Surgery is the only cure for primary hyperparathyroidism. That being the case, there are other treatments and measures that can also be taken for hyperparathyroidism. It is important that patients maintain adequate fluid intake and maintain physical activity. It has been shown that volume depletion or dehydration can worsen hypercalcemia and make one more susceptible to kidney stones. Physical inactivity also increases the mobilization of skeletal calcium into the bloodstream. Hence, it is important to continue to exercise.
Patients with primary hyperparathyroidism should supplement their diet with vitamin D and calcium. Approximately 600mg of elemental calcium with vitamin D should be taken daily (one pill of calcium and vitamin D with most over the counter preparations). This has shown to minimize Parathyroid Hormone (PTH) secretion, bone turnover and calcium loss and thus decrease one’s chance of having osteopenia and osteoporosis.
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 and Pamidronate inhibit PTH-bediated bone resorption in postmenopausal women by inhibiting osteoclast activity. The osteoclasts are cells that break down bone.
3) Calcitonin promotes bone deposition by stimulating osteoblasts. The osteoclasts are cells that build up bone.
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.
Can PTH Levels Return to Normal?
Yes, but only after removal of the abnormal tumor. Elevated PTH caused by hyperparathyroidism will not fix itself in time. Only the removal of the bad parathyroid gland will cure the parathyroid disease.
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