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Difference Between Hyperparathyroidism and Hyperthyroidism

What is Hyperparathyroidism?

Hyperparathyroidism is a disease, resulting from increased production of parathyroid hormone by the parathyroid glands.

Hyperparathyroidism may be primary, secondary, and tertiary. It is also known as Recklinghausen syndrome.

Primary hyperparathyroidism may result from solitary or multiple adenoma of the parathyroid glands or from hyperplasia of the cells. Rarely it can be a part of the MEN-syndrome (multiple endocrine neoplasias).

Secondary hyperparathyroidism occurs when, due to a disease, there is a decrease in serum calcium. The parathyroid glands react with increased secretion of parathyroid hormone. The most common cause of secondary hyperparathyroidism is a chronic renal failure.

Tertiary hyperparathyroidism occurs in case of hypercalcemia during the course of secondary hyperparathyroidism.

In primary hyperparathyroidism, the symptoms include:

  • Nephrolithiasis, nephrocalcinosis, polyuria, polydipsia, renal insufficiency;
  • Negative bone balance, subperiosteal osteolysis, diffuse osteopenia;
  • Dizziness, constipation, weight loss, acute pancreatitis;
  • Rapid tiredness, muscle weakness, atrophy, etc.;
  • Rhythm disorders of the heart;
  • Mental symptoms;
  • Calcium deposits in soft tissues, etc.

A rare complication is the so-called hypercalcemic crisis, characterized by polydipsia, polyuria, vomiting, dyspnoea, adynamia, psychological abnormalities, somnolence, and coma.

The secondary hyperparathyroidism is characterized by the symptoms of chronic renal failure. Hyperparathyroidism may lead to pain in the bones, muscular weakness, waddling gait, etc.

The diagnosis of hyperparathyroidism is based on the clinical picture and laboratory data. The diagnosis of primary hyperparathyroidism is based on multiple determinations of the levels of parathyroid hormone and serum calcium. They are elevated in 90% of the cases.

In secondary hyperparathyroidism caused by kidney disease, the levels of urea and creatinine are elevated, serum calcium is normal or decreased, and renal anemia and hyperphosphatemia occur. X-ray examination helps to detect the signs of bone damage in secondary hyperparathyroidism.

Primary hyperparathyroidism, which is most often due to a parathyroid adenoma, is treated by surgical removal of the enlarged gland. Treatment of hypercalcemic crisis may be necessary.

The treatment of secondary hyperparathyroidism involves a decrease in the uptake of phosphates and calcium-containing preparations that bind phosphates and substitution treatment with Calcitriol.

 

What is Hyperthyroidism?

Hyperthyroidism is a condition of increased thyroid function. The immunogenic hyperthyroidism, in particular, is also known as Graves’ disease.

Hyperthyroidism can be caused by an adenoma in the thyroid gland or enlarged volume of the thyroid as a result of iodine deficiency. Rarely it can occur with some inflammatory thyroid diseases, a malignant process, or as a result of medical treatment.

Graves’ disease is an autoimmune disease. Hyperthyroidism, in this case, can be with or without enlargement of the thyroid gland.

In 70-90% of the patients with hyperthyroidism, there is an increase in the thyroid volume. Typical symptoms are psychomotor agitation, tremor, nervousness, insomnia, tachycardia, rhythm disorders, weight loss with increased appetite, hunger. There may be disturbances in the menstrual cycle, disorders of calcium-phosphate metabolism, carbohydrate metabolism, protein metabolism, heat intolerance, and diarrhea.

In the case of Graves’ disease, additional symptoms are endocrine ophthalmopathy (exophthalmos) and pretibial edema.

A rare complication of hyperthyroidism is the thyrotoxic coma.

The diagnosis is based on the clinical picture and at results of laboratory tests. Individuals with hyperthyroidism have an elevated free thyroxine index (FT4). Very often patients with hyperthyroidism have an elevated triiodothyronine (T3) level. In some cases the thyroid stimulating hormone (TSH) is low, the FT4 is normal, and only the T3 is elevated.

The treatment depends on the age of the patient and the form of the hyperthyroidism. It includes:

  • Medications (thyreostatics) – cause chemical blockade of thyroid hormone synthesis;
  • Operative treatment;
  • Radioiodine treatment.

The thyreotoxic crisis is treated with thyreostatics and with infusions of water-electrolyte solutions, beta-blockers, corticosteroids, sedative preparations, lowering of the body temperature, etc.

 

Difference Between Hyperparathyroidism and Hyperthyroidism

Definition

Hyperparathyroidism: Hyperparathyroidism is a disease, resulting from increased production of parathyroid hormone by the parathyroid glands.

Hyperthyroidism: Hyperthyroidism is a condition of increased thyroid function.

Types

Hyperparathyroidism: Hyperparathyroidism may be primary, secondary, and tertiary.

Hyperthyroidism: The immunogenic hyperthyroidism is also known as Graves’ disease.

Etiology

Hyperparathyroidism: Primary hyperparathyroidism may result from adenoma of the parathyroid glands or from hyperplasia of the cells. Secondary hyperparathyroidism occurs when, due to a disease, there is a decrease in serum calcium. Tertiary hyperparathyroidism occurs when hypercalcemia occurs during the course of secondary hyperparathyroidism.

