Hyperparathyroidism: Primary Type Explained

Hyperparathyroidism is a condition in which the parathyroid glands become overactive and produce more parathyroid hormone (PTH) than normal. This affects the balance of calcium, phosphorus, and vitamin D in the body, leading to various problems ranging from bone health to kidney function. Primary hyperparathyroidism is the most common form of this disorder.

Hyperparathyroidism is divided into three main types:

1. Primary Hyperparathyroidism: Excess PTH production due to a problem in the parathyroid glands. 

2. Secondary Hyperparathyroidism: Overactivity of the parathyroid glands caused by conditions such as chronic kidney disease or vitamin D deficiency. 

3. Tertiary Hyperparathyroidism: Develops when secondary hyperparathyroidism is untreated or persists for a long time.

Primary hyperparathyroidism is a condition characterized by uncontrolled elevation of PTH levels due to an adenoma (benign tumor), hyperplasia (gland enlargement), or rarely cancer in the parathyroid glands. The increased PTH level raises the amount of calcium in the blood (hypercalcemia).

Primary hyperparathyroidism often does not present with obvious symptoms, making it difficult to diagnose. However, the following signs may be observed:

• Bone pain and fragility
• Muscle weakness
• Fatigue and weakness
• Kidney stones
• Frequent urination
• Abdominal pain and nausea
• Mental confusion and forgetfulness

The main causes of primary hyperparathyroidism are:

• Parathyroid adenoma: The formation of a benign tumor in the parathyroid glands.
• Hyperplasia: Enlargement of all the parathyroid glands.
• Genetic factors: May be associated with hereditary transmission or genetic syndromes.
• Radiation exposure: Radiation treatments applied to the head and neck region.

For the diagnosis of primary hyperparathyroidism, the following tests may be performed:

• Blood Tests: To measure elevated calcium and PTH levels.
• Urine Tests: To evaluate calcium excretion.
• Bone Density Measurement: DEXA scan to detect bone loss.
• Imaging Techniques: Ultrasound, sestamibi scintigraphy, or MRI to assess the parathyroid glands.

Treatment varies based on the patient’s overall health, symptom severity, and calcium levels:

1. Surgical Treatment (Parathyroidectomy)
   Surgical removal of the problematic parathyroid gland provides a permanent solution and is especially preferred in cases of parathyroid adenoma.

2. Medication

   • Calcimimetics: Reduce PTH production.

   • Vitamin D and calcium supplements: Recommended if there is a vitamin D deficiency.

3. Diet and Lifestyle Changes

   • Avoid foods rich in calcium.

   • Maintain regular exercise and proper hydration.

Although it is not entirely possible to prevent primary hyperparathyroidism, you can reduce your risk by taking the following steps:

• Regular health check-ups.
• Monitoring vitamin D levels.
• Avoiding radiation exposure.

No, but if left untreated, it can lead to serious health problems.