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There are four parathyroid glands in the neck. They lie behind the thyroid gland and produce parathyroid hormone (PTH), which regulates calcium. Hyperparathyroidism involves increased production of this hormone. The hyperactivity of the parathyroid is divided into three types: primary, secondary and tertiary.
The primary type is caused by an abnormality of the gland, such as an adenoma or cancer. The secondary type is caused by other conditions, such as chronic renal failure; prolonged dialysis; or severe malabsorption, resulting in low calcium levels causing hyperactivity. The tertiary type occurs when secondary hyperparathyroidism has been present for a long time and has become independent of its original causative agent.
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Signs and Symptoms
Symptoms of hyperparathyroidism may include joint pain, bone loss leading to osteoporosis, muscle weakness, abdominal discomfort, nausea and vomiting, constipation, lack of appetite, kidney stones, excessive thirst, excessive urination, anxiety, memory loss, fatigue. Some patients will have a couple of symptoms, some will have a few and some will have almost all of them.
The number of symptoms from which a patient is suffering usually depends upon the length of time that he or she has been sick. The number of symptoms is not proportional to the level of calcium, which means that a person with calcium level 12 will necessarily have more symptoms than a person with calcium level 10. In fact, as the calcium level increases the number of symptoms become lower, but the symptoms become more severe, such as stroke.
There are also differences between symptoms in teenagers and the elderly; different age groups tend to suffer from different sets of symptoms.
The most common symptom in Hyperparathyroid patients is fatigue. This fatigue is caused by high levels of calcium. The calcium levels disturb the function of the nervous system, making patients feel weak, tired, forgetful and generally unwell.
The increased levels of PTH cause calcium to be released from bones, which causes bone pain. If the disease has been present for many years, the continuous release of calcium from bones causes them to become very weak, even break.
High calcium levels can also produce higher levels of acid in the stomach, causing Gastro Esophagel Reflux Disease (GERD).
Formation of kidney stones is another common problem for patients with hyperparathyroidism. The high level of calcium in the blood and urine has to be filtered through the tubules of the kidney and can accumulate there to form stones. The high levels of calcium can even cause calcification of the kidney and kidney failure. Apart from high blood pressure, this condition can also cause arrythmias and heart valve problems.
Headache is a common symptom of hyperparathyroidism in teenagers; usually it is the presenting complaint.
The life expectancy of people with hyperparathyroidism is almost five years less than people without the condition in the same age group. Rare probblems caused by this disease include acute pancreatitis and stomach ulcers.
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Scully,C, Cawson,R.A., (2005) Medical Problems in Dentistry 5th edition.Elsevier.