Primary Hyperparathyroidism

National patient organisation for people with any type of parathyroid condition

In Primary Hyperparathyroidism (PHPT or Hyperpara), too much parathyroid hormone is produced by one or more of the parathyroid glands because they have become enlarged or overactive. This in turn causes the body to release calcium from the bones into the blood and results in high calcium levels (hypercalcaemia).


  • The most common cause of PHPT is a parathyroid gland becoming enlarged due to the development of a benign (non-cancerous) tumour called an adenoma. This is more commonly diagnosed in women, particularly postmenopausal women, but can affect both men and women and all ages, including, less commonly, children.
  • Sometimes all four parathyroid glands may become enlarged – this is called parathyroid hyperplasia. This may occur sporadically (without a family history) or as part of three familial (inherited) syndromes: multiple endocrine neoplasia 1 (MEN 1) and MEN 2A, and isolated familial hyperparathyroidism. In MEN 1, the problems in the parathyroid glands are associated with other tumours in the pituitary and the pancreas. In MEN 2A, overactivity of the parathyroid glands is associated with tumours in the adrenal gland or thyroid.
  • Radiotherapy treatment to your head or neck may increase the risk of developing a parathyroid adenoma or carcinoma (cancer). Only in extremely rare cases indeed will the tumour be due to parathyroid cancer. If you have been diagnosed with parathyroid cancer please go to our Parathyroid Cancer


In Primary Hyperparathyroidism you may not notice any specific symptoms, or you may just feel ‘not quite right’, but for many the symptoms can be severely debilitating. Sometimes the condition is only discovered by chance while investigating something else.

Many of the symptoms of PHPT are vague, and as a result the condition can go undiagnosed for long periods. Tiredness, anxiety, thirst, polyuria (frequent urination), and body aches and pains can all be features of PHPT.

There does not seem to be any correlation between particular symptoms and the level of calcium in the blood. People with a slightly high calcium levels may have very severe symptoms while people with very high calcium levels may not be aware of their symptoms. This may be because the condition can develop over a long period of time and a gradual change is harder to notice.

For some people, symptoms may be subtle and develop gradually, and as a result are sometimes attributed to other causes such as menopause, depression, chronic fatigue, fibromyalgia, or to stress and the general pressures of life.

As calcium is found in every cell in the body, high levels of calcium and parathyroid hormone can affect bone, kidneys, muscles, nerves and the gut, as well as the emotions and cognitive function.

A substantive poll of our hyperpara members at Parathyroid UK members found the most common symptoms, in order of frequency, to be:

  • fatigue/ feeling tired and lethargic
  • brain fog / loss of concentration/ confusion
  • anxiety/depression/low mood/lack of enthusiasm in life
  • muscle pain and weakness
  • bone pain
  • joint pain
  • irritability
  • frequent urination
  • increased thirst
  • digestive problems, eg gastroesophageal reflux disease (GERD)
  • insomnia

Other warning signs can include:

  • loss of appetite
  • nausea
  • constipation
  • upper abdominal pain
  • migraine like headaches