Secondary hyperparathyroidism refers to a condition in which a person's thyroid gland works inappropriately due to some other disorder or injury. Secondary hyperparathyroidism can occur because of radiation therapy, previous cancer treatment, or other causes. The problem stems from the fact that the thyroid gland cannot function properly if calcium levels are low enough for it to produce an excess hormone. When this happens, the person will develop hyperthyroidism, which can eventually lead to cancer. In most cases, secondary hyperparathyroidism will go away on its own after the underlying problem has been corrected.
Secondary hyperparathyroidism treatment requires surgery and medications. One of the first medications that should be used to treat this condition is calcitonin. Calcium is needed by the parasympathetic nervous system, which is primarily controlled by the thyroid gland. Tertiary hyperparathyroidism and chronic kidney disease are believed to have a genetic connection. Therefore, correcting one of the underlying conditions can actually correct the symptoms of the other.
Another common medication used in secondary hyperparathyroidism treatment and chronic kidney failure is estazolam. This drug acts in a manner similar to calcitonin that corrects the abnormally high levels of PTH in people with chronic kidney failure. Atazolam can be used with success in the treatment of hypocalcemia and hyperchloremic kidney disease, although this is not a recommended course of treatment for secondary hyperparathyroidism.
Corticosteroids can also be used in secondary hyperparathyroidism treatment, although this treatment may not prove effective in some patients. Corticosteroids work by preventing the release of PTH by controlling the activity of the enzymes that produce it. They are particularly effective in people with chronic obstructive pulmonary disease (COPD), a condition that causes the narrowing of the arterial blood vessels. COPD can also lead to a decrease in the amount of PTH that is produced, which can lead to hyperparathyria. The effects of corticosteroid therapy on PTH levels can be modest, and the increased fluid production that occurs as a side effect can cause significant electrolyte imbalance, especially if the dose is increased repeatedly over time.
New research suggests that surgical removal of one or both parathyrogens (PTH) may provide relief from secondary hyperparathyroidism and its associated symptoms. Patients with at least one of the following conditions acute compartment syndrome, primary hyperparathyria, or congenital heart disease may benefit from simultaneous surgery atrial septal defect (cessation of a Septa), paraganglioma, or paracentesis. Surgery may also be indicated for the secondary hyperparathyroidism treatment in patiensts who do not respond to initial drug therapy.
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