How do I know if I have a parathyroid disorder?

The parathyroid glands produce parathyroid hormone, a hormone that regulates the amount of calcium and phosphorus in the body. When the parathyroid glands make too much parathyroid hormone (a condition called hyperparathyroidism), many symptoms arise such as bone pain, bone fractures, muscle weakness, fatigue, irritability, depression, abdominal pain, constipation, and kidney stones.  If you are experiencing these symptoms, it is possible that you have hyperparathyroidism. However, because these symptoms can also be caused by numerous other disease processes, it is important to have a complete evaluation by a doctor to determine the cause of your symptoms.

Many people with hyperparathyroidism do not experience any symptoms. Thus, they may not be aware of the problem until their doctor discovers and increased calcium level on a routine blood test. Calcium levels may be elevated for many reasons, so your doctor may need to ask you more questions or perform more tests to determine the cause of high calcium.

Parathyroid disorders are diagnosed by measuring the parathyroid hormone levels and calcium levels in the blood.  Elevated parathyroid hormone levels along with values above the normal total calcium or ionized calcium range indicate hyperparathyroidism.  There is more than one type of hyperparathyroidism.  The most common type (primary hyperparathyroidism) is due to an abnormality in the parathyroid gland that increases parathyroid hormone levels.  Secondary hyperparathyroidism is due to a problem in the kidneys that causes the normal parathyroid glands to overproduce parathyroid hormone. 

There is also a disease of hypoparathyroidism or low levels of parathyroid hormone and low calcium levels. Nearly all cases of hypoparathyroidism result from removal (unintentionally or planned) of the parathyroid glands during surgery. If you have had surgery of the thyroid gland or parathyroid glands, your doctor should follow you with blood tests to determine whether hypoparathyroidism has developed.

Following the calcium blood test and parathyroid hormone blood test, the doctor may order a radiology scan called a sestamibi scan.  This test will help to determine the location.