Version July 2025
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What is primary hyperparathyroidism? —
This is a disorder of the parathyroid glands in the neck (figure 1). These glands make a hormone called "parathyroid hormone," or "PTH." It helps control the amount of calcium in the blood.
Primary hyperparathyroidism is when the parathyroid glands make too much PTH. This can cause too much calcium to build up in the blood. It can happen when a gland develops an abnormal benign (non-cancer) growth. It can also happen when 1 or more of the glands grow too big. Parathyroid cancer is a very rare cause of primary hyperparathyroidism.
What are the symptoms of primary hyperparathyroidism? —
Most people have no symptoms. But some have symptoms that might be related to having too much calcium in their blood. These symptoms include:
●Pain in the joints
●Feeling tired or weak
●Loss of appetite
●Feeling depressed
●Trouble concentrating
If your blood calcium levels get very high, you might get constipated, feel very thirsty, or urinate more often than usual. Some people have more serious problems, such as:
●Problems with how the kidneys work
●Kidney stones
●Weak bones
"Parathyroid crisis" is a rare but serious problem. It can happen if you have primary hyperparathyroidism and get sick with something that causes you to lose fluids (like vomiting or diarrhea). This causes the amount of calcium in the blood to suddenly rise to a very high level. If this happens, you might have belly pain, nausea, and sometimes problems thinking clearly and staying alert.
Is there a test for primary hyperparathyroidism? —
Yes. A doctor or nurse can do tests to measure the levels of PTH and calcium in your blood. Many people with primary hyperparathyroidism do not notice any symptoms. The condition is often found when a doctor or nurse does a blood test for another reason.
If you have primary hyperparathyroidism, your doctor or nurse might do other tests, too. You will probably get a special kind of X-ray to see if your bones are weaker than normal. Plus, you might get checked for kidney stones.
What can I do on my own? —
Even if you do not have any symptoms, there are things that you can do to help prevent problems:
●Drink plenty of liquids, and try not to get dehydrated. This can help prevent kidney stones.
●Stay active. This can help keep your calcium levels normal and your bones healthy.
●Try to get about 1000 milligrams of calcium each day. These tables show how much calcium is in certain foods and vitamin supplements (table 1 and table 2). It is better to get your calcium from foods and drinks rather than supplements (figure 2). Some people might need to reduce the amount of calcium in their diet. Your doctor will talk to you about how to make sure that you get the right amount of calcium.
●Try to get about 400 to 800 international units, or "IU," of vitamin D each day (table 3). This is the same as 10 to 20 micrograms of vitamin D. Not having enough vitamin D can weaken your bones.
●Do not take certain medicines that can affect the amount of calcium in your blood. Your doctor or nurse can tell you which medicines to avoid.
How is primary hyperparathyroidism treated? —
The main treatment is surgery to remove the gland or glands that are causing the problem. Surgery usually cures the condition. Still, people who have no symptoms do not always need surgery.
You will most likely need surgery if:
●The amount of calcium in your blood is much higher than normal.
●Your primary hyperparathyroidism is causing problems with your kidneys or bones.
●You are younger than 50.
●You cannot get regular check-ups and tests.
If you do not need surgery, your doctor or nurse should still check your blood calcium every 6 months. They will also do regular tests to check your kidneys and bones.
Rarely, a person cannot have surgery. In this case, they can take medicine instead. These do not cure primary hyperparathyroidism, but they can help:
●Strengthen your bones
●Lower the amount of calcium in your blood
When should I call the doctor? —
Call your doctor or nurse if:
●Your symptoms are getting worse.
●You have bone or joint pain.
●Your feet, ankles, or legs are swollen.
●You feel weak or very tired.
●You feel very thirsty.
●You are urinating more often than usual.
●You have vomiting or diarrhea and cannot keep fluids down.
●You have symptoms of a kidney stone, such as:
•Pain in your side or the lower part of your belly
•Nausea or vomiting
•Pain when urinating
•Needing to urinate in a hurry
Patient education: Osteoporosis and osteopenia (low bone mass) (The Basics)
Patient education: Bone density testing (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Calcium blood test (The Basics)
Patient education: Hypercalcemia (The Basics)
Patient education: Kidney stones in adults (The Basics)
Patient education: Primary hyperparathyroidism (Beyond the Basics)
Patient education: Osteoporosis prevention and treatment (Beyond the Basics)
Patient education: Bone density testing (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)
Patient education: Kidney stones in adults (Beyond the Basics)
