A medical evaluation of hyperparathyroidism begins with a complete history and physical examination.

Physical findings in someone with hyperparathyroidism may include:

• A normal exam is common
• Arthritis:
• swelling and tenderness in various joints
• Confusion
• Lethargy:
• A condition of excessive sleepiness or drowsiness.
• High blood pressure
• Muscular weakness
• Nail abnormalities
• Slow pulse (less than 60 beats per minute)

Tests are necessary to make the diagnosis of hyperparathyroidism.

Tests that may be used to evaluate hyperparathyroidism include:

• Parathyroid gland biopsy
• Performed during surgery
• Parathyroid hormone levels:
• Often elevated
• Serum calcium levels:
• Usually elevated
• Serum phosphate levels:
• Usually decreased
• Vitamin D levels
• Electrocardiogram:
• May demonstrate evidence for elevated calcium level in the bloodstream