Secondary parathyroid

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Overview

Hyperparathyroidism is when your parathyroid glands create high amounts of parathyroid hormone in the bloodstream. These glands, located behind the thyroid at the bottom of your neck, are about the size of a grain of rice.

The parathyroid hormone produced by the thyroid glands helps maintain the right balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning. This is especially important for nerve and muscle function, as well as bone health.

There are two types of hyperparathyroidism. In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of parathyroid hormone. This causes high calcium levels in the blood, which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism.

Secondary hyperparathyroidism occurs due to another disease that first causes low calcium levels in the body. Over time, increased parathyroid hormone levels occur as the body fights to keep the calcium level up in the standard range. This is common in kidney disease and after certain intestinal surgeries or diseases.

Symptoms

If you have early hyperparathyroidism, you may not have any symptoms. If you have mild hyperparathyroidism, you may have some of the following symptoms:

Joint pain.

Muscle weakness.

Feeling tired.

Depression.

Trouble concentrating.

Loss of appetite.

If your hyperparathyroidism is more severe, you may have these symptoms:

Nausea and vomiting.

Confusion, forgetfulness.

Increased thirst and need to urinate.

Constipation.

Bone pain.

Other problems associated with severe hyperparathyroidism include:

Reduced kidney function, which affects your kidney’s ability to filter blood.

Kidney stones.

Thinning bones (osteoporosis).

High blood pressure. High blood calcium levels may play a role in the development of high blood pressure.

Causes

The most common cause of secondary hypothyroidism is a pituitary tumor (such as a pituitary adenoma). This sets it apart from primary hypothyroidism, which is most often caused by an autoimmune disease called Hashimoto’s disease (also known as lymphocytic thyroiditis).

In rare instances, hypothyroidism secondary may occur when inflammatory cells infiltrate the pituitary gland.

Risk factors for secondary hypothyroidism include:

Age over 50 years old

Female gender

Head trauma

Chronic stress

Personal or family history of pituitary dysfunction

Risk factors

You may be at an increased risk of primary hyperparathyroidism if you:


Are a woman who has gone through menopause

Have had prolonged, severe calcium or vitamin D deficiency

Have a rare, inherited disorder, such as multiple endocrine neoplasia, type 1, which usually affects multiple glands

Have had radiation treatment for cancer that has exposed your neck to radiation

Have taken lithium, a drug most often used to treat bipolar disorder

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Complications

Complications of hyperparathyroidism are mainly related to the long-term effect of too little calcium in your bones and too much calcium in your bloodstream. Common complications include:

Osteoporosis. The loss of calcium from bones often results in weak, brittle bones that break easily (osteoporosis).

Kidney stones. Too much calcium in your blood may lead to too much calcium in your urine. This can cause small, hard deposits of calcium and other substances to form in your kidneys (kidney stone). A kidney stone usually causes major pain as it passes from the kidneys through the urinary tract.

Cardiovascular disease. Although the exact cause-and-effect link is unclear, high calcium levels are associated with heart and blood vessel (cardiovascular) conditions, such as high blood pressure and certain types of heart disease.

Neonatal hypoparathyroidism. Severe, untreated hyperparathyroidism in pregnant women may cause dangerously low levels of calcium in newborns. Primary hyperparathyroidism is not common in women of childbearing age.

Prevention

If you and your health care provider have chosen to monitor, rather than treat, your primary hyperparathyroidism, the following suggestions can help prevent complications:

Monitor how much calcium and vitamin D you get in your diet. ...

Drink plenty of fluids. ...

Exercise regularly. ...

Don't smoke.