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Elevated Parathyroid Hormone or Hyperparathyroidism | Causes, Symptoms & Treatment
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**Secondary hyperparathyroidism** is a condition where the parathyroid glands overproduce parathyroid hormone (PTH) in response to low blood calcium levels caused by an underlying issue, typically related to chronic kidney disease (CKD), vitamin D deficiency, or malabsorption syndromes. Unlike primary hyperparathyroidism, the problem originates outside the parathyroid glands themselves.
### **Causes**
- **Chronic kidney disease (CKD):** The most common cause. CKD leads to imbalances in calcium, phosphorus, and vitamin D metabolism.
- **Vitamin D deficiency:** Reduces calcium absorption in the gut.
- **Malabsorption disorders:** Conditions like celiac disease can impair calcium and vitamin D absorption.
- **Hypocalcemia:** Persistent low calcium levels stimulate the parathyroid glands.
---
### **Symptoms**
The symptoms of secondary hyperparathyroidism are often related to its underlying cause and the effects of prolonged elevated PTH. Common symptoms include:
1. **Bone-related symptoms:**
- Bone pain or tenderness.
- Increased risk of fractures (osteopenia or osteoporosis).
2. **Kidney-related symptoms:**
- Kidney stones (less common in secondary hyperparathyroidism than in primary).
- Calcification in soft tissues or organs.
3. **Muscle and joint issues:**
- Muscle weakness or cramps.
- Joint pain.
4. **Neurological and general symptoms:**
- Fatigue.
- Depression or irritability.
- Difficulty concentrating.
5. **Symptoms related to chronic kidney disease:**
- Itching (pruritus) due to high phosphorus levels.
- Vascular calcification or cardiovascular complications in advanced cases.
6. **Calcium-phosphorus imbalance effects:**
- Elevated phosphorus levels (hyperphosphatemia).
- Low calcium levels (hypocalcemia).
---
### **Diagnosis**
Secondary hyperparathyroidism is diagnosed through blood tests showing:
- Elevated PTH levels.
- Low to normal calcium levels.
- High phosphorus levels (in CKD) or vitamin D deficiency.
Bone density scans and imaging studies might be used to assess bone health and detect calcifications.
### **Treatment**
- **Addressing the underlying cause:** Managing CKD, supplementing vitamin D, or correcting malabsorption issues.
- **Dietary modifications:** Reducing dietary phosphorus and increasing calcium intake under medical supervision.
- **Medications:**
- **Vitamin D analogs** or active forms of vitamin D (e.g., calcitriol).
- **Phosphate binders** to lower phosphorus levels.
- **Calcimimetics** to reduce PTH secretion.
- **Surgical intervention:** In severe, refractory cases, parathyroidectomy (surgical removal of parathyroid glands) may be necessary.
Early detection and management can prevent complications like severe bone loss and vascular calcification.
Shafiq Cheema
MBBS(KE), MD (USA), Diplomate American Board Internal Medicine, Diplomate American Board of Nephrology, Fellow American College Physician (FACP), Fellow American College of Nephrology (FASN), Hypertension specialist by ASH...
How to Book an Online appointment:
3 simple steps:
Call & Book an Appointment by calling sim No 0315-238-1111
Send your reports & Meds via WhatsApp
Talk to Professor Shafiq Cheema via Video Call
Ph # 0315-238-1111
For More Information Please Visit our Websites & Social Media:-
#drshafiqcheema #bestnephrologistinlahore
#topnephrologistinlahore #kidneyfailure #hypertension #kidney #nephrologist #dialysis #nephchat #nephchatwithdrshafiqcheema
#topnephrologistinpakistan #bestnephrologisinpakistan #kidneyissues #ckd #chronickideydisease #kidneyspecualist #kidneytips #proteinuria #kidneydiet
Professor Dr. Shafiq Cheema is a Gold Medalist and was the most distinguished Graduate of KEMU, in 1996. He has extensive training & experience in the field of Internal Medicine, Hypertension, and Nephrology. He is a Diplomat American Board of Internal Medicine and Nephrology as well as a Fellow of the American College of Physicians and American Society of Nephrology. He is a renowned Hypertension specialist by ASH. He was lately appointed as Professor of Nephrology at AIMC-Jinnah Hospital. He is amongst America’s top Nephrologists and the world's leading physician. He is the Founder & Patron in Chief of Pak Kidney Foundation (PKF), Chairperson MD Nephrology UHS, and Founder of NephChat with Dr. Shafiq Cheema, providing valuable awareness through YouTube videos related to different diseases. He has worked extensively in the USA in senior positions, including, as former Medical Director of FMC North America, USA, Former Assistant Professor UTHSC Texas, Former Chief of Medicine LMC Texas.
