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Diagnosis and Treatment

Diagnosis

It is often detected on routine blood work drawn when evaluating or monitoring other health conditions. Certain medications can cause high calcium. These medications are stopped and blood work is repeated. An elevated calcium and elevated PTH diagnose hyperparathyroidism. A calcium level in the high end of the normal range and/or a PTH level in the high end of the normal range also diagnose hyperparathyroidism.

DiagnosisChart

The vast majority of enlarged parathyroids causing hyperparathyroidism are noncancerous (benign). Parathyroid cancer occurs in less than 1% of people with hyperparathyroidism.

Treatment

Primary HPT
The only way to treat hyperparathyroidism is to remove some or all of the parathyroid glands in surgery. Most people have a single adenoma, or one parathyroid that is enlarged.

Secondary HPT
Most of the time it is treated with medications and sometimes with surgery for patients with kidney disease. Most people have hyperplasia, or all 4 parathyroids are enlarged.

Tertiary HPT
Most of the time it is treated with surgery. People with tertiary hyperparathyroidism typically have hyperplasia, or all 4 parathyroids are enlarged.

FHH
Familial hypocalciuric hypercalcemia is not treated with surgery.

Now that I have hyperparathyroidism, what else
should I be thinking about?

If you haven’t already, a bone mineral density scan should be performed to look for any evidence of low bone mass (osteopenia) or osteoporosis. Vitamin D deficiency is common in patients with hyperparathyroidism and should be treated. Adequate calcium intake, through dietary forms or supplements, is recommended following parathyroidectomy.


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