Primary hyperparathyroidism and osteoporosis

Abstract

Primary hyperparathyroidism (PHPT) has been associated with bone loss most notable in the cortical bones, with osteoporosis being prevalent in up to 60 % of patients. PHPT should be evaluated as a secondary cause of osteoporosis. In addition, bone mineral density should be assessed in patients with PHPT, as the presence of osteoporosis may alter management. The diagnosis of PHPT should be based on solid biochemical evidence, and imaging studies should be reserved for patients in whom surgery is being strongly considered. Patients with PHPT who also have bone mineral density in the osteopenia/osteoporosis range should adhere to the Institute of Medicine recommendations to ensure adequate intake of calcium and vitamin D (i.e., there is no need for calcium restriction).