Medical Matters > Hyperparathyroidism

ME Essential Spring 2023

Question

Many symptoms of Hyperparathyroidism are similar to ME/CFS and Fibromyalgia. Would a GP be able to recognise hyperparathyroidism and what are the treatment options?

Answer

As you indicate, hyperparathyroidism can cause a number of symptoms that are the same, or similar, to those found in ME/CFS:

  • depression.
  • tiredness.
  • feeling thirsty and passing a lot of urine.
  • feeling sick and losing your appetite.
  • muscle weakness.
  • constipation.
  • stomach pain.
  • loss of concentration.
  • mild confusion.

If the condition is not recognised early on it can then cause blood calcium levels to rise (hypercalcaemia), which may cause:

  • feeling or being sick.
  • drowsiness.
  • confusion.
  • muscle spasms.
  • bone pain or tenderness.
  • joint pain.
  • irregular heartbeat.
  • high blood pressure (hypertension).

This is why the ME Association recommends that the level of calcium in the blood should always be checked before a diagnosis of ME/CFS is made. As far as recognition is concerned, this is a fairly unusual condition. So it’s something that is more likely to be diagnosed by a specialist. Having said that, if someone has a raised level of calcium on a GP blood test then this should always be investigated further. Treatment options are available should you receive this diagnosis depending on whether the hyperparathyroidism is primary, secondary, or tertiary – see information from The NHS, below.

More information

Treating primary hyperparathyroidism

        • Surgery to remove the parathyroid gland is usually the only way of treating primary hyperparathyroidism.
        • If your calcium levels are very high, you may need to be admitted to hospital urgently if you have lost a lot of fluids (dehydration). You may need to have fluids through an intravenous drip.
        • Medicine called bisphosphonates may also be given to lower calcium. These are only used as a short-term treatment. Surgery will be needed once the calcium levels are stabilised.
        • For people who are unable to have surgery – for example, because of other medical conditions or they're too frail – a tablet called cinacalcet may be used to help control the condition.
        • Make sure you have a healthy, balanced diet.
        • You do not need to avoid calcium altogether. A lack of dietary calcium is more likely to lead to a loss of calcium from your skeleton, resulting in brittle bones (osteoporosis).
        • But you should avoid a high-calcium diet and drink plenty of water to prevent dehydration.
        • Medicines such as thiazide diuretics (water tablets commonly used to treat high blood pressure) should be avoided because they can cause dehydration and raise calcium levels.
Treating secondary hyperparathyroidism

    • Treatment for secondary hyperparathyroidism depends on the underlying cause.
    • Low vitamin D is the most common cause and can be corrected with oral vitamin D (colecalciferol).
    • Another common cause is kidney disease.
Treating tertiary hyperparathyroidism

    • Surgery is usually the main treatment for tertiary hyperparathyroidism that occurs in very advanced kidney failure.

MEDICAL DISCLAIMER

Information provided by The ME Association should not be construed as medical advice. Don't assume any new or worsened symptoms are simply the result of having ME/CFS or Long Covid. We recommend that any information you deem relevant is discussed with your NHS GP as soon as possible. It is important that you seek personalised medical advice from the GP who is in charge of your care and who knows you well.

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