Hyperparathyroidism Symptoms: Causes & Treatment Canada

Hyperparathyroidism symptoms can range from bone pain and fatigue to kidney stones and mood changes, yet many Canadians are diagnosed before they even notice something is wrong. This condition occurs when one or more of your parathyroid glands produce too much parathyroid hormone (PTH), causing calcium levels in your blood to rise above normal.

Recognizing Hyperparathyroidism Symptoms Early

Understanding the causes and treatment options for parathyroid gland problems is essential for protecting your long-term health. Whether detected through routine blood work ordered by your family doctor or investigated after unexplained high calcium in blood tests, early awareness can make a significant difference. In this guide, we explain what hyperparathyroidism is, who is most at risk in Canada, and when you should seek medical care.

What Is the Parathyroid Gland?

Types of Hyperparathyroidism: Symptoms, Causes, and Management Approaches

Type	Key Characteristics	Common Hyperparathyroidism Symptoms	Management Approach
Primary Hyperparathyroidism	One or more overactive parathyroid glands; most often caused by a benign adenoma; most common form in Canada	Kidney stones, bone pain, fatigue, frequent urination, depression, nausea, and confusion (“bones, stones, groans, and moans”)	Surgical removal of affected gland(s) (parathyroidectomy); monitoring with regular calcium and PTH blood tests for mild cases
Secondary Hyperparathyroidism	Overproduction of PTH in response to low calcium; commonly linked to chronic kidney disease or severe vitamin D deficiency	Bone weakness, muscle cramps, fatigue, itching, and symptoms related to underlying condition	Treat underlying cause; vitamin D and calcium supplementation; phosphate binders; calcimimetic medications such as cinacalcet
Tertiary Hyperparathyroidism	Parathyroid glands become autonomous after prolonged secondary hyperparathyroidism; often seen in long-term dialysis patients	Severe bone pain, fractures, calcifications in soft tissue, persistent high calcium levels	Parathyroidectomy typically required; ongoing monitoring of calcium and PTH levels post-surgery
Asymptomatic Hyperparathyroidism	Elevated calcium and PTH detected on routine bloodwork with no obvious symptoms; increasingly common due to widespread lab screening in Canada	Often no noticeable symptoms; mild fatigue or slight cognitive changes may be present	Active surveillance with annual calcium, kidney function, and bone density (DEXA) assessments; surgery considered if criteria are met

Most people have four parathyroid glands, each about the size of a grain of rice. They sit behind your thyroid gland, in the front of your neck. Despite being close neighbours, the parathyroid and thyroid glands do very different jobs.

Your parathyroid glands control calcium and phosphorus levels in your body. They do this by releasing parathyroid hormone (PTH). When blood calcium drops too low, PTH signals your bones to release calcium and tells your intestines to absorb more from food. Vitamin D also plays a key role in this process. Health Canada recognizes calcium and vitamin D as essential nutrients for bone health.

Understanding Hyperparathyroidism

Hyperparathyroidism happens when this system breaks down and your parathyroid glands keep releasing PTH even when they should not. As a result, calcium levels in your blood rise too high. This is called hypercalcaemia. Phosphorus levels may fall at the same time.

There are three main types of this condition. Each has a different cause and affects the body in slightly different ways. Knowing which type you have helps your doctor choose the right treatment.

Primary Hyperparathyroidism

Primary hyperparathyroidism means the problem starts inside the parathyroid gland itself. One or more glands begin overproducing PTH without a clear trigger from the rest of the body. This is the most common form of the condition.

The most frequent cause is a benign (non-cancerous) tumour called an adenoma growing on one gland. Less often, two or more glands become enlarged, a condition called hyperplasia. In very rare cases, a cancerous tumour is responsible. Primary hyperparathyroidism can develop suddenly, though some people inherit a gene that makes them more likely to develop it.

Secondary Hyperparathyroidism

Secondary hyperparathyroidism happens when another health condition causes low calcium levels. Your parathyroid glands then work overtime to bring calcium back up. Chronic kidney disease is the most common trigger for this type.

Other causes include a severe lack of calcium in your diet and a serious vitamin D deficiency. Without enough vitamin D, your intestines cannot absorb calcium properly, and blood calcium drops. Your parathyroid glands respond by producing more PTH to compensate.

Tertiary Hyperparathyroidism

Tertiary hyperparathyroidism is less common. It usually develops in people who have had secondary hyperparathyroidism for a long time, often due to chronic kidney disease. Over time, the glands begin producing excess PTH on their own, even if the original problem is treated. This often requires more aggressive management.

Symptoms of Hyperparathyroidism

Many people with hyperparathyroidism have no obvious symptoms at first. The condition is often caught during routine blood tests that show elevated calcium levels. However, when symptoms do appear, they can affect many parts of the body.

Symptoms develop because of damage caused by abnormal calcium levels in the blood, bones, and organs. They can range from mild and vague to quite serious. According to the Mayo Clinic’s guide on hyperparathyroidism, patients often describe feeling generally unwell before a diagnosis is made.

