Understanding Primary Hyperparathyroidism

Back view of thyroid showing three normal parathyroids and one enlarged one.The parathyroid glands are 4 tiny glands in the neck. They make parathyroid hormone (PTH). PTH controls the amount of calcium and phosphorus in your blood. Primary hyperparathyroidism is when there is too much PTH in your blood. It occurs when one or more of the glands are too active.

The job of PTH is to tell the body how to control calcium. Too much PTH means the body increases the amount of calcium in the blood. This leads to a problem called hypercalcemia. This is when the amount of calcium in the blood is too high. Hypercalcemia can cause serious health problems.


Hyperparathyroidism can occur when a parathyroid gland becomes enlarged. It can also occur as a complication of another health conditions, such as kidney failure or rickets. In these conditions, calcium is usually not high. This is called secondary hyperparathyroidism.

Who’s at risk

The risk factors for this condition include:

  • Being a woman (it’s less common in men)

  • Being older (it’s more likely to occur with age)

  • Having parents or siblings with the condition or other endocrine tumors

  • Having certain kidney problems

  • Taking certain medicines

  • Having had radiation treatment in the head or neck


Symptoms of the condition can include:

  • Muscle weakness

  • Depression

  • Tiredness

  • Confusion and memory loss

  • Poor memory

  • Nausea and vomiting

  • Pain in the stomach area (abdomen)

  • Hard stools (constipation)

  • Stomach ulcers

  • Need to urinate often

  • Kidney stones

  • Joint or bone pain

  • Bone disease (osteopenia or osteoporosis), an increase in bone fractures

  • High blood pressure

  • Increased thirst


If primary hyperparathyroidism is not treated, it can get worse over time. Treatments include:

  • Surgery. This may be done to remove any enlarged parathyroid glands. This lets the amount of calcium in the blood go back to normal. You may need to take vitamin D and calcium supplements before the surgery. This will reduce the risk of low calcium after the surgery. 

  • Medicine. This lowers the amount of parathyroid hormone made by the overactive glands. 

You and your healthcare provider can discuss your treatment options. Make sure to ask any questions you have.