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Signs and symptoms of primary hyperparathyroidism can range from none or very mild to extremely serious. Measurable signs of abnormally functioning parathyroid glands may include:

• Brittle bones (osteopenia and osteoporosis) which can lead to fractures
• Kidney stones and decreased kidney function
• Increased acid secretion in the stomach with may lead to gastritis or ulcers
• Pancreatitis
• Heart disease

Since the symptoms of primary hyperparathyroidism can be non-existent or very mild for a long time, the condition is often discovered as part of routine blood testing done at the time of a yearly routine physical examination or at the time of evaluation for another unrelated medical condition. If a patient goes to a physician already experiencing some of the above signs or symptoms, blood tests can be ordered to check for primary hyperparathyroidism. Common tests ordered to check for primary hyperparathyroidism include serum and/or ionized calcium, parathyroid hormone, basic metabolic panel, phosphorous, 25 hydroxy vitamin D, and 24-hour urine for calcium and creatinine.

How are abnormal parathyroid glands located?

A number of different types of imaging studies may be used to locate abnormal parathyroid glands, but even if someone has the disease, an abnormal gland or multiple abnormal glands may not show up on the imaging study. Primary hyperparathyroidism is a biochemical (lab) diagnosis, so parathyroid surgery should not be dismissed if an abnormal gland is not identified by imaging. Often, the glands hide behind other structures and can’t be seen until structures can be moved out of the way during surgery. The most common imaging studies obtained are ultrasound and sestamibi scans, but CT, MRI, and other types of imaging studies may also be ordered.