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Parathyroid Conditions

Your parathyroid glands are four small endocrine glands, about the size of a grain of rice, found behind the thyroid gland in your neck. They help your body regulate calcium levels. Calcium helps with nerve function, muscle contraction and bone health.

Even though the parathyroid and thyroid glands have similar names and are found next to each other, they have different functions.

When the calcium levels in your blood get low, your parathyroid glands release parathyroid hormone (PTH). PTH causes your bones to release calcium, helps your intestines absorb it and reduces the amount the kidneys remove. That way, your body has a steady supply of calcium.

Sometimes, this process doesn’t work properly and your parathyroid glands produce too much or too little PTH. There are two main types of parathyroid conditions: hyperparathyroidism and hypoparathyroidism.


Hyperparathyroidism is when your parathyroid glands produce too much PTH. It’s the most common parathyroid condition.

With it, you may not have any symptoms. Or you may notice fatigue, weakness, kidney stones, increased urination, loss of appetite, nausea and vomiting, depression or bone pain. Your health care provider may also spot high calcium levels on a routine blood test.

Primary hyperparathyroidism happens when one or more of your parathyroid glands makes too much PTH, which in turn causes your calcium level to become too high (hypercalcemia). This is a benign (non-cancerous) process, although it can be associated with parathyroid cancer in extremely rare instances.

While anyone can develop primary hyperparathyroidism, it’s most common in women aged 50 to 70 years. In rare cases, people may have an inherited genetic condition that can lead to hyperparathyroidism. Radiation therapy in the head and neck can also increase the risk of developing hyperparathyroidism. 

Secondary hyperparathyroidism can be caused by kidney failure, although it is also caused by other conditions that affect your calcium levels, such as vitamin D deficiency and poor calcium absorption from the intestines. 


Hypoparathyroidism is rare. It’s when your parathyroid glands don’t produce enough PTH. With it, you may have muscle cramps, tingling sensations and even seizures.

Hypoparathyroidism can be caused by surgery involving the thyroid or parathyroid glands, autoimmune disorders or genetic factors.

When to see a health care provider 

Talk to a health care provider if you notice any of the following symptoms of parathyroid conditions:

  • Ongoing fatigue, which could have many causes but may be a sign of a calcium imbalance.
  • Unexplained muscle weakness or pain, particularly in the bones. 
  • Severe or frequent kidney stones. 
  • Tingling or numbness that doesn’t go away, especially in your hands and feet.
  • Unexplained changes in mood or thinking such as feeling foggy or clouded.

It’s important to treat parathyroid conditions. Untreated, they can cause fatigue, sleep issues, memory loss, heart rhythm problems, high blood pressure, kidney disease, pancreatitis and osteoporosis (brittle bone disease).

Diagnosing parathyroid conditions

If you have symptoms of hyperparathyroidism or hypoparathyroidism, you’ll want to see a health care provider. They can recommend tests, interpret results, consider your health history and recommend treatment options.

Your provider will ask you about your symptoms and medical history to make an accurate diagnosis. They may perform or recommend:

  • A physical exam.
  • Blood tests to measure levels of calcium, vitamin D and PTH.
  • Urine tests to measure the amount of calcium in your urine. 
  • Neck ultrasound, specialized CT scans, nuclear medicine scans and/or bone density tests. 

Treating parathyroid conditions

Your provider will work with you to create a personalized treatment plan for your parathyroid condition, based on your diagnosis, overall health, preferences and other considerations.

Hyperparathyroidism treatment

The only cure for hyperparathyroidism is surgery to remove the overactive parathyroid gland(s). Normal parathyroid glands remain in place. Usually, the surgery is an outpatient procedure, meaning you can recover at home shortly after it is completed.

Following surgery, your calcium and PTH levels should return to normal; however, you may need to take calcium and/or vitamin D supplements for a while as your body adjusts. 

There is no medication that can cure hyperparathyroidism. However, some patients with extremely severe cases might be placed on a medication called cinacalcet to temporarily lower the blood levels of calcium and PTH until surgery is possible. Cinacalcet might also be used in patients who have too many other medical problems to safely have surgery, such as patients with kidney failure.

If you have a mild case of hyperparathyroidism, your endocrinologist may recommend monitoring your condition rather than having surgery. In this case, you may have blood, urine and bone density tests once or twice a year to keep an eye on your condition.

Steps to stay healthy with hyperparathyroidism

You can take steps to help manage your calcium levels, control your symptoms and improve your overall well-being. Here are some good options:

  • Stay hydrated: Hydration supports your kidneys and can help prevent kidney stones, which are common with hyperparathyroidism. It also prevents dehydration which can lead to increased calcium levels.
  • Get regular exercise: Moderate exercise helps maintain your health and improve your overall well-being. Weight-bearing exercise can help strengthen your bones. Your doctor can recommend an exercise program based on your condition.
  • Monitor your calcium intake: Keep a close eye on your calcium intake, especially if you have hyperparathyroidism. 
  • Prioritize bone health: Choose foods rich in vitamin D and calcium to support bone strength. Dairy foods, leafy greens, fatty fish and fortified foods are good options. Talk to your provider about recommendations for getting vitamin D from supplements and/or sun exposure.
  • Take medication as directed: Set reminders so you don’t forget to take your medicine and refill your prescriptions in advance so you don’t run out. Talk to your provider if you have any concerns or side effects. 
  • Limit high-phosphorus foods: These foods can be harmful if you have kidney disease. Processed foods and sodas often have high phosphorus levels. 

Hypoparathyroidism treatment 

To treat hypoparathyroidism, your provider may recommend calcium supplements to increase calcium levels and vitamin D supplements to help your body absorb calcium. You may also need medication to manage symptoms and maintain calcium levels. Your provider will monitor your calcium levels to make sure your treatment plan is working as it should.

Key points

Your parathyroid glands are four small glands behind your thyroid that release a hormone that helps regulate your body’s calcium levels. Sometimes they don’t work properly leading to calcium levels that are too high or low. 

If you have a parathyroid condition such as hyperparathyroidism or hypoparathyroidism, you can work with your health care provider to determine the best treatment plan.