Signs and symptoms of
"Non-specific" or "Non-classical" Symptoms
Muscle, Joint, and Bone Pain/ Muscle Weakness
Muscle, joint, and bone pain as well as muscle weakness are symptoms that have been reported in patients with primary hyperparathyroidism. Some studies have demonstrated significant improvement in muscle strength and pain for many of the patients who underwent parathyroidectomy. 4-6
Neurocognitive and Psychiatric Problems
Neurocognitive complaints are problems related to how the brain works. Neurocognitive symptoms that have been associated with primary hyperparathyroidism include worsening concentration, worsening memory (especially short-term memory), slower processing of information, decreased motivation, and decreased ability to make plans. 7-14 The mechanism of how primary hyperparathyroidism causes neurocognitive symptoms is unclear. However, research has shown that patients with primary hyperparathyroidism demonstrated improved functioning (up to 80% of patients) across several areas, including attention, memory, and reasoning following parathyroidectomy. 14, 15 Essentially the brain seems to function better after parathyroidectomy.
There are a wide range of psychiatric or mood-related problems that may be associated with primary hyperparathyroidism, including depression, anxiety, agitation, irritability, delusions, auditory and visual hallucinations, and paranoid thoughts. 7-12, 16-22 The presence of these symptoms ranges from 32% to 66%. 7, 10, 23 Since these symptoms can be so vague and hard to describe, the psychiatric symptoms may be the most difficult of the nonclassic symptoms to study. However, after a successful operation, there can be substantial improvement with emotional functioning. 24 In addition, the frequency and severity of depression improved significantly after parathyroidectomy. 25
Primary hyperparathyroidism has been associated with symptoms of disturbances in sleep. 26, 27 A number of studies have looked at whether or not parathyroidectomy improves sleep disturbances in patients with primary hyperparathyroidism and the results have been mixed. 8, 13, 28 One well-conducted study suggested that patients felt less daytime sleepiness following parathyroidectomy compared to those patients who did not have an operation. 29 Studies of sleep using fMRI-measured brain function suggest that sleep plays a role in causing some of the "nonclassic" and neurocognitive symptoms of mild PHPT.