Difference Between Hyperparathyroidism and Hyperthyroidism

Hyperparathyroidism and hyperthyroidism are two distinct medical conditions that affect the endocrine system of the body. Although the two conditions share some similarities, they have different causes, symptoms, and treatments. In this essay, we will discuss the differences between hyperparathyroidism and hyperthyroidism.

What is Hyperparathyroidism?

Hyperparathyroidism is a condition in which the parathyroid glands produce too much parathyroid hormone (PTH). These glands are located in the neck and are responsible for regulating the level of calcium in the body. When the parathyroid glands produce too much PTH, the calcium level in the blood increases, leading to hypercalcemia.

• 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.

What is Hyperthyroidism?

Hyperthyroidism, on the other hand, is a condition in which the thyroid gland produces too much thyroid hormone. The thyroid gland is located in the neck, and its main function is to produce hormones that regulate metabolism. When the thyroid gland produces too much hormone, it results in hypermetabolism.

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.

Differences: Hyperparathyroidism and Hyperthyroidism

Causes − The causes of hyperparathyroidism and hyperthyroidism are different. Hyperparathyroidism is usually caused by a benign tumor in one or more of the parathyroid glands, which causes them to produce too much PTH. In some cases, hyperparathyroidism can be caused by an inherited genetic condition. On the other hand, hyperthyroidism is usually caused by an autoimmune disorder called Graves' disease, which causes the thyroid gland to produce too much hormone. However, other causes of hyperthyroidism include thyroid nodules and thyroiditis.

Symptoms − The symptoms of hyperparathyroidism and hyperthyroidism are also different. Hyperparathyroidism often causes no symptoms, especially in its early stages. However, as the calcium level in the blood increases, patients may experience symptoms such as fatigue, weakness, muscle aches, bone pain, kidney stones, and gastrointestinal problems.

On the other hand, hyperthyroidism can cause symptoms such as weight loss, rapid heartbeat, nervousness, irritability, muscle weakness, tremors, and sweating.

Diagnosis − The diagnosis of hyperparathyroidism and hyperthyroidism involves different tests. In hyperparathyroidism, blood tests are performed to measure the level of calcium, PTH, and vitamin D in the blood. Imaging tests such as ultrasound, CT scan, and MRI may also be performed to locate the tumor in the parathyroid gland.

In hyperthyroidism, blood tests are performed to measure the level of thyroid hormones (T3 and T4) and thyroid-stimulating hormone (TSH). Imaging tests such as thyroid scan and ultrasound may also be performed to locate the cause of hyperthyroidism.

Treatment − The treatment of hyperparathyroidism and hyperthyroidism is also different. In hyperparathyroidism, the primary treatment is surgery to remove the tumor in the parathyroid gland. This is usually successful in curing hyperparathyroidism. In some cases, medication may be prescribed to manage the symptoms of hypercalcemia.

In hyperthyroidism, treatment options include medications to reduce the production of thyroid hormone or surgery to remove the thyroid gland. Radioactive iodine therapy may also be used to destroy the thyroid gland.

The following table highlights the major differences between Hyperparathyroidism and Hyperthyroidism −

Characteristics	Hyperparathyroidism	Hyperthyroidism
Definition	Hyperparathyroidism is a disease, resulting from increased production of parathyroid hormone by the parathyroid glands.	Hyperthyroidism is a condition of increased thyroid function.
Types	Hyperparathyroidism may be primary, secondary, and tertiary	The immunogenic hyperthyroidism is also known as Graves’ disease.
Etiology	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. 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	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.	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	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.	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	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.

Conclusion

In conclusion, hyperparathyroidism and hyperthyroidism are two different medical conditions that affect the endocrine system. Hyperparathyroidism is caused by the overproduction of PTH, while hyperthyroidism is caused by the overproduction of thyroid hormone. The symptoms, diagnosis, and treatment of the two conditions are also different.

It is important to seek medical attention if you experience any symptoms of these conditions to receive an accurate diagnosis and appropriate treatment.