Since parathyroid gland disease (hyperparathyroidism) was first described in 1925, the symptoms have become known as “moans, groans, stones, and bones… with psychic overtones”. About 95% of people with hyperparathyroidism will have some of the classic symptoms listed below, with 5% saying they feel just fine. However, almost 100% of patients will say they feel better after the parathyroid tumor has been removed and the disease cured. Most people will say that having the parathyroid tumor removed changes their quality of life in an amazing way within a few days or weeks. As we often tell our patients: “you will be amazed at how a 20 minute procedure will change your life!”
Sometimes the symptoms of primary hyperparathyroidism are really obvious, like kidney stones, frequent headaches, fatigue, depression, and atrial fibrillation (fast heart beat). Sometimes the symptoms are not so obvious, like high blood pressure, poor concentration ability, and poor memory.
Hyperparathyroidism can show up differently in different people. Sometimes it makes people miserable within the first year or two of having high blood calcium. Other times it can go 4-5 years without causing too many problems other than fatigue, bad memory, kidney stones, and osteoporosis. There is increasing evidence that “watching” or “monitoring” high calcium and hyperparathyroidism will often cause multiple progressive health problems that can occasionally lead to early death.
The most common symptoms of hyperparathyroidism are:
- Loss of energy. Don’t feel like doing much. Tired all the time. Chronic fatigue.
- Just don’t feel well; don’t quite feel normal. Hard to explain but just feel bad.
- Feel old. Don’t have the interest in things that you used to.
- Can’t concentrate, or can’t keep your concentration like in the past.
- Depression (many patients are even put on anti-depression medications)
- Osteoporosis and Osteopenia.
- Bones hurt; typically it’s bones in the legs, hips, back, and arms.
- Don’t sleep like you used to. Wake up in middle of night. Trouble getting to sleep.
- Tired during the day and frequently feel like you want a nap (but naps don’t help).
- Spouse claims you are more irritable and harder to get along with (cranky).
- Forget simple things that you used to remember very easily (worsening memory).
- Gastric acid reflux; heartburn; GERD.
- Decrease in sex drive.
- Thinning hair (predominately in middle aged females on the front part of the scalp).
- Kidney Stones (and eventually kidney failure).
- High Blood Pressure (sometimes mild, sometimes quite severe; up and down a lot).
- Recurrent Headaches (usually patients under the age of 40).
- Heart Palpitations (arrhythmias). Typically atrial arrhythmias.
- Atrial Fibrillation (rapid heart rate, often requiring blood thinners and pacemakers).
- High liver function tests (liver blood tests).
90% of people with hyperparathyroidism will have 6 or more of these symptoms. In general, the longer you have hyperparathyroidism, the more symptoms you will develop, and the worse they become.
Some of the symptoms of hyperparathyroidism are easy to understand: people get osteoporosis and bone pain because the PTH removes calcium from the bones; kidney stones occur because the excess calcium collects in the kidneys to form stones made of calcium; heart disease and high blood pressure occur because the excess calcium builds up in the arteries causing them to become stiff. But other symptoms such as fatigue, memory loss and muscle cramps can be hard to understand unless you know how our nervous system and muscles use calcium to do their jobs. Calcium is the element that allows the normal conduction of electrical currents along nerves–its how our nervous system works and how one nerve ‘talks’ to the next. Our entire brain works by fluxes of calcium into and out of the nerve cells and when the blood calcium is even a little bit too high, this process slows down. Calcium is also the primary element which causes muscles to contract. This is why many people get muscle cramps or have symptoms of fatigue or memory loss when they have a parathyroid problem and their blood calcium is even a little bit high.
Fatigue is the most common symptom of primary hyperparathyroidism (85% of patients). Often these patients say: “I’m tired of being tired”. This fatigue usually resolves within a few days or weeks following successful parathyroid surgery and the disease is cured. Almost all of the symptoms of hyperparathyroidism will improve or go away after successful parathyroid surgery in most people. Often, the changes in people’s lives are dramatic.
Patients with hyperparathyroidism have a higher incidence of heart attacks and heart-related deaths. Recent studies have shown that the small arteries of the heart are affected by the high calcium and by the PTH, decreasing blood flow to the heart increasing the rate of heart attacks. A number of studies have shown that these heart blood flow abnormalities are restored back to normal after parathyroid surgery. Heart function, including how much blood the heart can pump with each squeeze (the ejection fraction), is known to improve following parathyroid surgery. Therefore, the concept that a patient with a poor heart may not be a good candidate for parathyroid surgery is not necessarily correct—the patient’s heart function can be expected to improve with parathyroid surgery.
Patients with hyperparathyroidism have a higher rate of: stroke, heart failure, heart attack, atrial fibrillation, cardiomyopathy, renal failure, depression, shingles, kidney stones, osteoporosis, serious bone fractures, need for hip replacement, GERD, high blood pressure, memory loss, chronic fatigue, MGUS, anemia, cancers of the breast, colon, kidney, and prostate, and early death. Because of these increased risks, experts now believe that it is best to remove the tumor when the diagnosis of hyperparathyroidism is made, rather than wait until these complications arise.
For more detailed information on this topic: http://www.parathyroid.com/parathyroid-symptoms.htm