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what are the symptoms of hyperparathyroidism?

does osteoporosis improve after parathyroidectomy?


Hyperparathyroidism is due, in the majority of cases, to one or more small benign tumours  (parathyroid adenomas) located close to the thyroid gland. These tumours  secrete excess parathyroid hormone (PTH) which stimulates the osteoclast bone cells to deplete the bones of calcium leading to osteoporosis and minimal trauma fractures. The excess calcium then gets deposited throughout the body, essentially slowly turning the tissues to concrete, with a multitude of adverse outcomes and symptoms.  The classic constellation of symptoms  of “Bones, Stones, Moans and Groans” (osteoporosis and fracture, kidney stones, constipation and abdominal pain and neuropsychiatric disturbances and depression) is now recognized as only part of the wider spectrum of hyperparathyroidism related symptomatology.  Most symptoms improve after parathyroidectomy but there is a wide range in actual improvement. Additionally other factors can contribute to, and overlap as the cause of some of the more non-specific symptoms.


OSTEOPOROSIS improves after parathyroidectomy, with bone mineral density returning to the expected normal levels in 12 months in over 90% of patients. A number of studies have shown that this is associated  with a reduction in the risk of fracture.


KIDNEY STONES stop forming after parathyroidectomy, although any small stones present before operation will still need to pass.


ABDOMINAL SYMPTOMS include not just constipation and pains but also nausea  and anorexia. These symptoms improve rapidly.


NEUROPSYCHIATRIC SYMPTOMS are common and include disturbed sleep patterns, daytime tiredness and lethargy, loss of “executive functioning” such as memory and decision making, as well as depression and anxiety. Most  improve within a month an underlying disorder other than hyperparathyroidism contributing.


FIBROMYALGIA AND ARTHRALGIA with aches and pains in the joints and muscles are both very common and generally improve within days of surgery.


HYPERTENSION is common due to calcification of the arteries and leads to a doubling of the risk of heart attacks. There is some improvement although the damage to the arteries, especially if the hyperparathyroidism is longstanding,  may never fully recover even with successful surgery


EXCESS THIRST AND URINARY FREQUENCY is common as the body tries to dilute the excess calcium in the blood. It recovers quickly after parathyroidectomy.

Professor Delbridge parathyroid surgeon Sydney osteoporosis symptoms improve after parathyroidectomy
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