provider's Office

The diagnosis of primary hyperparathyroidism is made mostly on the basis of lab tests that show high levels of calcium and parathyroid hormone. About half the time, healthcare providers discover primary hyperparathyroidism inadvertently from a blood test drawn for other reasons. Once a provider suspects that a person has primary hyperparathyroidism, he or she will do a physical examination and will ask about symptoms of abdominal pain and constipation, depression, anxiety, memory loss, muscle weakness, and urinary problems. Urine is often collected to check for excess calcium. Imaging may be done to assess any bone loss. An ultrasound of the neck may be performed to determine if the parathyroid glands are enlarged. A computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used to check for a tumor.

Treatment Options


There are no known preventive measures for primary hyperparathyroidism; however, it may be prudent for people who are at risk to avoid dehydration.

Treatment Plan

Surgery to remove one or more of the parathyroid glands is very successful in treating primary hyperparathyroidism. Because of this, surgery is usually recommended. In rare cases, if a patient does not show any signs or symptoms of the disease and has only mildly elevated calcium levels, the medical specialist may be willing to wait, observe carefully over time, and consider the nonsurgical approach of medications to prevent or treat complications and/or a further rise in calcium levels.

Drug Therapies

Surgery is the treatment of choice; however, under certain circumstances, the following medications for primary hyperparathyroidism may be considered:

Surgical and Other Procedures

Parathyroidectomy involves removal of one or more parathyroid glands.

Complementary and Alternative Therapies

Nutrition A person with primary hyperparathyroidism who also has borderline nutritional status may develop deficiencies in the following substances that are necessary for normal bone formation: In these cases, the healthcare provider may recommend that the person take particular nutritional supplements.

A naturopathic doctor or other appropriately trained practitioner may consider the following medicinal herbs to treat or prevent bone abnormalities related to hyperparathyroidism. Before using these herbs, however, it is best to obtain guidance and advice from such a practitioner: Homeopathy
A qualified homeopath would do a clinical assessment and guide treatment appropriately.

A homeopathic doctor may use one of the following to treat problems related to calcium levels: To date the use of these substances for hyperparathyroidism has not been examined in scientific studies.

Prognosis/Possible Complications

The prognosis is excellent for persons with primary hyperparathyroidism who have no symptoms, as well as those who have surgery to remove one or more parathyroid glands. Possible complications include skeletal damage, urinary tract infections, kidney damage or kidney stones, peptic ulcers, inflammation of the pancreas, high blood pressure, nervous system disorders, and rare complications from surgery.

Following Up

People who have had surgery will have their blood calcium levels monitored for several months afterward to be sure that the levels remain stable. The healthcare provider will check blood calcium levels for a longer period of time if a person does not have surgery. In this case, the person will have regular checkups that will include a careful assessment of the bones and kidneys.


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