Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. Effective measures for secondary prevention of secondary hyperparathyroidism include maintain adequate nutrition, proper intake of vitamin D and/or sufficient sunlight exposure, and adequate physical activity. Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or parathyroidectomy.

• Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. These guidelines include:^[1]
  • Serum calcium
    • Serum calcium should be monitored annually.
  • Skeletal monitoring
    • Dual-energy X-ray absorptiometry (DEXA) is used for skeletal monitoring. DEXA should be done every 1-2 years (at 3 sites).
    • X-ray or vertebral fracture assessment of spine may be done if indications are present such as height loss, and/or back pain.
  • Renal monitoring
    • Estimated glomerular filtration rate (eGFR) and serum creatinine should be done annually.
    • 24-hour biochemical stone profile, renal imaging by x-ray, ultrasound, or CT scan may be considered if renal stones are suspected.

• Effective measures for secondary prevention of secondary hyperparathyroidism include:
  • Maintain adequate nutrition
  • Proper intake of vitamin D and/or sufficient sunlight exposure
  • Adequate physical activity

• Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or parathyroidectomy.