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So you have primary hyperparathyroidism.

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So you have primary hyperparathyroidism

You may feel fine * but you could need surgery.

If you've been told that you have primary hyperparathyroidism, chances are the diagnosis came as a complete surprise. It's typically discovered in the course of blood testing for other reasons, and there are usually no symptoms * or only nonspecific ones, such as fatigue, constipation, aches and pains, trouble concentrating, or low mood. Primary hyperparathyroidism occurs mainly in postmenopausal women, who may blame such vague symptoms on other health problems or just on normal aging. In the United States, about one in 500 women ages 60 and over develops the disorder each year.

At one time, the condition was recognized only when it had progressed to the point of causing serious problems such as bone disease, kidney stones, gastrointestinal disorders, and cognitive difficulties * classic signs and symptoms that clinicians have dubbed "the bones, stones, abdominal moans, and groans." These days, some people with primary hyperparathyroidism do have such symptoms. But since the introduction of automated blood chemistry screening in the 1970s, clinicians have been able to detect the disease, which causes elevated levels of calcium in the blood (hypercalcemia), before symptoms appear. This raises the question of what to do about asymptomatic (non-symptomatic) primary hyperparathyroidism, which now accounts for 80% of cases. Most people with asymptomatic primary hyperparathyroidism can have a fairly benign course for years, even a lifetime. But the condition does progress in some people, and they should undergo surgery, which is the only complete cure, as soon as possible. The question is, who?

Expert panels have met three times since 1990 to review the evidence and update guidelines for managing the disorder in people without symptoms, in an effort to identify those most likely...

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