Primary hyperparathyroidism is the third most common endocrine system disease. 

Almost everyone knows about diabetes and thyroid diseases, but hypothyroidism remained unnoticed for a long time.

Causes of the disease

The reason for this is clinical manifestations: it hurts in places that have nothing to do with the parathyroid glands. 

The parathyroid glands are located near the thyroid gland, there are usually four of them. They are responsible for the exchange of calcium. The glands produce parathyroid hormone ( parathyroid hormone , PTH), whose task is to supply calcium into the blood.

The work of the parathyroid glands is limited by vitamin D. With age, it is absorbed more and more poorly, therefore, and control worsens. Having received complete freedom of action, the parathyroid gland begins to increase the level of calcium in the blood.

Kidney

Excess calcium is excreted in the urine. This is fraught with the formation of kidney stones. After removal of stones, relapse develops quickly enough. no one removed the reason for the formation.

Another common complication is thirst and increased urination, especially at night. Such patients are usually immediately tested for blood sugar and, having received a normal result, shrug their shoulders. In the case of hyperparathyroidism, thirst is caused by the kidneys’ urge to excrete calcium.

Gastrointestinal tract

An increase in blood calcium stimulates the production of hydrochloric acid in the stomach, leading to erosion or ulceration. Treatment by a gastroenterologist has only a temporary effect, and ulcers regularly relapse.

The cardiovascular system

The impact of the cardiovascular system goes through several channels:

• Deposition of calcium in vessels and valves – this makes it difficult for them to move and makes them more brittle;
• Calcium, the amount of which is increased inside the cell, stimulates an increase in blood pressure. The symptom manifests itself in patients first of all, and remains the only one for a long time.

Nervous system

There is still debate about the effect of excess blood calcium levels on the function of the nervous system.

On the one hand, patients with hyperparathyroidism show weakness, mood swings, and increased fatigue, which are significantly reduced after normalization of calcium and parathyroid hormone levels .

On the other hand, the symptoms are too nonspecific to be associated directly with parathyroid hormone .

The parathyroid glands themselves increase in size and can often be noticed by an ultrasound doctor when examining the thyroid gland .   

Hyperparathyroidism treatment

If the disease is in a mild form, when there are no clinical manifestations yet, and laboratory parameters have already been violated, then the treatment can be conservative (especially if there is no strong increase in the parathyroid glands). In this case, the patient should be monitored regularly by an endocrinologist . 

If the disease has turned into an explicit form with clinical manifestations, then the main method of treatment is surgical . 

NCCDC recommendations

Any disease is better prevented than cured.

A set of tests for detecting the disease has long been approved and is available. These are ionized calcium , vitamin D and parathyroid hormone .    

Ionized calcium readings will suffice for simple screening. With its increase, a repeated study is recommended (in order to exclude an error), as well as a more detailed analysis, which includes other indicators.

There is a situation when, at the initial stage of the disease, parathyroid hormone may be normal (at the upper limit), but with an increased level of ionized calcium, the doctor must still observe such a patient.

Vitamin D readings, a direct participant in the described events, should also not be discounted. With hyperparathyroidism, it can be either increased or decreased, therefore, therapy regimens should be developed taking into account its dynamics.