If the result of a blood test indicates you have elevated calcium in your blood, your doctor will likely repeat the test to confirm the results after you have not eaten for a period of time (fasted).
A number of conditions can raise calcium levels, but your doctor can make a diagnosis of hyperparathyroidism if blood tests show you also have elevated parathyroid hormone.
Additional diagnostic tests
After making a diagnosis of hyperparathyroidism, your doctor will likely order additional tests to rule out possible secondary causes, to identify possible complications and to judge the severity of the condition. These tests include:
Bone mineral density test (bone densitometry). The most common test to measure bone mineral density is dual energy X-ray absorptiometry, or a DXA scan.
This test uses special X-ray devices to measure how many grams of calcium and other bone minerals are packed into a segment of bone.
Urine tests. A 24-hour collection of urine can provide information on how well your kidneys function and how much calcium is excreted in your urine.
This test may help in judging the severity of hyperparathyroidism or diagnosing a kidney disorder causing hyperparathyroidism. If a very low level of calcium in the urine is found, this may indicate a condition that doesn't require treatment.
- Imaging tests of kidneys. Your doctor may order X-rays or other imaging tests of your abdomen to determine if you have kidney stones or other kidney abnormalities.
Imaging tests before surgery
If your doctor recommends surgery, he or she will likely use one of these imaging tests to locate the parathyroid gland or glands that are causing problems:
May 28, 2014
Sestamibi parathyroid scan. Sestamibi is a radioactive compound that is absorbed by overactive parathyroid glands and can be detected by a scanner that detects radioactivity.
The normal thyroid gland also absorbs sestamibi. To eliminate uptake in the thyroid obscuring the uptake in a parathyroid adenoma, radioactive iodine, which is only taken up by the thyroid, is also given and the thyroid image is digitally subtracted.
Computerized tomography (CT) scanning may be combined with the scan to improve detection of an abnormality.
Ultrasound. Ultrasound uses sound waves to create images of your parathyroid glands and surrounding tissue.
A small device held against your skin (transducer) emits high-pitched sound waves and records the sound wave echoes as they reflect off internal structures. A computer converts the echoes into images on a monitor.
- Primary hyperparathyroidism. National Endocrine and Metabolic Diseases Information Service. http://endocrine.niddk.nih.gov/pubs/hyper/. Accessed Feb. 15, 2014.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Feb. 15, 2014.
- El-Hajj Fuleihan G. Pathogenesis and etiology of primary hyperthyroidism. http://www.uptodate.com/home. Accessed Feb. 15, 2014.
- Papadakis MA, et al. Current Medical Diagnosis & Treatment 2014. 53rd ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Feb. 15, 2014.
- Bilezikian JP, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: Summary statement from the third international workshop. Journal of Clinical Endocrinology and Metabolism. 2009;94:335.
- Hormone replacement therapy. Micromedex 2.0 Healthcare Series. http://www.micromedexsolutions.com. Accessed Feb. 15, 2014.
- Vitamin D: Fact sheet for consumers. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts. Accessed Feb. 15, 2014.
- Calcium: Fact sheet for consumers. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/Calcium-QuickFacts. Accessed Feb. 15, 2014.
- Smoking and bone health. NIH Osteoporosis and Related Bone Diseases — National Resource Center. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/bone_smoking.asp. Accessed Feb. 15, 2014.
- Korkmaz HA, et al. Neonatal seizure as a manifestation of unrecognized maternal hyperparathyroidism. Journal of Clinical Research in Pediatric Endocrinology. 2013;5:206.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 28, 2014.
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