Overview Of Hypoparathyroidism

Hypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH).

Commonly Associated With

Parathyroid-related hypocalcemia

Causes Of Hypoparathyroidism

There are 4 tiny parathyroid glands in the neck, located near or attached to the backside of the thyroid gland.

The parathyroid glands help control calcium use and removal by the body. They do this by producing parathyroid hormone (PTH). PTH helps control calcium, phosphorus, and vitamin D levels in the blood and bone.

Hypoparathyroidism occurs when the glands produce too little PTH. The blood calcium level falls, and the phosphorus level rises.

The most common cause of hypoparathyroidism is an injury to the parathyroid glands during thyroid or neck surgery.

It may also be caused by any of the following:

  • Autoimmune attack on the parathyroid glands (common)
  • Very low magnesium level in the blood (reversible)
  • Radioactive iodine treatment for hyperthyroidism (very rare)
  • DiGeorge syndrome is a disease in which hypoparathyroidism occurs because all the parathyroid glands are missing at birth. This disease includes other health problems besides hypoparathyroidism. It is usually diagnosed in childhood.

Familial hypoparathyroidism occurs with other endocrine diseases such as adrenal insufficiency in a syndrome called type I polyglandular autoimmune syndrome (PGA I).

Symptoms Of Hypoparathyroidism

The onset of the disease is very gradual and symptoms can be mild. Many people diagnosed with hypoparathyroidism have had symptoms for years before they are diagnosed. Symptoms may be so mild that the diagnosis is made after a screening blood test that shows low calcium.

Symptoms may include any of the following:

  • Tingling lips, fingers, and toes (most common)
  • Muscle cramps (most common)
  • Muscle spasms called tetany (can affect the larynx, causing breathing difficulties)
  • Abdominal pain
  • Abnormal heart rhythm
  • Brittle nails
  • Cataracts
  • Calcium deposits in some tissues
  • Decreased consciousness
  • Dry hair
  • Dry, scaly skin
  • Pain in the face, legs, and feet
  • Painful menstruation
  • Seizures
  • Teeth that do not grow in on time, or at all
  • Weakened tooth enamel (in children)

Exams & Tests

The health care provider will do a physical exam and ask about symptoms.

Tests that will be done for hypoparathyroidism include:

  • PTH blood test
  • Calcium blood test
  • Magnesium
  • 24-hour urine test

Other tests that may be ordered include:

  • ECG to check for an abnormal heart rhythm
  • CT scan to check for calcium deposits in the brain

Treatment Of Hypoparathyroidism

The goal of treatment is to reduce symptoms and restore the calcium and mineral balance in the body.

Treatment involves calcium carbonate and vitamin D supplements. These usually must be taken for life. Blood levels are measured regularly to make sure that the dose is correct. A high-calcium, low-phosphorous diet is recommended.

Injections of PTH may be recommended for some people. Your doctor can tell you if this medicine is right for you.

People who have life-threatening attacks of low calcium levels or prolonged muscle contractions are given calcium through a vein (IV). Precautions are taken to prevent seizures or larynx spasms. The heart is monitored for abnormal rhythms until the person is stable. When the life-threatening attack has been controlled, treatment continues with medicine taken by mouth.