Primary Hyperparathyroidism

What is Primary Hyperparathyroidism?

Primary hyperparathyroidism occurs when one or more of the parathyroid glands become abnormal and increase production of parathyroid hormone (PTH). The parathyroid glands use PTH production to regulate and maintain calcium levels in the body. When the parathyroid glands produce too much PTH, calcium levels can become elevated. If left untreated, the calcium increase can lead to osteoporosis and kidney stones. 

At Tampa General Hospital’s Parathyroid & Thyroid Institute, our expert surgeons diagnose and treat primary hyperparathyroidism daily. Our patients are our top priority, and we offer the highest cure rates for the condition. Recognized as One of the Nation's Best and Highest Ranked Hospital in Florida for Ear, Nose & Throat by U.S. News & World Report 2024-25, TGH attracts patients from around the globe.     

What Causes Primary Hyperparathyroidism? 

In the order of most to least common, the following abnormalities of the parathyroid glands can cause PTH production to rise: 

  • Adenomas – benign tumors that grow on one or more parathyroid glands (majority)
  • Hyperplasia – all four parathyroid glands are enlarged or overactive (10% of cases)
  • Cancer – a malignant tumor that grows from a parathyroid gland (extremely rare)

What Are the Symptoms of Primary Hyperparathyroidism

Not every patient with primary hyperparathyroidism will have symptoms. This is just one reason why regular blood tests can be an important part of monitoring one’s health. Those that do have syptoms may experience: 

  • Abdominal pain (pancreatitis, constipation and GERD) 
  • Brittle bones (osteoporosis or osteopenia) 
  • Decreased kidney function 
  • Depression 
  • Anxiety
  • Heart disease (atrial fibrillation and coronary artery disease)
  • Increased urination 
  • Joint pain 
  • Bone pain
  • Kidney stones 
  • Loss of appetite 
  • Muscle weakness 
  • Nausea or vomiting 
  • Hair loss
  • Hypertension

How Is Primary Hyperparathyroidism Diagnosed? 

Commonly, primary hyperparathyroidism is found during a routine blood test. If your blood test shows elevated levels of calcium (above 10.2), your doctor may order one or more of the following tests: 

  • A bone mineral density test to measure how many grams of calcium and other minerals are found in a bone segment 
  • A urine test that will collect your urine in a 24-hour period to determine how much calcium is excreted in the urine and how well your kidneys are working 
  • Imaging tests, such as an X-ray, to evaluate your kidneys 

How Is Primary Hyperparathyroidism Treated? 

There are various ways to treat primary hyperparathyroidism and the treatment plan will vary from patient to patient. At Tampa General Hospital, our parathyroid surgeons have completed more than 35,000 parathyroid gland examinations combined and recommend the following treatments for patients with primary hyperparathyroidism: 


  • Medication: Hormone replacement therapy, calcimimetics and bisphosphonates are some of the medications used to treat primary hyperparathyroidism. We only recommend it when patients are too sick to have surgery.
  • Surgery: Surgery is the only treatment that provides a cure. At TGH’s Parathyroid & Thyroid Institute, our surgeons perform several procedures to treat primary hyperparathyroidism, including:
    • Minimally invasive radioguided parathyroidectomy (MIRP): A surgery requiring a small, one-inch incision to remove only enlarged glands or parathyroid tumors; if all four glands are enlarged, a portion of the fourth gland may remain to provide the patient with functioning parathyroid tissue. This procedure is a quick outpatient surgery that takes just 20-25 minutes to perform
    • Reoperative parathyroidectomy: A procedure performed to discover and remove parathyroid glands that may have been missed during a previous surgery
    • Complex dual surgery: A procedure that involves the removal of both the parathyroid and thyroid glands

Why Choose Tampa General Hospital

Doctors Politz and Lopez are two of the leading parathyroid surgeons in the world operating today. Together they have performed more parathyroid operations than any other pair of surgeons during the last decade. As parathyroid specialists, they only work with patients who have parathyroid disorders and are extremely knowledgeable thanks to their 30 years of combined experience.

Both doctors work on every case together, along with their entire team. This means that each patient receives the collective experience and knowledge of many medical experts at TGH’s Parathyroid & Thyroid Institute.

We treat patients from all over the world and have close to 100% cure rates. Our parathyroid treatments are outpatient procedures with quick recovery times and low complication rates.

Plus, our team is dedicated to making the entire process easy and as worry-free as possible for our patients. We accomplish this by ensuring that each patient has the resources to understand the treatment process. We help them understand their condition, teach them how to navigate MyChart and more.

Lastly, one of the most simple but meaningful differences between TGH’s Parathyroid & Thyroid Institute and other parathyroid clinics is that we do not charge extra fees for consultations. We understand that dealing with primary hyperparathyroidism or thyroid cancer can cause unease for a patient, and we want to ensure our patients feel comfortable and cared for without added expenses.