Early primary hyperparathyroidism prevalent in premenopausal women

Issue: February 2008

Mild disturbances in calcium homeostasis may be more common among premenopausal women than was previously thought, according to a recent study.

The researchers estimated the prevalence of mild disturbances in calcium homeostasis by conducting a population-based screening of serum calcium in 1,900 premenopausal women aged 40 to 50. Two hundred fourteen women met the criteria for primary hyperparathyroidism and were matched with 214 controls.

The findings revealed that 5.1% of women (n=96) were assumed to have mild primary hyperparathyroidism. Further, women with minor disturbances in calcium homeostasis had impaired BMD in the proximal femur and femoral neck, higher BMI and decreased quality of life. – by Katie Kalvaitis

J Clin Endocrinol Metab. 2008;93:47-53.

This article has important findings in two areas. The first is that we are realizing that hyperparathyroidism is not as uncommon as once thought. A lot of patients with this disease are misdiagnosed or are not being diagnosed. The second important finding here is that the quality of life was poor compared with people who do not have parathyroid disease – even in patients with mild hyperparathyroidism. We have been saying this for many years. In our recent review of our last 8,000 patients with parathyroid disease, less than 5% said they are asymptomatic. Others have shown that too, but for some reason the endocrinology literature is replete with researchers who report small numbers of select patients and say the patients are asymptomatic. They are not without symptoms if you ask the right questions or have them fill out quality of life questionnaires as this group did. The number one symptom is chronic fatigue and this is a large part of their decreased quality of life scores. The next thing to do is get it fixed and let the patient move on with their life.

– James Norman, MD, FACS, FACE

Parathyroid Surgeon, Norman Parathyroid Surgery Clinic, Tampa