Fibromyalgia Patients Should be Monitored for Hyperparathyroidism, Study Suggests

Fibromyalgia Patients Should be Monitored for Hyperparathyroidism, Study Suggests

Patients with fibromyalgia (FM) also may develop primary hyperparathyroidism (PHP), a disease that shares several symptoms with FM, according to a study by Brazilian researchers.

The study, “High Frequency Of Asymptomatic Hyperparathyroidism In Patients With Fibromyalgia: Random Association Or Misdiagnosis?,” was published in the journal Revista Brasileira de Reumatologia.

PHP is a disease characterized by a hyperactive parathyroid gland (high levels of parathyroid hormone – PTH) and consequent hypercalcemia (high levels of calcium in the blood). The condition affects mostly people older than 50 and post-menopausal women.

The clinical diagnosis of PHP often is difficult because its symptoms are variable and similar to those of fibromyalgia, including musculoskeletal pain, cognitive disorders, insomnia, depression and anxiety.

Most PHP patients have asymptomatic hypercalcemia, which is elevated levels of calcium without the presence of the classic manifestations of PHP. But another form of PHP also can occur, consisting of patients who have normal blood calcium levels and high levels of PTH in the absence of other known cause for this hormonal increase; that is called normocalcemic hyperparathyroidism. It has been proposed this would be the first phase of the disease, starting with elevated PTH only and then developing later into full PHP with high levels of calcium.

“Despite the similarity between symptoms of FM and asymptomatic hyperparathyroidism, there are few publications evaluating this association,” the authors wrote. “This study aimed to determine the frequency of asymptomatic hyperparathyroidism in women with FM, verify the association with clinical parameters, and compare the results of PTH and calcium found in healthy women,” they said.

Researchers evaluated FM symptoms in 100 women with FM (mean age 42.4 years), in comparison with 57 healthy women. At the end of the consultation, a blood sample was collected to analyze levels of calcium and PTH.

The analysis showed that 6% of the FM patients had hypercalcemic PHP, but 17% had only high levels of PTH without high levels of calcium (normocalcemic hyperparathyroidism).

Also, there was no significant association between hyperparathyroidism and FM symptoms, except for epigastric pain, which was more frequent in the group of patients who were diagnosed with both diseases.

“A high frequency of hyperparathyroidism was noted in women with FM versus the general population. Normocalcemic hyperparathyroidism was also more frequent in patients with FM,” the team concluded.

“Normocalcemic hyperparathyroidism should be considered as part of the diagnostic spectrum of hyperparathyroidism, and such patients should be monitored with periodic laboratory determinations, with the aim of an early detection of hypercalcemia,” the authors wrote.

The team considers the results still preliminary and suggests that more studies with larger groups are warranted to confirm the association of the two diseases, and to provide more information about what should be the routine assessment of parathyroid glands in patients with FM.

“Longitudinal studies with greater number of patients are needed to assess whether this is an association by chance only, if the increased serum levels of PTH are part of FM pathophysiology, or even if these would not be cases of FM, but of hyperparathyroidism.” the researchers wrote.



  1. Ella says:

    I’m trying to print out this article for my physician (I’m an FMS patient with symptoms that may indicate hyperparathyroidism). Why is there no easy option for printing out of articles? Even if I use my browser’s print function, the article prints out in a long column with superfluous matter on the side. Please make this more user friendly; most pages print off the internet with little problem. Thank you.

    • Maggie says:

      Return to your original e-mail, go to the fibromyalgia News Today link and click on to it. This will open FNT, on the left side of the screen click on to the envelope symbol and you will be able to email the link for the article to your GP. It will then be easier for the GP to store the document for future reference to benefit other patients as well

    • Mary Power says:

      Here is another way to print an online article that doesn’t provide an easy printing symbol.
      Press and hold anywhere within the article. The word you are pressing becomes highlighted and 2 “handles” appear at either end. Carefully drag the left handle UP to the top of the article, then drag the right handle to the bottom of the paragraph or page you wish to save. NEXT: you will notice a “copy/paste” toolbar has appeared at the TOP of your screen. Press the COPY symbol. THEN, open your phone’s messaging app and long-press the empty message-writing space. The word “paste” appears, allowing you to paste the copied article. If you wish to include the website/ article-source, simply save your message as a draft, return to to the online article, long-press the website name IN THE SEARCH BOX and the full name becomes highlighted. Once again, the copy/paste toolbar appears…. And the rest is easy peasy :-). Hope this helps someone 😉 Mary (fibromyalgia/osteoartrthritis/manic-depreasion sufferer with little-better-to-do!! ,’D

    • Margie says:

      oh i can't wait till you have another little ella (or maybe an elliot? lol) running around. i think 2.5 is a great gap, just old enough to be somewhat inenepnddet and out of that crazy toddler stage…but still close in age. btw, you look great pregnant! 🙂

  2. Norma Ortiz says:

    After seven years, I recently got diagnosed with FM however, My symptoms started with neuropathy(I’m not diabetic) and then hypothyroid. I’m educating myself now to learn more about FM.

  3. Rebecca Hudson says:

    I am currently under evaluation for removal of one or more of my parathyroid glands as my calcium levels fluctuate yet I have elevated PT hormone levels. Assessing which parathyroid glands have benign tumors by way of a 4D CT scan with contrast..66 years old.

  4. Cheryl says:

    I was diagnosed with fibromyalgia by my rheumatologist, I also have hypothyroidism, and later we found hyperparathyroidism. I was sent to a nephrologist to evaluate my hyperparathyroid, I did not have an elevation of calcium in my blood and we did not find any parathyroid masses. This is a very interesting article because I was not aware of a connection to my fibromyalgia.
    I also have a mild case of interstitial cystitis, this was diagnosed about ten years before any of my other conditions.

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