### **Causes**
- **Chronic kidney disease (CKD):** The most common cause. CKD leads to imbalances in calcium, phosphorus, and vitamin D metabolism.
- **Vitamin D deficiency:** Reduces calcium absorption in the gut.
- **Malabsorption disorders:** Conditions like celiac disease can impair calcium and vitamin D absorption.
- **Hypocalcemia:** Persistent low calcium levels stimulate the parathyroid glands.
---
### **Symptoms**
The symptoms of secondary hyperparathyroidism are often related to its underlying cause and the effects of prolonged elevated PTH. Common symptoms include:
1. **Bone-related symptoms:**
- Bone pain or tenderness.
- Increased risk of fractures (osteopenia or osteoporosis).
2. **Kidney-related symptoms:**
- Kidney stones (less common in secondary hyperparathyroidism than in primary).
- Calcification in soft tissues or organs.
3. **Muscle and joint issues:**
- Muscle weakness or cramps.
- Joint pain.
4. **Neurological and general symptoms:**
- Fatigue.
- Depression or irritability.
- Difficulty concentrating.
5. **Symptoms related to chronic kidney disease:**
- Itching (pruritus) due to high phosphorus levels.
- Vascular calcification or cardiovascular complications in advanced cases.
6. **Calcium-phosphorus imbalance effects:**
- Elevated phosphorus levels (hyperphosphatemia).
- Low calcium levels (hypocalcemia).
---
### **Diagnosis**
Secondary hyperparathyroidism is diagnosed through blood tests showing:
- Elevated PTH levels.
- Low to normal calcium levels.
- High phosphorus levels (in CKD) or vitamin D deficiency.
Bone density scans and imaging studies might be used to assess bone health and detect calcifications.
### **Treatment**
- **Addressing the underlying cause:** Managing CKD, supplementing vitamin D, or correcting malabsorption issues.
- **Dietary modifications:** Reducing dietary phosphorus and increasing calcium intake under medical supervision.
- **Medications:**
- **Vitamin D analogs** or active forms of vitamin D (e.g., calcitriol).
- **Phosphate binders** to lower phosphorus levels.
- **Calcimimetics** to reduce PTH secretion.
- **Surgical intervention:** In severe, refractory cases, parathyroidectomy (surgical removal of parathyroid glands) may be necessary.
Early detection and management can prevent complications like severe bone loss and vascular calcification.
Shafiq Cheema
MBBS(KE), MD (USA), Diplomate American Board Internal Medicine, Diplomate American Board of Nephrology, Fellow American College Physician (FACP), Fellow American College of Nephrology (FASN), Hypertension specialist by ASH...
How to Book an Online appointment:
3 simple steps:
Call & Book an Appointment by calling sim No 0315-238-1111
Send your reports & Meds via WhatsApp
Talk to Professor Shafiq Cheema via Video Call
Ph # 0315-238-1111
For More Information Please Visit our Websites & Social Media:-
#drshafiqcheema #bestnephrologistinlahore
#topnephrologistinlahore #kidneyfailure #hypertension #kidney #nephrologist #dialysis #nephchat #nephchatwithdrshafiqcheema
#topnephrologistinpakistan #bestnephrologisinpakistan #kidneyissues #ckd #chronickideydisease #kidneyspecualist #kidneytips #proteinuria #kidneydiet
Professor Dr. Shafiq Cheema is a Gold Medalist and was the most distinguished Graduate of KEMU, in 1996. He has extensive training & experience in the field of Internal Medicine, Hypertension, and Nephrology. He is a Diplomat American Board of Internal Medicine and Nephrology as well as a Fellow of the American College of Physicians and American Society of Nephrology. He is a renowned Hypertension specialist by ASH. He was lately appointed as Professor of Nephrology at AIMC-Jinnah Hospital. He is amongst America’s top Nephrologists and the world's leading physician. He is the Founder & Patron in Chief of Pak Kidney Foundation (PKF), Chairperson MD Nephrology UHS, and Founder of NephChat with Dr. Shafiq Cheema, providing valuable awareness through YouTube videos related to different diseases. He has worked extensively in the USA in senior positions, including, as former Medical Director of FMC North America, USA, Former Assistant Professor UTHSC Texas, Former Chief of Medicine LMC Texas.
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