Primary hyperparathyroidism

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Endocrine glands

Parathyroid glands

Parathyroid-related hypercalcemia

Treatment depends upon the severity and cause of the condition. If calcium levels are mildly high, they may simply be monitored, but not treated, unless the kidneys do not work correctly, kidney stones develop, or there is a loss of calcium from bones, which makes them weaker.

Treatment may include:

• Drinking more fluids to prevent the formation of kidney stones
• Movement and exercise
• Avoiding immobilization
• Avoiding thiazide-type diuretics ("water pills")
• Using estrogen therapy (for postmenopausal women)
• Treating with a calcium-receptor sensitizer (cinacalcet) to decrease levels of PTH

For severe cases that cause problems, hospitalization may be required. An IV may be used to replace fluids (rehydrate the body). Medications to bring down calcium levels quickly may be given. They include bisphosphonates and calcitonin

Surgery to remove the tumor or removal of excess parathyroid tissue resulting from hyperplasia is necessary for severely high calcium levels or one or more of the following complications are present: kidney stones, pancreatitis, psychiatric disease, or bone demineralization.

Surgery is also recommended for patients less than 50 years of age.

The prognosis is good for mild cases. Most cases of primary hyperparathyroidism are mild.

Complications that result from excess calcium deposits within the body:

• Skeletal damage
• Urinary tract infection due to kidney stones and obstruction
• Pancreatitis
• Pseudogout

Call for an appointment with your health care provider if symptoms indicate that primary hyperparathyroidism may be present.

Call your health care provider if signs of complications develop.

Review Date: 08/08/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.