Hyperparathyroidism
Primary hyperparathyroidism is the most common cause of hypercalcemia in outpatients, caused by autonomous overproduction of parathyroid hormone (PTH) — usually by a single benign parathyroid adenoma. Mild hypercalcemia may be asymptomatic and found on routine labs. Moderate to severe hypercalcemia causes a broad range of symptoms affecting multiple organ systems.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
The classic mnemonic is 'bones, stones, groans, and psychic moans': osteoporosis (bone loss), nephrolithiasis (kidney stones), gastrointestinal symptoms (nausea, constipation, abdominal pain), and neurocognitive effects (fatigue, cognitive slowing, depression, anxiety). Many patients are asymptomatic on current surveillance criteria.
Causes & Risk Factors
A single parathyroid adenoma is responsible in 85% of cases. Multigland hyperplasia accounts for 15%. Parathyroid carcinoma is rare (less than 1%). Risk factors include previous head and neck radiation, lithium use, and MEN syndromes.
How We Evaluate
Elevated calcium with inappropriately normal or elevated PTH confirms primary hyperparathyroidism. We check 24-hour urine calcium (to exclude familial hypocalciuric hypercalcemia), 25-OH-D, creatinine, and phosphorus. Sestamibi nuclear scan and ultrasound localize the adenoma preoperatively. DEXA assesses bone impact.
Treatment Options
Parathyroidectomy is the only curative treatment and is recommended for symptomatic disease and most asymptomatic patients under age 50, or with hypercalcemia above 1 mg/dL above the upper limit of normal, T-score below −2.5, eGFR below 60, or a kidney stone. For patients not undergoing surgery, we monitor calcium, creatinine, and DEXA every 1–2 years.
When It Is Urgent
Hypercalcemic crisis — calcium above 14 mg/dL with nausea, vomiting, confusion, and severe weakness — is a medical emergency requiring IV hydration, loop diuretics, and urgent endocrine or surgical consultation.
Frequently Asked Questions
Do I need a referral to see an endocrinology provider?
No referral is needed at Nomi Beach Health. You can book directly with our team for hormone, thyroid, metabolic, or weight-management concerns.
How long does it take to see results from treatment?
Timeline depends on the condition. Thyroid medication often improves symptoms within four to eight weeks. Weight-loss interventions show measurable changes in four to twelve weeks. Hormone therapy timelines vary by the specific condition and individual response.
Will I need labs before my first visit?
You can come in without prior labs — we order whatever is appropriate during or after your visit. If you have recent results, bring them so we can start the conversation right away.
Are these conditions managed long-term or treated once?
Most endocrine and metabolic conditions require ongoing management rather than a single treatment. We build a follow-up schedule around your specific diagnosis and goals.
Can I be seen for weight loss even if I do not have a hormone diagnosis?
Yes. We evaluate weight holistically — including metabolic markers, lifestyle factors, and, when appropriate, medication options such as GLP-1 agonists.
Get a Clear Plan for Hyperparathyroidism
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.