Hyperparathyroidism Treatment

Surgery is the only cure for primary hyperparathyroidism.  That being the case there are other measures that can also be taken.  It is important that patients maintain adequate fluid intake and maintain physical activity.  It has been shown that volume depletion or dehydratoin can worsen hypercalcemia and make you more susceptible to kidney stones.  Also physical inactivity increases the mobilization of skeletal calcium into the bloodstream.  Hence, it is important to continue to exercise.

Patients with primary hyperparathyroidism should supplement with vitamin D and calcium. Approximately 600mg or one calcium pill with vitamin D should be taken daily.  This has shown to minimize PTH secretion, bone turnover and calcium loss.

Drug therapy is usually reserved for patients who are unable to undergo surgery for some reason. This is not a cure, but a temporizing measure.  Drug therapy includes the following classes:

1) Estrogens or progestins inhibit PTH-mediated bone resorption in postmenopausal women.
2) Biphosphonates like Raloxifene, Alendronate, Risedronate nad Pamidronate inhibit PTH-bediated bone resoprtoin in postmenopausal women by inhibiting osteoclast activity.
3) Calcitonin promotes bone deposition by stimulating osteoblasts.
4) Sensipar (generic cinacalcet) and other similar drugs may be used in secondary hyperparathyroidism.  It increases the sensitivity of the parathyroid gland to the calcium in the body.  This causes a decrease in levels of PTH, calcium and phosphorus in the body.