Hyperparathyroidism Quiz
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Itchy
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Fatigued
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Upper jaw hurts
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What is Hyperparathyroidism?
The parathyroid glands are located behind the thyroid at the bottom of the neck and produce parathyroid hormone. Hyperparathyroidism occurs when these glands produce too much parathyroid hormone. Causes include problems with the parathyroid glands, gland enlargement, or a gland tumor.It can cause problems with vitamin D, calcium, osteoporosis and kidney issues.
Typical Symptoms of Hyperparathyroidism
- Pain at the back of the head
- Fainting
- Itchy skin
- Decreased motivation
- Recent changes in mental state
- Dry mouth
- History of osteoporosis / weak bones
- Forehead pain
Diagnostic Questions for Hyperparathyroidism
Your doctor may ask these questions to check for this disease:
- Do you have pain at the back of your head?
- Have you fainted recently?
- Do you have itchy skin?
- Have you been experiencing decreased motivation recently?
- Recently, are you more confused than before?
Treatment of Hyperparathyroidism
Treatment involves medication and/or surgery to remove the parathyroid glands to avoid complications.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Hidetaka Hamasaki, MD (Endocrinology)
Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.
Content updated on May 13, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Lack of motivation
- Feel anxiety suddenly
- The skin is itchy and has scratches
- Felt nauseous then fainted
- Feeling less ambitious nowadays
- Sweating followed by fainting
- Skin itching that worsens at night
- Change in mental status
- Fainting followed by a headache
- Fewer creative urges nowadays
- Itch is mild
- Fainting when walking
- Chest pain with fainting
- Appears dazed
- Itching
See full list
Symptoms Related to Hyperparathyroidism
Diseases Related to Hyperparathyroidism
FAQs
Q.
Always Tired and Aching? Why Your Parathyroid is Overactive & Medical Next Steps
A.
Persistent fatigue and aching can stem from hyperparathyroidism, where overactive parathyroid glands raise PTH and blood calcium, leading to bone loss, kidney stones, digestive issues, and mood or cognitive changes. There are several factors to consider; see below for key symptoms, risk clues, and how this condition can be easily missed. Next steps include speaking with a clinician about serum calcium and PTH testing, vitamin D and kidney function labs, bone density scanning, and imaging to locate an overactive gland; treatment ranges from highly effective minimally invasive surgery to monitored care or medications, depending on severity. Seek urgent care for signs of severe hypercalcemia such as confusion, extreme weakness, dehydration, or abnormal heart rhythms, and see below for important details that could change your plan.
References:
* Sippell S, Aboodi G. Primary hyperparathyroidism: an update on symptoms, diagnosis, and management. JAAPA. 2020 Jun;33(6):14-18. PMID: 32470120.
* Shah K, Bhuta S. Symptoms of primary hyperparathyroidism: focus on neuropsychological and musculoskeletal manifestations. J Endocrinol Invest. 2023 Jan;46(1):15-20. PMID: 35687702.
* Bilezikian JP, Bandeira L, Khan A, et al. Fifth International Workshop on Primary Hyperparathyroidism: Executive Summary. J Bone Miner Res. 2018 Sep;33(9):1723-1734. PMID: 29346747.
* Tella SH, Bilezikian JP. Surgical management of primary hyperparathyroidism: impact on bone health, quality of life, and cardiovascular outcomes. Curr Opin Endocrinol Diabetes Obes. 2023 Feb 1;30(1):1-7. PMID: 36367807.
* Tella SH, Bilezikian JP. Medical Management of Primary Hyperparathyroidism: When to Treat and How. JAMA. 2022 Oct 18;328(15):1560-1561. PMID: 36254188.
Q.
Always Tired? Why Your Parathyroid is Failing & Medically Approved Next Steps
A.
Always tired with brain fog or muscle weakness? Parathyroid disorders that push calcium too high or too low are an often overlooked, treatable cause and can also trigger bone loss, kidney stones, mood changes, and heart rhythm problems; see below for the key differences between overactive and underactive parathyroid disease. Medically approved next steps include asking your doctor to check calcium, PTH, vitamin D, and kidney function, then considering an endocrinology referral, imaging only after abnormal labs, and treatment such as curative parathyroid surgery for hyperparathyroidism or calcium plus active vitamin D for hypoparathyroidism; seek urgent care for chest pain, severe spasms, confusion, or palpitations, and review the important details below that could shape your next steps.
References:
* Minisola S, D'Alessandro A, Al-Daghri N, Al-Saleh Y, Al-Musharaf S, Al-Suwaidan F, Rossi M, Pepe J, Scarda A, Biamonte F, et al. Fatigue and hyperparathyroidism: a review. Clin Endocrinol (Oxf). 2021 Nov;95(5):673-680. doi: 10.1111/cen.14545. Epub 2021 Jul 11. PMID: 34185799.
