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Hyperfunction of the parathyroid glands is a medical condition that depends on the excessive secretion of parathyroid hormone (PTH) by the adenomatous overgrowth of the parathyroid gland. As a result, there is an increase in calcium (Ca) concentration and a decrease in phosphorus (P) in the plasma, with subsequent changes mainly in the skeletal system (extensive decalcification and even bone fractures), urinary system (a tendency to build up calcium salt deposits, i.e. to urolithiasis). urinary tract) and in the digestive tract (chronic recurrent gastric or duodenal ulcer disease, sometimes acute or chronic pancreatitis).
What is an overactive parathyroid gland?
Hyperfunction of the parathyroid glands is a condition associated with the production of parathyroid hormone in excessive amounts, it is associated with the increased activity of the parathyroid adenoma. As a consequence, there is an increase in calcium and a decrease in the amount of phosphorus in the blood, which is additionally accompanied by; calcification, urolithiasis, chronic ulcers of the stomach or duodenum or inflammation of the pancreas. The disease is divided into three types; primary, secondary and tertiary. Hyperfunction of the parathyroid glands more often affects women than men.
The causes of the disease
The main cause of primary hyperparathyroidism is an adenoma that produces too much parathyroid hormone, resulting in increased levels of calcium in the blood. As for the secondary form of this disease, it occurs when there is a small amount of calcium in the blood. In contrast, tertiary hyperfunction of the parathyroid glands is a reaction to secondary hypothyroidism. It is rare.
Symptoms of overactive parathyroid glands
Overproducing PTH causes hypercalcemia – high levels of calcium in the blood at the expense of calcium in the bones. The consequence of hypercalcemia is osteoporosis and pathological bone fractures.
For hyperfunction of the parathyroid glands (in its original form), the glands transform into adenomas.
People with overactive parathyroid glands complain of:
- loss of appetite
- losing weight,
- easy fatigue and general weakness,
- increased thirst,
- persistent constipation,
- polyuria
- symptoms related to recurrent urolithiasis and pathological calcium deposition in the tissues of various organs, e.g. in the parenchyma of the kidneys, pancreas and skeletal muscles,
- in addition, most patients may experience abdominal pain, nausea, and memory impairment.
Types of hyperfunction of the parathyroid glands
1. Primary hyperfunction of the parathyroid glands – characterized by the transformation of the parathyroid glands into adenomas. Most patients develop symptoms such as joint pain, muscle weakness or lack of appetite. This type of hyperthyroidism can appear in several forms, eg enterogastric form; a form of the kidney that causes kidney stones, or an overactive form affecting the bones that causes them to decalcify.
2. Secondary hyperfunction of the parathyroid glands – not related to the glands themselves. Lack of calcium can be caused by eating low-calcium foods. On the other hand, the amount of calcium produced may be too low, e.g. for pregnant women. Unfortunately, pregnant women who forget to replenish their body’s calcium can pass the disease on to their baby.
3. Tertiary hyperfunction of the parathyroid glands – occurs quite rarely as a reaction to secondary hypothyroidism, causing changes in the kidneys.
Hyperfunction of the parathyroid glands – diagnosis
The doctor makes the diagnosis of hyperfunction of the parathyroid glands on the basis of:
• patient complaints about malaise,
• recognized changes in bones,
• high levels of calcium in the blood serum,
• increased secretion of parathyroid hormone,
• especially any hypertrophy of any of the four parathyroid glands.
However, for the final diagnosis, blood tests are needed to determine the level of: calcium, phosphorus and parathyroid hormone. In addition, creatinine tests are performed, and the concentration of creatinine and calcium in weters to exclude the risk of nephrolithiasis and to assess how the patient’s kidneys work. In addition, the doctor may perform an ultrasound or X-ray of the kidneys.
To find out whether an overactive parathyroid gland affects bone disease, markers of bone metabolism (urine: collagen breakdown products; serum: alkaline phosphatase) are taken. Additionally, bone mineral density is analyzed to assess bone loss.
Treatment of hyperfunction of the parathyroid glands
Therapy of hyperfunction of the parathyroid glands is primarily the surgical removal of the parathyroid adenoma, which causes the increase in parathyroid hormone. In addition, pharmacological treatment of disease symptoms and biochemical changes is used in order to inhibit the secretion of parathyroid hormone. Some doctors advise patients to use calcium and vitamin D3.
Complications of the disease
Complications of hyperfunction of the parathyroid glands are related to the diseases that develop on its basis. Examples include pancreatitis, nephrolithiasis, and gastric or duodenal ulcers.