Why is hyperparathyroid disease so hard to diagnose?

Hard to diagnose. HPT is hard to diagnose in its early stages because tumors are small, PTH levels are lower, and PTH and calcium levels can fluctuate from day to day or even within the same day.
No symptoms. Most time asymptomatic. Usually found b/o calcium levels are high several times then we order the pthintact ( intact parathyroid hormone high).The problem is that high calcium may be caused by cancers and many other entities like multiple myeloma, familiar hypercalcemia, secondary hyperparathyroidism. We also order 24 urine collection of calcium to assess the excretion.
Not hard. It's not a hard diagnosis to make. Sometime it's hard to localize the growth but the initial diagnosis is not difficult. .
It is not hard to di. It is not hard to diagnose Hyperparathyroidism if you visit your doctor for regular check up.Most of the time it is discovered by finding high level of Calcium in the blood and is confirmed by doing a parathyroid hormone level which is also elevated.Putting the two together you have the diagnosis of hyperparathyroidism and by doing VitD level you can differentiate if it is Primary or Secondary HP.
Minimalism. Routine chemistry panels include calcium levels, making diagnosis easier, but diagnoses are not made unless the possibility is considered. If the physician is minimalistic in their approach and does not workup findings, it can be missed. This should not be a problem for conscientious physicians.