Secondary parathyroid

Because the symptoms of hyperparathyroidism can be nonexistent, mild or common to many other disorders, a diagnosis of hyperparathyroidism can be missed. Often, the condition is discovered through a blood test that is ordered for another condition.

If you have primary hyperparathyroidism, your blood test will show a higher-than-normal levels of calcium and parathyroid hormone. Your provider may order a sestamibi scan to check for any growths on your parathyroid glands or enlargement of the gland(s).

Other tests may be ordered to check for complications of hyperparathyroidism. These tests may include:

A blood test to check your vitamin D level. It’s common to have a low vitamin D level if you have hyperparathyroidism.

A bone density test to check for bone loss.

An ultrasound or other imaging test of your kidneys to check for kidney stones.

A 24-hour urine collection test to measure the amount of calcium and other chemicals in your urine to help determine the cause of your hyperparathyroidism.

Blood tests to check how well your kidneys are working.

If you have mild hyperparathyroidism (no symptoms, blood calcium levels only slightly elevated), your healthcare provider may not choose to treat it right away. Instead, your provider will monitor your blood calcium levels (every six months), blood pressure (every six months), kidney function (every year), and bone density (every one to three years).

If your healthcare provider believes your hyperparathyroidism doesn’t need immediate treatment, be sure to:

Drink more water.

Keep active and get more exercise to keep your bones strong.

Don’t take thiazide diuretics or lithium because these drugs can increase the level of calcium in your blood.

Ask your provider if you need to take a vitamin D supplement if your vitamin D level is low.

If you have more severe hyperparathyroidism symptoms or have an enlarged parathyroid gland (or glands) or a growth on your parathyroid gland, your provider may recommend surgery to remove the overactive gland(s). Surgery by an experienced surgeon can cure hyperparathyroidism in about 95% of cases.

Medical management

Cinacalcet (Sensipar®) has been approved by the Food and Drug Administration for the treatment of secondary hyperparathyroidism. The drug works by signaling the parathyroid glands to produce less PTH. Although cinacalcet is intended for secondary hyperparathyroidism, some healthcare providers prescribe it for primary hyperparathyroidism.

Another medication type that is sometimes prescribed is bisphosphonates. These drugs help prevent loss of calcium from bones, which reduces the risk of fracture and osteoporosis. Examples of bisphosphonates include etidronate (Didronel®), alendronate (Fosamax®), zoledronic acid (Zometa®) and ibandronate (Boniva®).

If you're a woman and you’ve already gone through menopause and have signs of osteoporosis, your provider may prescribe hormone replacement therapy (HRT). HRT may help your bones retain calcium.