There are two main types of hyperparathyroidism, primary hyperparathyroidism and secondary hyperparathyroidism. Learn more about the differences.

1. The New York Center for Advanced Parathyroid Surgery
15 Maple Avenue | Warwick, NY 10990
Toll Free: 888-760-0966
What is Hyperparathyroidism?
There are two main types of hyperparathyroidism, primary
hyperparathyroidism and secondary
hyperparathyroidism. The term "hyperparathyroidism"
generally refers to primary hyperparathyroidism.
Primary hyperparthyroidism is most commonly caused by
one or more of the parathyroid glands forming a tumor that
secretes excessive parathyroid hormone. Over 95% of these
tumors are benign. Over 80% of the time, this is from a
single enlarged parathyroid gland. This enlarged
parathyroid gland tumor is called a parathyroid adenoma.
Rarely primary hyperparathyroidism is caused by
parathyroid cancer. Normal parathyroid glands stop
secreting parathyroid hormone (PTH) in response to normal or elevated calcium levels in the blood. The
abnormal parathyroid adenoma does not "turn-off" in response to a normal or elevated calcium level in
the blood stream and therefore continues to secrete PTH. This in turn causes an elevated calcium level
in the blood stream.
Symptoms of primary hyperparathyroidism include bone pain, osteoporosis (thin bones), kidney stones,
and abdominal discomfort. Osteoporosis is caused by excessive action of osteoclasts which are cells that
break down bone tissue. This in turn may lead to bone pain and even fractures. Kidney stones are
caused from excessive calcium in the kidney and urine.
Primary hyperparathyroidism is usually first suspected from having an elevated calcium level in the
blood stream. Usually either this elevated calcium level, kidney stones or osteoporosis lead to a further
workup to rule out hyperparathyroidism. The diagnosis of hyperparathyroidism is made when there is
an elevated blood calcium level together with an elevated or high normal PTH. Normal parathyroid
glands are suppressed with an elevated calcium level; however a parathyroid adenoma continues to
secrete PTH despite an elevated calcium level. This is how the diagnosis is ultimately made. In almost all
cases, the recommendation is for surgery to remove the abnormal parathyroid adenoma. There is no
other medicine or treatment to cure primary hyperparathyroidism.
Secondary hyperparathyroidism is caused by medical conditions that cause low blood calcium levels. In
response to this low calcium level, the parathyroid glands react and produce PTH. The PTH is elevated
beyond the normal limits because the body is trying to increase the calcium levels in the blood stream.
Conditions that cause secondary hyperparthyroidism include vitamin D deficiency, kidney disease and
calcium deficiency. Treatment for secondary hyperparathyroidism is focused on correcting the
underlying cause of the low calcium levels. This usually includes vitamin D and calcium supplements.
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2. The New York Center for Advanced Parathyroid Surgery
15 Maple Avenue | Warwick, NY 10990
Toll Free: 888-760-0966
Surgery is sometimes indicated, but not as often as seen with primary hyperparathyoidism where
surgery is almost always indicated.
Hyperparathyroidism Treatment
Surgery is the only cure for primary hyperparathyroidism. That being the case, there are other
treatments and measures that can be taken for hyperparathyroidism. It is important that patients
maintain adequate fluid intake and maintain physical activity. It has been shown that volume depletion
or dehydration can worsen hypercalcemia and make one more susceptible to kidney stones. In addition,
physical inactivity increases the mobilization of skeletal calcium into the bloodstream. Hence, it is
important to continue to exercise.
Patients with primary hyperparathyroidism should supplement their diet with vitamin D and calcium.
This has shown to minimize Parathyroid Hormone (PTH) secretion, bone turnover and calcium loss and
thus decrease one's chance of having osteopenia and osteoporosis.
Drug therapy is usually reserved for patients who are unable to undergo surgery for some reason. This is
not a cure, but a temporizing measure.
A 'wait and see' approach will not work. Hyperparathyroidism will not fix itself in time. Only the removal
of the bad parathyroid gland will cure the parathyroid disease.
Minimally Invasive Parathyroidectomy
At the New York Center for Advanced Parathyroid Surgery, we have the benefit of placing our
operative suites next to our imaging facility enabling the ready use of the minimally invasive
parathyroidectomy technique.
About 97% of parathyroid disease patients have only one bad parathyroid. So rather than use the
traditional parathyroid operation technique requiring a large neck incision to locate and examine the
four parathyroid glands, the minimally invasive surgical technique simply removes the one bad gland
and leaves the others alone.
Minimally invasive parathyroid surgery is an outpatient procedure that requires just a one-inch incision
and can be performed in less than half an hour. In addition, patients recover faster with minimal
scarring.
At the New York Center for Advanced Parathyroid Surgery, we perform the latest in minimally invasive
parathyroid surgical techniques. For more information about your parathyroid surgery treatment
options, visit www.advancedparathyroid.com.
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