Hyperparathyroidism: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hyperparathyroidism?
An endocrinologist, a doctor who treats hormone problems, usually manages hyperparathyroidism. An endocrine surgeon, who operates on glands like the parathyroids, removes overactive glands if surgery is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hyperparathyroidism?
Hyperparathyroidism is a condition in which one or more of the parathyroid glands in your neck make too much parathyroid hormone (PTH). There are 4 tiny parathyroid glands, near or attached to the back of the thyroid gland.
PTH helps control the levels of calcium, phosphorus, and vitamin D in your blood and bone. When PTH is too high, blood calcium rises and can lead to bone thinning and kidney stones.
Doctors call it primary hyperparathyroidism when the problem begins in the parathyroid glands. It can also come from another health problem, such as kidney failure.
Symptoms
Many people have no symptoms. Often blood tests done for another reason show a high calcium level. Symptoms can include:
- Bone pain or tenderness.
- Feeling tired, ill, and weak.
- Depression, forgetfulness, and confusion.
- Nausea and loss of appetite.
- Needing to urinate more often.
- Kidney stones.
- Fragile bones in the limbs and spine that can break easily.
When it is not well controlled for a long time, bones can become weak or deformed. High blood pressure, heart disease, and long-term kidney disease can also develop.
Causes and who gets it
Most often, about 80 percent of the time, the cause is a benign tumor of a parathyroid gland. Benign means it is not cancer. This tumor is called a parathyroid adenoma. It usually happens for no known reason. Very rarely, parathyroid cancer is the cause.
It typically occurs between ages 40 and 65. It affects more women than men. Radiation to the head and neck raises the risk. So do some genetic syndromes, such as multiple endocrine neoplasia I.
Other health problems that lower blood calcium or raise blood phosphate can also lead to it. These include kidney damage or failure, not enough calcium in the diet, and vitamin D disorders. Problems absorbing nutrients from food can also be a cause.
How doctors diagnose it
Your provider will do a physical exam and ask about your symptoms. Blood tests check calcium, PTH, phosphorus, vitamin D, and kidney function. Doctors diagnose primary hyperparathyroidism when blood tests show high calcium and high PTH.
A 24-hour urine test can help find the cause. A bone density scan checks for weak bones. A kidney ultrasound or CT scan checks for kidney stones. A neck ultrasound or sestamibi neck scan can show where an overactive gland is.
Treatment
If your calcium level is mildly high and you have no symptoms, you may choose regular checkups or treatment. If you have symptoms or a very high calcium level, you may need surgery to remove the overactive gland.
When experienced surgeons do the operation, it almost always cures primary hyperparathyroidism. In about 1 out of every 100 people, surgery damages the nerves for the vocal cords. This most often causes hoarseness. It usually gets better on its own. Blood calcium can also run low for a few days or weeks. Rarely, the body is left without enough parathyroid tissue to make PTH.
Some people with mild disease do not need surgery right away. They can be safely monitored. Monitoring includes regular doctor visits, a yearly blood test, and a bone density test every 1 to 2 years.
A medicine called cinacalcet lowers PTH and calcium. Doctors may prescribe it for very high calcium in people who cannot have surgery. If kidney disease is the cause, treatment may include extra calcium and vitamin D. It may also include avoiding phosphates in your diet, dialysis, or a kidney transplant. If your vitamin D is low, your provider may prescribe it.
When to see a doctor
See a doctor if you have bone pain, bones that break easily, kidney stones, or confusion. Also see a doctor if a routine blood test shows a high calcium level.
Call 911 or go to the emergency room if you faint, have chest pain that lasts two minutes or more, or have a sudden change in mental state, such as unusual behavior or being very hard to wake up.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review blood tests and set up regular follow-up checks. Either can refer you to an endocrinologist or endocrine surgeon.
Common questions
Can hyperparathyroidism be cured?
Primary hyperparathyroidism can often be cured with surgery. When experienced surgeons remove the overactive glands, surgery almost always cures it. Your doctor will explain if surgery is right for you.
Do I always need surgery for hyperparathyroidism?
No. Some people with mild primary hyperparathyroidism can be safely monitored. This may be an option if you have no symptoms, only slightly high calcium, and normal kidneys and bone density.
Does hyperparathyroidism always cause symptoms?
No. Many people have no symptoms. The condition is often found when blood tests for another reason show a high calcium level.
Can kidney disease cause hyperparathyroidism?
Yes. Kidney damage or failure can lead to hyperparathyroidism because it makes it hard for the body to remove phosphate.
Sources
- MedlinePlus - Hyperparathyroidism
- National Institute of Diabetes and Digestive and Kidney Diseases - Primary Hyperparathyroidism
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