Hyperthyroidism: Hyperthyroidism can be caused by adenoma in the thyroid gland or enlarged volume of the thyroid as a result of iodine deficiency. Rarely it can occur with some inflammatory thyroid diseases, a malignant process, or as a result of medical treatment. Graves’ disease is an autoimmune disease.

Symptoms

Hyperparathyroidism: The symptoms of hyperparathyroidism include nephrolithiasis, nephrocalcinosis, polyuria, polydipsia, renal insufficiency, negative bone balance, subperiosteal osteolysis, diffuse osteopenia, dizziness, constipation, weight loss, acute pancreatitis, rhythm disorders of the heart, etc.

Hyperthyroidism: The symptoms of hyperthyroidism include increased thyroid volume, psychomotor agitation, tremor, nervousness, insomnia, tachycardia, rhythm disorders, weight loss with increased appetite, hunger, disturbances in the menstrual cycle, disorders of calcium-phosphate metabolism, carbohydrate metabolism, protein metabolism, heat intolerance, and diarrhea. In the case of Graves’ disease, additional symptoms are endocrine ophthalmopathy and pretibial edema.

Diagnose

Hyperparathyroidism: The diagnosis of primary hyperparathyroidism is based on multiple determinations of the levels of parathyroid hormone and serum calcium. In secondary hyperparathyroidism caused by kidney disease, the levels of urea and creatinine are elevated, serum calcium is normal or decreased, and renal anemia and hyperphosphatemia occur.

Hyperthyroidism: Individuals with hyperthyroidism have an elevated FT4 and often – an elevated T3 level. In some cases the TSH is low, the FT4 is normal, and only the T3 is elevated.

Treatment

Hyperparathyroidism: Primary hyperparathyroidism is treated by rapid surgical removal of the enlarged gland. The treatment of secondary hyperparathyroidism involves a decrease in the uptake of phosphates, calcium-containing preparations that bind phosphates and substitution treatment with Calcitriol.

Hyperthyroidism: The treatment of hyperthyroidism includes medications, operative treatment, and radioiodine treatment.

Hyperparathyroidism and Hyperthyroidism: Comparison Chart

 

Summary of Hyperparathyroidism vs. Hyperthyroidism :

  • Hyperparathyroidism is a disease, resulting from increased production of parathyroid hormone by the parathyroid glands.
  • Hyperthyroidism is a condition of increased thyroid function.
  • Hyperparathyroidism may be primary, secondary, and tertiary. The immunogenic hyperthyroidism is also known as Graves’ disease.
  • Primary hyperparathyroidism may result from adenoma of the parathyroid glands or from hyperplasia of the cells. Secondary hyperparathyroidism occurs when, due to a disease, there is a decrease in serum calcium. Tertiary hyperparathyroidism occurs when hypercalcemia occurs during the course of secondary hyperparathyroidism. Hyperthyroidism can be caused by adenoma in the thyroid gland or enlarged volume of the thyroid as a result of iodine deficiency. Graves’ disease is an autoimmune disease.
  • The symptoms of hyperparathyroidism include nephrolithiasis, nephrocalcinosis, polyuria, polydipsia, subperiosteal osteolysis, diffuse osteopenia, dizziness, constipation, weight loss, acute pancreatitis, rhythm disorders of the heart, etc. The symptoms of hyperthyroidism include increased thyroid volume, psychomotor agitation, tremor, nervousness, insomnia, rhythm disorders, weight loss with increased appetite, metabolism disorders, heat intolerance, etc.
  • Primary hyperparathyroidism is treated by rapid surgical removal of the enlarged gland. The treatment of secondary hyperparathyroidism involves a decrease in the uptake of phosphates, calcium-containing preparations that bind phosphates and substitution treatment with Calcitriol. The treatment of hyperthyroidism includes medications, operative treatment, and radioiodine treatment.

 

Dr. Mariam Bozhilova Forest Research Institute, BAS

Environmental Expert with PhD in Botany at Forest Research Institute, Bulgarian Academy of Sciences.
Mariam has a Master’s degree in Ecology and a PhD in Botany.
Currently, she works in the Forest Research Institute, Bulgarian Academy of Sciences.
Mariam has more than 10 years of professional experience in scientific research and environmental consultancy. She has worked within non-profit, profit, and academic environment, and consulted business clients and competent authorities.
Her main professional interests are in the area of:
Scientific research;
Web content writing;
Environmental consultancy.
Dr. Mariam Bozhilova Forest Research Institute, BAS

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References :


[0]Image credit: https://commons.wikimedia.org/wiki/File:Hyperthyroidism_(2).jpg

[1]Image credit: https://commons.wikimedia.org/wiki/File:Parathyroid_diseases_and_relation_between_calcium_and_PTH.jpg

[2]Hinson, J., P. Raven, S. Chew. The Endocrine System: Systems of the Body Series 2nd Edition. London: Churchill Livingstone. 2010. Print.

[3]Licata, A., E. Lerma (Eds.). Diseases of the Parathyroid Glands. Berlin: Springer. 2012. Print.

[4]Markus Luster, M., H. Duntas, L. Wartofsky. The Thyroid and Its Diseases. A Comprehensive Guide for the Clinician. Berlin: Springer. 2019. Print.

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