* Underbjerg L, Jensen T, Mosekilde L, Rejnmark L. Hypoparathyroidism and fatigue: a systematic review. Endocr Pract. 2017 Jul;23(7):855-862. doi: 10.4158/EP170622.SYSR. PMID: 28867373.
* Bilezikian JP, Khan AA, Silverberg SJ, Fuleihan GEH, Marcocci A, Minisola S, Perrier ND, Sitges-Serra A, Thakker RV, Åkerström G, Brandi ML. Evaluation and Management of Primary Hyperparathyroidism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022 Feb 17;107(1):1-20. doi: 10.1210/jcem.2021-01775. PMID: 34694901.
* Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke B, Khan A, Marcocci A, Minisola S, Rejnmark L, Rizzoli R, et al. Advances in the Management of Hypoparathyroidism. J Clin Endocrinol Metab. 2021 Dec 17;107(1):3-22. doi: 10.1210/jcem.2021-01764. PMID: 34694900.
* Abdel-Aziz M, Helmy AS, Khairy MA, Al-Azzazi AS, Sabra WM, Elsherif H. Neurocognitive and Psychological Symptoms in Primary Hyperparathyroidism: A Systematic Review. World Neurosurg. 2022 Oct;166:e151-e160. doi: 10.1016/j.wneu.2022.07.032. Epub 2022 Jul 14. PMID: 35843477.
Q.
Unexplained Fatigue? Why Your Calcium Is High & Medically Approved Next Steps
A.
Unexplained fatigue with a high calcium level usually means hypercalcemia, most often from primary hyperparathyroidism, though medications or supplements, kidney or thyroid issues, prolonged immobility, and less commonly cancer can also be responsible. There are several factors to consider, and the right next steps can change based on details like your PTH, corrected or ionized calcium, and kidney function; confirm the result, review meds and vitamin D or calcium intake, and seek urgent care for severe symptoms such as confusion, vomiting that will not stop, chest pain, or an irregular heartbeat. See the complete guidance below.
References:
* Lundgren, E., et al. (2020). Primary hyperparathyroidism: an update on diagnosis, pathogenesis, and treatment. *European Journal of Endocrinology, 183*(2), R1-R16. pubmed.ncbi.nlm.nih.gov/32463768/
* Wang, S. Z., et al. (2020). Prevalence of fatigue in primary hyperparathyroidism: a meta-analysis. *Journal of Parathyroid Disease, 8*(1), 1-8. pubmed.ncbi.nlm.nih.gov/32007823/
* Marcocci, C., & Cetani, F. (2021). Primary hyperparathyroidism. *The Lancet Diabetes & Endocrinology, 9*(12), 856-871. pubmed.ncbi.nlm.nih.gov/34748721/
* Willey, E. M., et al. (2023). Medical and surgical management of primary hyperparathyroidism: an update. *Frontiers in Endocrinology, 14*, 1175127. pubmed.ncbi.nlm.nih.gov/37168393/
* Silverberg, S. J. (2019). The evolving phenotype of primary hyperparathyroidism. *Journal of Bone and Mineral Research, 34*(3), 374-381. pubmed.ncbi.nlm.nih.gov/30588636/
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Jamal SA, Miller PD. Secondary and tertiary hyperparathyroidism. J Clin Densitom. 2013 Jan-Mar;16(1):64-8. doi: 10.1016/j.jocd.2012.11.012. Epub 2012 Dec 23. PMID: 23267748.
https://www.sciencedirect.com/science/article/abs/pii/S1094695012002417?via%3DihubTaniegra ED. Hyperparathyroidism. Am Fam Physician. 2004 Jan 15;69(2):333-9. PMID: 14765772.
https://www.aafp.org/pubs/afp/issues/2004/0115/p333.htmlvan der Plas WY, Noltes ME, van Ginhoven TM, Kruijff S. Secondary and Tertiary Hyperparathyroidism: A Narrative Review. Scand J Surg. 2020 Dec;109(4):271-278. doi: 10.1177/1457496919866015. Epub 2019 Jul 31. PMID: 31364494.
https://journals.sagepub.com/doi/10.1177/1457496919866015Allerheiligen DA, Schoeber J, Houston RE, Mohl VK, Wildman KM. Hyperparathyroidism. Am Fam Physician. 1998 Apr 15;57(8):1795-802, 1807-8. Erratum in: Am Fam Physician 1998 Jul;58(1):52. PMID: 9575320.
https://www.aafp.org/pubs/afp/issues/1998/0415/p1795.htmlOrgan CH Jr. Hyperparathyroidism. J Natl Med Assoc. 1969 Mar;61(2):175-82 passim. PMID: 4887706; PMCID: PMC2611693.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2611693/Hyperparathyroidism - Johns Hopkins Medicine
https://www.hopkinsmedicine.org/health/conditions-and-diseases/hyperparathyroidism#:~:text=What%20is%20hyperparathyroidism%3F,in%20the%20bloodstream%20when%20needed.