Is your calcium level high? Let's talk about Hyperparathyroidism in simple terms

Do you often feel weak, have bone pain, or have a memory lapse? Although we may think these are normal things, there may be a medical reason behind this. That is, the level of calcium in the blood is elevated. The main cause of this is a condition called Hyperparathyroidism. Although the name may be a bit complicated, don't be afraid. Let's talk about it simply.

What exactly is hyperparathyroidism?

Simply put, Hyperparathyroidism is when one or more of the parathyroid glands in our body become overactive and produce too much parathyroid hormone (PTH).

Imagine, in our neck, behind the thyroid gland, there are four small pea-sized glands. These are what we call the parathyroid glands. Their main job is to maintain the calcium level in our blood at a certain level. They also reduce the phosphate level in the blood.

These glands produce the hormone PTH and send several signals to our body:

• Our bones: The blood tells them to release calcium and phosphate.
• Our kidneys: They are told to reduce the amount of calcium excreted in the urine and reabsorb it back into the body. They are also told to excrete excess phosphate in the urine.

Then, the kidneys activate vitamin D and send it to our intestines. The intestines then absorb the calcium from the food we eat.

However, when these parathyroid glands produce too much PTH hormone, too much calcium is released from our bones, making them weak and brittle. Also, this excess calcium can be deposited in our kidneys, blood vessels, heart, and other parts of the body. This increase in blood calcium levels is called hypercalcemia .

Are there different types of this?

Yes, there are three main types of Hyperparathyroidism. They are classified according to how they occur. Let's see what these are.

What are the symptoms of this?

Many times, people with this condition don't have any symptoms. It's often discovered incidentally during a blood test for another condition. However, when blood calcium levels become very high, symptoms such as:

• Pain in bones and joints
• Muscle weakness
• Constant tiredness and fatigue
• Depression-like mood
• Difficulty paying attention to something
• Appetite
• Nausea and vomiting
• Memory loss or forgetfulness
• Feeling more thirsty than usual and needing to urinate more frequently
• Constipation

The risks and possible complications of this condition

High blood calcium levels over a long period of time can cause various complications.

• Kidney stones: Calcium deposits in the kidneys can cause kidney stones.
• Osteoporosis: Bones become weak and easily breakable as calcium is lost from the bones.
• Heart disease: Calcium deposits in the blood vessels and heart increase the risk of conditions such as high blood pressure, heart attack, or stroke.
• Skin problems: Calcium deposits on the skin can cause wounds and infections.

There are several factors that increase the risk of developing this condition. The most important of these are having received radiation treatment to the neck area, calcium or vitamin D deficiency, kidney disease, and being a woman.

How to diagnose this disease?

If your doctor suspects this disease, he or she will order several tests to confirm it.

• Blood tests: These measure the levels of calcium, parathyroid hormone (PTH), vitamin D, and phosphate in your blood.
• 24-hour urine test: A urine sample collected over the course of a day is used to test the amount of calcium in the urine.
• Parathyroid scan: This scan can determine exactly which of the four glands is overactive.
• Other scans: An ultrasound scan of the kidneys or a bone density scan may also be performed.

How is it treated?

Treatment methods depend on whether you have primary or secondary type and the severity of the disease.

Treatment for Primary Hyperparathyroidism

• Surgery: The best and most permanent treatment for this is to surgically remove the problematic gland or glands. This surgery is called a parathyroidectomy . Your doctor is more likely to recommend surgery, especially if you are under 50, have severe symptoms, or have kidney stones or osteoporosis.
• Medications: In cases where surgery is not necessary or is not possible, the doctor may prescribe medications.
• Bisphosphonates: These prevent calcium from being released from the bones.
• Calcimimetics: These medications trick the parathyroid glands into reducing the production of the PTH hormone.
• Lifestyle changes: Some medications (e.g., Thiazide diuretics, Lithium) can increase calcium levels. Therefore, you may need to avoid them as advised by your doctor.

Treatment for Secondary Hyperparathyroidism

The main thing in this is to treat the underlying cause of this condition.

• If you have chronic kidney disease, you may need dialysis or a kidney transplant .
• Dietary changes, especially limiting foods high in phosphorus, may be advised.
• Medications such as phosphate binders (medicines that reduce phosphate in the blood), vitamin D supplements, and calcimimetics may be prescribed.

If these treatments fail to control the condition, surgical removal of the glands may be recommended.

Things to consider when living with this condition

If you have hyperparathyroidism, these things can help you stay healthy:

• Drink plenty of water: Keeping the body hydrated is good for the kidneys.
• Stay active: Exercise can keep your bones strong.
• Be careful with your diet: If your doctor advises you to reduce your phosphorus intake, avoid foods that end in "-phos" (e.g., calcium phosphate) on food packages.
• About Vitamin D: People who are deficient in Vitamin D may be advised to take supplements. However, never take any vitamin or supplement without consulting your doctor.

Your doctor will check your blood calcium levels, blood pressure, kidney function, and bone density at regular intervals (perhaps once or twice a year).

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