Hypoparathyroidism

Hypoparathyroidism is a rare, treatable condition that happens when your parathyroid glands don’t produce enough parathyroid hormone (PTH). PTH helps regulate calcium and phosphorus levels in your blood. This condition causes calcium levels in your blood to drop and phosphorus levels to rise. Too much phosphorus in your blood can lower your calcium even more. This can lead to several health problems.

Calcium is one of the most important minerals in your body. Most of your calcium is stored in your bones, but you have it and need it in your blood, too. The calcium in your blood has many important roles, including helping:

• Your nerves work
• Your muscles contract so you can move
• Your blood clot
• Your heart work
• Your bones stay strong

Low calcium levels in your blood (hypocalcemia) can affect your how well your body works.

Symptoms of hypoparathyroidism

Signs and symptoms of hypoparathyroidism include:

• Tingling or numbness in your lips, fingers and toes
• Muscle cramps and spasms
• “Brain fog” or confusion
• Abnormal heart rhythm
• Brittle nails and dry skin
• Cataracts
• Weak tooth enamel (in children)

In most cases, hypoparathyroidism progresses gradually, and symptoms can be mild. Many people have symptoms for years before they get a diagnosis.

Hypoparathyroidism causes

Causes of hypoparathyroidism include:

• Damage to your parathyroid glands: About 75% of cases are caused by accidental damage to the parathyroid glands during neck or thyroid surgery. This usually happens soon after surgery, but it can also occur many years later. In rare cases, radiation therapy can damage your parathyroid glands.
• Certain genetic conditions: Less than 10% of cases are genetic. The most common is DiGeorge syndrome, where babies are born without parathyroid glands, leading to lifelong low calcium. About 60% of children with hypoparathyroidism have DiGeorge syndrome.
• Certain autoimmune diseases: Certain diseases cause your immune system to attack your parathyroid glands.
• Low levels of magnesium: Low magnesium can cause the parathyroid glands to stop making or releasing enough PTH, leading to low calcium levels.

Risk factors

Risk factors for hypoparathyroidism include:

• Having recent neck or thyroid surgery
• Having a family history of parathyroid conditions
• Having an autoimmune disease that affects your endocrine system
• Having radiation therapy for head or neck cancer

Both adults and children can get hypoparathyroidism. Adults are more likely to get hypoparathyroidism from accidental damage to their parathyroid glands during surgery. Children are more likely to have hypoparathyroidism due to a genetic condition.

Complications of hypoparathyroidism

Long-term complications of hypoparathyroidism can include:

• Issues with kidney function
• Kidney stones
• Calcium deposits in your brain

For children, complications from hypoparathyroidism can include:

• Slow growth
• Dental issues
• Developmental delays
• Bone problems

Complications of a sudden drop in calcium levels include seizures and larynx spasms. These can be dangerous. If you’re experiencing these symptoms, get to the nearest hospital as soon as possible.

How doctors diagnose hypoparathyroidism

Hypoparathyroidism is generally diagnosed when a person has low levels of calcium and parathyroid hormone in their blood.

Healthcare providers sometimes “accidentally” find hypoparathyroidism when a routine blood screening shows you have low levels of blood calcium.

You have chronic hypoparathyroidism if you have low levels of PTH and calcium at least twice within six months.

Tests that are used

If you’re experiencing symptoms of hypoparathyroidism, your healthcare provider will perform a physical exam and ask questions about your symptoms and medical history.

They may order one or more of the following tests to help diagnose hypoparathyroidism:

• Parathyroid hormone (PTH) blood test
• Calcium blood test
• Phosphorus blood test
• Magnesium blood test
• 24-hour urine calcium test

Your healthcare provider may want to check for more serious side effects of hypoparathyroidism, including:

• An electrocardiogram (ECG or EKG) to check for an abnormal heart rhythm
• A computed tomography (CT) scan to check for calcium deposits in your brain

Hypoparathyroidism treatment

The goal of treatment for hypoparathyroidism is to get the right amount of calcium and minerals in your body.

Treatment can include:

• Taking calcium carbonate and vitamin D supplements: You have to take calcium and vitamin D supplements for life. Your body needs vitamin D to absorb and use calcium, so you need to take both supplements. Some people also need a magnesium supplement.
• Eating a high-calcium and low-phosphorus diet: Your healthcare provider may recommend eating less red meat and eating more calcium-rich foods like broccoli, yogurt and tofu. They may also ask you to limit processed foods, which usually contain phosphorus. A dietitian may give you specific instructions on what foods to avoid.
• Getting parathyroid hormone (PTH) injections: If taking calcium and vitamin D supplements isn’t working to treat hypoparathyroidism, your provider might have you take parathyroid hormone injections.
• Thiazide diuretics: This medication can help reduce how much calcium you lose in your pee.

When should I see my healthcare provider?

Contact a healthcare provider if you have symptoms of hypoparathyroidism. If you already have a diagnosis, you should have regular visits with them. They’ll monitor your blood calcium levels to make sure treatment is working.

If you have symptoms of acute hypocalcemia, like painful muscle cramps or seizures, go to the nearest hospital.

What can I expect if I have hypoparathyroidism?

The prognosis for hypoparathyroidism is generally good, especially if a healthcare provider catches it early. With treatment, you can feel relief from your symptoms. If calcium levels are hard to manage, you may have long-term issues like kidney problems and muscle changes. Regular check-ups with your provider are important. They’ll perform blood tests to check your calcium and phosphorus levels.

How long does hypoparathyroidism last?

Most cases of hypoparathyroidism are chronic (lifelong), though it can sometimes be temporary.