Key takeaways

  • Overactive parathyroid glands (hyperparathyroidism) may lead to osteoporosis by causing bones to release excess calcium into the bloodstream, lowering bone density.
  • Underactive parathyroid glands (hypoparathyroidism), while less directly linked to calcium loss, may contribute to osteoporosis by slowing bone turnover, potentially weakening bone material over time.
  • Managing hyperparathyroidism and hypoparathyroidism is key to preventing or reversing bone density loss. Treatments may include monitoring, medication, surgery, and supplements, based on the condition’s severity and type.
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Osteoporosis is a bone disease that raises the risk of fractures and other health complications. The disease develops when bones lose too much mass. Bone tissue constantly breaks down and builds back up. If there isn’t enough available calcium to replace bone mass that has broken down, osteoporosis can occur.

The parathyroid glands help maintain healthy levels of calcium and other minerals in your blood.

When one or more of your parathyroid glands become overactive, a condition called “hyperparathyroidism,” they produce too much of the hormone that regulates calcium levels. As a result, your bones release excessive amounts of calcium into your bloodstream, and bone density decreases.

You have four pea-sized parathyroid glands on the surface of your thyroid gland, found in the front of your neck. Although they’re tiny, the parathyroid glands play a big role in your health.

The glands release parathyroid hormone (PTH), which helps control blood levels of calcium, phosphorous, and vitamin D. You need these substances in healthy ranges to support healthy functioning of your heart, muscles, and nerves.

Hyperparathyroidism occurs when the parathyroid glands produce too much PTH. The most common version of the condition is called primary “hyperparathyroidism,” meaning it originates in the glands as opposed to being a complication of kidney disease, cancer, or another condition.

Typically, a parathyroid gland becomes overactive due to the presence of a parathyroid adenoma, a noncancerous tumor that affects how the gland functions.

The Endocrine Society reports there are about 100,000 diagnoses of primary hyperparathyroidism in the United States each year.

The complications of hyperparathyroidism used to be quite severe, but advances in calcium and PTH monitoring and treatment have made the condition manageable, often with little impact on long-term health or quality of life.

Still, hyperparathyroidism remains a risk factor for osteoporosis. PTH causes the bones to release small amounts of calcium from your bones.

If circulating levels of calcium are low, the parathyroid glands produce a little more PTH to pull a little more calcium from the bones. Once calcium levels in the blood return to normal levels or are too high and the parathyroid glands are healthy, PTH production is halted or reduced significantly.

With hyperparathyroidism, one or more glands continue to produce PTH even when calcium levels are normal or above normal. Too much PTH may cause your bones to lose calcium faster than osteoblasts (cells that form bone) can help rebuild bone tissue by covering your bones with a new layer of minerals.

Over time, this calcium imbalance in your bones causes the bones to become less dense and more susceptible to fractures.

Hypoparathyroidism occurs when your parathyroid glands produce too little PTH. It’s a rare condition that sometimes develops when your thyroid is injured or removed for treatment of a different condition. Hypoparathyroidism may also occur with an autoimmune disorder or because of a family history of the condition.

Even though lower PTH production is linked to less calcium loss from your bones, hypoparathyroidism can contribute to osteoporosis. Hypoparathyroidism leads to less frequent turnover in bone breakdown and rebuilding.

A recent review of research indicates that these slowed processes may negatively affect bone material strength over time and contribute to osteoporosis and increased fracture risk.

Early on, hyperparathyroidism and hypoparathyroidism often have no obvious symptoms. As the conditions progress, mild to moderate symptoms may develop.

For hyperparathyroidism, symptoms may include:

More severe cases of hyperparathyroidism may include symptoms such as:

When symptoms appear for hypoparathyroidism, they may include painful and uncomfortable problems such as:

The best treatment for hyperparathyroidism depends on its severity. If you have a mild case, the condition may be tracked with regular blood tests that check your calcium levels as well as periodic bone density scans to check for signs of osteoporosis.

In some instances, medications such as cinacalcet may be prescribed to help lower calcium levels in your blood.

An older study suggests the only cure for hyperparathyroidism is surgery to remove one or more of the abnormal parathyroid glands, followed by regular monitoring of PTH levels and the levels of circulating calcium, phosphorus, and vitamin D.

A more recent evidence review also indicates surgery is currently the only cure for hyperparathyroidism.

Treatment for hypoparathyroidism usually involves taking daily supplements of calcium carbonate and vitamin D.

Both hyperparathyroidism and hypoparathyroidism can be manageable conditions that shouldn’t lead to severe long-term health problems or diminished quality of life.

Hypoparathyroidism usually requires long-term calcium supplementation, and for some people, the use of synthetic PTH. For people who have surgery to treat hyperparathyroidism, most complications, including bone density loss, can be stopped or reversed.

Diagnosing diseases of the parathyroid gland starts with a doctor ordering blood tests to measure your PTH and blood calcium levels. If they suspect hypoparathyroidism, they may also check your phosphorus levels. Abnormally high phosphorus levels can indicate hypoparathyroidism.

A doctor will also typically request your medical history, family history, and symptoms to review them to help diagnose the condition.

Should I keep taking a calcium supplement if I have hyperparathyroidism?

You may want to consult a healthcare professional, but it’s likely you’ll be advised to hold off on any calcium supplementation until your condition stabilizes.

Does having an overactive thyroid mean I’ll have hyperparathyroidism?

Although the thyroid and parathyroid glands are attached and perform similar functions, a condition that affects one doesn’t necessarily affect the other.

You can have thyroid disease and have normal functioning parathyroid glands and vice versa, but if a problem develops with one gland, it can be helpful to have a doctor check the other to be cautious.

Does a diagnosis of osteoporosis mean I have problems with my parathyroid gland?

Many risk factors for osteoporosis exist that are unrelated to the parathyroid gland. Certain medications can affect bone health, while changes in estrogen and testosterone later in life may also contribute to decreased bone density.

A sedentary lifestyle and insufficient vitamin D levels are other risk factors.

Having healthy functioning parathyroid glands is critical to preserving bone density and lowering your risk of osteoporosis. The parathyroid glands produce PTH, a hormone that balances calcium levels in the body.

You can ask a healthcare professional about whether you should have your PTH levels checked to make sure you’re not at risk of complications such as osteoporosis.

If you are at risk, they can discuss steps you can take to counter the negative effects of too much or too little PTH production.