page_title: Hyperparathyroidism
section_title: Diagnosis
hierarchical_section_title: Hyperparathyroidism / Diagnosis
caption_attribution_description: English: Calcification in the brain due to hyperparathyroidism (Phar's syndrome)
context_page_description: Hyperparathyroidism is an increase in parathyroid hormone levels in the blood. This occurs from a disorder either within the parathyroid glands or outside the parathyroid glands. Most people with primary disease have no symptoms at the time of diagnosis. When symptoms occur, they are due to elevated blood calcium. With long-standing elevation, the most common symptom is kidney stones. Other symptoms may include bone pain, weakness, depression, confusion, and increased urination. Both primary and secondary may result in osteoporosis.
  In 80% of cases, primary hyperparathyroidism is due to a single benign tumor known as a parathyroid adenoma. Most of the remainder are due to several of these adenomas. Rarely it may be due to parathyroid cancer. Secondary hyperparathyroidism typically occurs due to vitamin D deficiency, chronic kidney disease, or other causes of low blood calcium. The diagnosis of primary hyperparathyroidism is made by finding elevated calcium and PTH in the blood.
  Primary hyperparathyroidism may be cured by removing the adenoma or overactive parathyroid glands.
context_section_description: The gold standard of diagnosis is the PTH immunoassay. Once an elevated PTH has been confirmed, the goal of diagnosis is to determine whether the hyperparathyroidism is primary or secondary in origin by obtaining a serum calcium level:
  Tertiary hyperparathyroidism has a high PTH and a high serum calcium.  It is differentiated from primary hyperparathyroidism by a history of chronic kidney failure and secondary hyperparathyroidism.
  Hyperparathyroidism can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis.
caption: Calcification in the brain due to hyperparathyroidism
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