People living with HIV often take medications called antiretroviral drugs to manage their condition. A new review of recent research shows that some of these medications, particularly one called Tenofovir, may affect how the parathyroid gland works. The parathyroid gland is a small gland in your neck that controls calcium levels in your body, which is important for strong bones. When this gland doesn’t work properly, it can lead to weak bones and higher fracture risk. The review suggests that doctors should regularly check parathyroid health in HIV patients, especially those taking specific medications, to catch problems early and prevent serious complications.

The Quick Take

  • What they studied: How HIV infection and HIV medications affect the parathyroid gland, a small gland that controls calcium levels in the body
  • Who participated: This was a review of existing research studies about people living with HIV, rather than a new study with participants
  • Key finding: Some HIV medications, especially one called Tenofovir Disoproxil Fumarate (TDF), appear to raise parathyroid hormone levels more than other HIV medications do, which can weaken bones over time
  • What it means for you: If you’re living with HIV and taking certain medications, your doctor should regularly check your parathyroid health and bone strength. Early detection of problems can help prevent broken bones and other complications. Talk to your healthcare provider about whether you need these checks.

The Research Details

This is a narrative review, which means researchers looked at many existing studies about parathyroid gland problems in people with HIV and summarized what they found. Rather than conducting a new experiment, the authors gathered information from published research to understand the current state of knowledge about this topic.

The review focused on three main areas: how common parathyroid problems are in HIV patients, what causes these problems, and what health effects they have. The researchers examined how HIV itself, HIV medications, and the body’s immune response all work together to affect the parathyroid gland.

This type of review is useful because it brings together information from many different studies to give a complete picture of what scientists currently know about a health topic.

Understanding how HIV and its medications affect the parathyroid gland is important because these problems often go unnoticed. Many doctors don’t routinely check parathyroid health in HIV patients, so problems may develop silently without anyone knowing. By reviewing all the available evidence, this research helps doctors understand what they should be watching for and checking regularly.

This is a narrative review, which means it summarizes existing research rather than presenting new experimental data. While reviews are helpful for understanding current knowledge, they depend on the quality of the studies being reviewed. The strength of the conclusions depends on how many high-quality studies have been done on this topic. The authors appear to have carefully examined recent evidence and identified important gaps in current medical practice.

What the Results Show

The review found that parathyroid gland problems are common in people living with HIV. One specific medication called Tenofovir Disoproxil Fumarate (TDF) appears to cause more parathyroid problems than other HIV medications. People taking TDF had significantly higher levels of parathyroid hormone compared to those taking other HIV drugs.

The research shows that the parathyroid gland can become enlarged (a condition called hyperplasia) in HIV patients, often because they don’t have enough calcium, magnesium, and vitamin D in their bodies. The combination of HIV infection, the immune system’s response to HIV, and the effects of medications all work together to create these problems.

Interestingly, the parathyroid dysfunction can show up in different ways. Some people have too much parathyroid hormone even when their calcium levels are normal, which is unusual and suggests the medications are directly affecting the gland. Others may have too little parathyroid hormone. Both situations can lead to weak bones and increased risk of fractures.

The review found that parathyroid cancer is extremely rare in HIV patients, even though HIV patients have higher rates of other cancers. This is reassuring news for people concerned about this particular complication. The research also highlighted that bone density loss happens quickly when the parathyroid gland isn’t working properly, making fracture prevention especially important.

This review updates and expands on previous knowledge about parathyroid problems in HIV patients. As HIV medications have improved and people with HIV are living longer, doctors have noticed these parathyroid complications more often. The specific finding that TDF-based medications cause more parathyroid problems than other HIV drugs is an important update that helps doctors choose the best treatment options for their patients.

This review summarizes existing studies rather than conducting new research, so its conclusions depend on the quality and completeness of those studies. Not all HIV patients have been screened for parathyroid problems, so we may not know the true frequency of these issues. The review also notes that routine screening isn’t standard practice yet, meaning many cases may be missed. Additionally, most of the research has focused on specific populations, so results may not apply equally to all HIV patients worldwide.

The Bottom Line

If you’re living with HIV, ask your doctor about checking your parathyroid hormone, calcium, phosphate, and vitamin D levels regularly—especially if you’re taking Tenofovir-based medications. Make sure you get enough calcium and vitamin D through diet or supplements. Have your bone density checked periodically. If your doctor finds parathyroid problems, early treatment can prevent serious complications. These recommendations are based on solid evidence from multiple studies, though more research is still needed.

This research is most relevant for people living with HIV, particularly those taking Tenofovir-based medications. Healthcare providers caring for HIV patients should pay attention to these findings and incorporate parathyroid screening into routine care. People with HIV who have risk factors for weak bones (older age, family history of osteoporosis, low body weight) should especially discuss screening with their doctors. This information is less relevant for people without HIV.

Parathyroid problems develop gradually over time, so you won’t notice changes overnight. It typically takes months to years for bone density loss to become significant. This is why regular screening is important—catching problems early, before you develop symptoms or fractures, is the best approach. If treatment is started, it may take several months to see improvements in parathyroid hormone levels and bone health.

Want to Apply This Research?

  • Track your parathyroid hormone (PTH), calcium, and vitamin D lab results every 6-12 months. Record the dates of your tests and the results to monitor trends over time. Note which HIV medications you’re taking, as this helps identify patterns.
  • Set reminders to take vitamin D and calcium supplements daily if recommended by your doctor. Log your supplement intake in the app. Schedule regular lab work appointments 6-12 months apart and set reminders before each appointment. If you’re on a Tenofovir-based medication, make sure these monitoring appointments are prioritized.
  • Create a long-term tracking dashboard showing your PTH, calcium, and vitamin D levels over time. Compare results across appointments to spot trends. Share this data with your healthcare provider during visits. If levels are declining, work with your doctor to adjust supplements or medications. Track any bone-related symptoms like muscle weakness or bone pain.

This review summarizes research about parathyroid gland problems in people with HIV. It is not a substitute for professional medical advice, diagnosis, or treatment. If you’re living with HIV, consult with your healthcare provider before making any changes to your medications or treatment plan. Your doctor can assess your individual risk factors and recommend appropriate screening and monitoring. The findings in this review may not apply equally to all people with HIV. Always discuss any concerns about your parathyroid health or bone density with your medical team.