Hyperparathyroidism is a condition that arises from the excessive secretion of parathormone by the parathyroid glands. Parathormone is crucial for regulating calcium balance in the body. In hyperparathyroidism, there is an increase in blood calcium levels. This can lead to the loss of calcium from the bones and the formation of kidney stones.
Hyperparathyroidism can occur as a result of another health problem or due to a tumor in the parathyroid gland. When hyperparathyroidism develops, symptoms such as fatigue, bone pain, kidney stones, nausea, vomiting, depression, and muscle weakness may be observed.
Hyperparathyroidism occurs when the parathyroid glands become excessively active, leading to the overproduction of parathormone. The parathyroid glands regulate the levels of calcium and phosphorus in the body through the secretion of parathormone. It is typically caused by the following reasons:
Hyperparathyroidism may not show any symptoms. It can be detected by chance with blood tests. However, some patients may experience symptoms.
These symptoms include fatigue, weakness, muscle and bone pain, bone weakness, osteoporosis, increased bone fractures, urinary tract stones and kidney failure, nausea, vomiting, constipation, loss of appetite, weight gain, increased appetite, high blood pressure, depression, dry skin, and hair loss.
For the diagnosis of hyperparathyroidism, blood levels of calcium, phosphorus, and parathormone are measured. A high calcium test result may be associated with hyperparathyroidism. Measuring the level of phosphorus in the blood supports the diagnosis, and it is possible to determine whether the parathyroid glands are excessively active by assessing the level of parathormone in the blood.
Bone densitometry is a test that measures bone density, providing information about bone density, which is significant in hyperparathyroidism. Additionally, ultrasound, scintigraphy, MRI, PET, or CT scans are useful in detecting tumors or abnormalities in the parathyroid glands. By conducting one or several of these tests, or all of them, the diagnosis of hyperparathyroidism can be established, and appropriate treatment can be initiated.
Hyperparathyroidism is a condition characterized by the overactivity of the parathyroid glands, leading to elevated levels of parathormone in the blood. There are three different types: Primary Hyperparathyroidism, Secondary Hyperparathyroidism, and Tertiary Hyperparathyroidism.
Primary Hyperparathyroidism is the most common type of hyperparathyroidism. It is associated with the formation of tumors in one or more of the parathyroid glands. These tumors produce excessive amounts of parathormone, leading to an increase in blood calcium levels and promoting the release of calcium from the bones. This, in turn, results in bone weakening, osteoporosis, and an increased risk of fractures.
Secondary Hyperparathyroidism develops in response to low calcium levels. Conditions such as kidney diseases, renal failure, or vitamin D deficiency cause a decrease in blood calcium levels, triggering the parathyroid glands to release an excessive amount of parathormone. As a consequence, there is a weakening of the bones and an increased risk of developing calcium stones.
In Tertiary Hyperparathyroidism, the parathyroid glands function inadequately, leading to low calcium levels. This condition is often associated with factors such as vitamin D deficiency, diabetes, and certain types of cancer.
The treatment of hyperparathyroidism can vary depending on the type of the disease and the severity of symptoms. The primary goals of treatment are to prevent problems in the bones, regulate calcium and phosphorus levels, and alleviate symptoms.
In cases of Primary Hyperparathyroidism, which often arises from parathyroid tumors, surgical removal is usually necessary. After surgery, calcium levels decrease, and symptoms improve.
Medical treatments for hyperparathyroidism may include the use of calcium-binding agents, vitamin D supplements, calcium channel blockers, and bisphosphonates, aimed at lowering calcium levels.
Fluid therapy may be administered to accelerate the excretion of calcium from the kidneys, reducing blood calcium levels.
In terms of dietary changes, it is important to avoid foods rich in calcium, phosphorus, and vitamin D. Increasing fluid intake is also crucial.
The choice of treatment depends on the specific circumstances of each case, and a healthcare professional will tailor the approach to address the individual's needs. Regular monitoring and follow-up are essential to ensure the effectiveness of the chosen treatment plan.
Surgery for hyperparathyroidism is one of the primary treatment options for cases of primary hyperparathyroidism. The goal is to surgically remove the overactive hyperparathyroid glands. When these glands are removed, high blood calcium levels return to normal, and symptoms regress.
In hyperparathyroidism surgery, the localization of the parathyroid gland is crucial. Once the localization is complete, it is possible to remove the parathyroid gland through minimally invasive surgery. This type of surgery typically results in a short hospital stay for the patient and is highly successful. The return to social activities is also quick after the surgery.
Nutrition plays a crucial role in managing hyperparathyroidism. Since blood calcium levels are elevated in this condition, calcium intake should be limited, and precautions should be taken regarding phosphorus intake, as it can have adverse effects on the bones.
Calcium intake should be kept lower than normal, and phosphorus intake should be restricted. Vitamin D enhances calcium absorption and is important for bone health, so an adequate amount of vitamin D should be consumed. In individuals with hyperparathyroidism, sufficient fluid intake is essential. Limiting salt intake is advisable because high salt intake increases calcium excretion, potentially harming bone health.
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Prof. Dr. Sezai AydınGeneral Surgery Turkey
PROF. DR. SEZAI AYDIN