Common Symptoms to Watch For

• Bone and joint pain — aching bones or joints that do not have an obvious cause
• Kidney stones — severe pain in the back or side, often with blood in the urine
• Frequent urination — needing to urinate more often than usual, sometimes with excessive thirst
• Fatigue and weakness — feeling tired or physically weak without explanation
• Depression or forgetfulness — mood changes, feeling low, or having trouble concentrating
• Nausea and vomiting — stomach upset or loss of appetite
• Osteoporosis — weak, brittle bones that fracture more easily
• Abdominal pain — general discomfort or pain in the belly area
• Recurring urinary tract infections — frequent UTIs that keep coming back

These symptoms can look like many other conditions. Therefore, it is important not to self-diagnose. A simple blood test is often all it takes to start getting answers.

Causes and Risk Factors

The underlying causes of hyperparathyroidism depend on the type. In primary hyperparathyroidism, the glands themselves malfunction. In secondary and tertiary types, an external problem forces the glands into overdrive.

Who Is at Higher Risk?

Certain groups of people face a higher risk of developing this condition. Understanding these risk factors can help you and your doctor stay alert. You may be at greater risk if you:

• Are a woman going through or past menopause
• Have a long-term, severe vitamin D or calcium deficiency
• Have chronic kidney disease
• Have a rare inherited disorder, such as Multiple Endocrine Neoplasia Type 1 (MEN1)
• Have had radiation therapy to the neck area for cancer treatment
• Take lithium, a medication used to treat certain mental health conditions

Vitamin D deficiency is particularly common in Canada, especially during the long winter months when sun exposure is limited. Healthline’s overview of vitamin D deficiency explains how low vitamin D levels can affect calcium absorption and overall health. If you are concerned about your vitamin D levels, ask your family doctor about testing.

How Is Hyperparathyroidism Diagnosed?

Diagnosis usually begins with a blood test that checks calcium and PTH levels. If both are elevated, your doctor will likely suspect primary hyperparathyroidism. Your doctor may also check your phosphorus levels and kidney function.

Further tests may include a urine test to measure how much calcium your kidneys are excreting. Imaging tests, such as an ultrasound or a special nuclear medicine scan called a sestamibi scan, can help locate an overactive gland. A bone density scan (DEXA scan) may also be ordered to check for osteoporosis. In Canada, most of these tests are covered under provincial health plans, though wait times may vary depending on where you live.

Treatment Options for Hyperparathyroidism

Treatment depends on the type of hyperparathyroidism, your symptoms, and how high your calcium levels are. Not everyone needs immediate treatment. Your doctor will weigh the benefits and risks before recommending a plan.

Surgery

Surgery is the only permanent cure for primary hyperparathyroidism. A surgeon removes the overactive gland or glands. This procedure is called a parathyroidectomy. It is highly effective and often leads to a full recovery.

Surgery is usually recommended if you have significant symptoms, kidney stones, osteoporosis, or very high calcium levels. Even some people without symptoms may be advised to have surgery, depending on their age and calcium levels.

Monitoring Without Surgery

If your symptoms are mild and your calcium levels are only slightly elevated, your doctor may suggest regular monitoring instead. This means scheduled blood tests, bone density scans, and kidney function checks over time. This approach works well for older adults or those who cannot safely undergo surgery.

Medications and Lifestyle Changes

For secondary hyperparathyroidism, treating the underlying cause is the main goal. This may involve vitamin D supplements, calcium supplements, or medications to control phosphorus levels. Staying well-hydrated, exercising regularly, and eating a balanced diet rich in calcium and vitamin D are also helpful steps. Your family doctor or a specialist called an endocrinologist can guide your treatment plan.

When to See a Doctor

See your family doctor if you notice any of the symptoms listed above, especially if they are new or getting worse. Many of these symptoms — such as fatigue, bone pain, or depression — can be caused by other conditions. However, catching hyperparathyroidism early makes it easier to manage.

You do not need a referral to get a blood test checked. A walk-in clinic can also order basic blood work if your regular doctor is unavailable. If your calcium or PTH levels come back abnormal, you will likely be referred to an endocrinologist or a specialist in parathyroid conditions. Always consult a qualified healthcare provider before drawing any conclusions about your health or starting any new treatment.

Key Takeaways

• Hyperparathyroidism occurs when the parathyroid glands produce too much PTH, raising calcium levels in the blood.
• There are three types: primary (gland malfunction), secondary (caused by another condition), and tertiary (long-term secondary disease).
• Symptoms include bone pain, kidney stones, fatigue, depression, nausea, and frequent urination — but many people have no symptoms at first.
• Chronic kidney disease and vitamin D deficiency are leading causes of secondary hyperparathyroidism, both of which are relevant health concerns in Canada.
• Surgery is the most effective treatment for primary hyperparathyroidism, while secondary forms focus on treating the root cause.
• If you suspect you have symptoms, speak with your family doctor or visit a walk-in clinic. A simple blood test can often point you in the right direction.
• Always consult a qualified healthcare provider before making any decisions about your health or treatment.