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Tests and diagnosis

By Mayo Clinic staff

Blood tests
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.
  • 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 a combination of two imaging tests to locate the parathyroid gland or glands that are causing problems:

  • 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.
  • Sestamibi scan. Sestamibi is a specially designed radioactive compound that is absorbed by overactive parathyroid glands and can be detected on computerized tomography (CT) scans. A small dose of the compound is injected into your bloodstream before the imaging test is done.
Treatments and drugs Preparing for your appointment

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References
  1. Hyperparathyroidism. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.endocrine.niddk.nih.gov/pubs/hyper/hyper.htm. Accessed March 3, 2011.
  2. El-Hajj Fuleihan G. Diagnosis and differential diagnosis of primary hyperparathyroidism. http://www.uptodate.com/home/index.html. Accessed March 1, 2011.
  3. El-Hajj Fuleihan G. Clinical manifestations of primary hyperparathyroidism. http://www.uptodate.com/home/index.html. Accessed March 1, 2011.
  4. Potts JT. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. In: Fauci AS, et al. Harrison's Online. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=2903222&searchStr=hyperparathyroidism#2903222. Accessed Feb. 28, 2011.
  5. El-Hajj Fuleihan G. Pathogenesis and etiology of primary hyperthyroidism. http://www.uptodate.com/home/index.html. Accessed March 1, 2011.
  6. Fitzgerald PA. Hyperparathyroidism. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 50th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=14894&searchStr=hyperparathyroidism. Accessed March 1, 2011.
  7. Silverstein SJ. Management of primary hyperthyroidism. http://www.uptodate.com/home/index.html. Accessed March 1, 2011.
  8. Estrogen and progestin combination (Ovarian hormone therapy) (Oral route). Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 3, 2011.
  9. Bisphosphonates. Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 3, 2011.
  10. Dietary supplement fact sheet: Vitamin D. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts. Accessed March 3, 2011.
  11. Dietary supplement fact sheet: Calcium. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/Calcium-QuickFacts. Accessed March 3, 2011.
DS00396 May 13, 2011

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