Hypoparathyroidism is a rare condition that occurs when the parathyroid glands in the neck don’t produce enough parathyroid hormone (PTH).
Everyone has four parathyroid glands located near or behind the thyroid gland. Each gland is the size of a grain of rice. The major function of PTH is to regulate the level of calcium in your body. It also controls the level of phosphorus and has a role in the production of the active form of vitamin D. All of these activities are required to maintain calcium balance.
Having too little PTH causes low levels of calcium and high levels of phosphorus in the body. This condition may not cause any serious medical problems when it’s caught early, but it does require lifelong monitoring and treatment.
The causes of hypoparathyroidism include:
- injury to or removal of the parathyroid glands
- DiGeorge syndrome, which is a genetic disorder that affects development of certain body systems
- autoimmune disease
- cancer radiation treatments
- low magnesium levels
Low calcium levels cause many of the symptoms of this condition. They can include:
- muscle aches or cramps
- tingling, burning, or numbness in the fingertips, toes, and lips
- muscle spasms, especially around the mouth
- patchy hair loss
- dry skin
- brittle nails
- anxiety or depression
- painful menstruation
Children with hypoparathyroidism may also have headaches, vomiting, or dental issues such as weakened tooth enamel or poor tooth development.
Your doctor will begin by reviewing your medical history. They’ll then do a physical examination to check for symptoms such as dry skin, muscle spasms, and hair loss.
Your doctor will order blood tests to check the levels of the following in your blood:
Additional tests include the following:
- Your doctor may test your urine for calcium to determine if excess levels of calcium are being secreted in the urine.
- An electrocardiogram (EKG) measures the electrical activity in your heart. The information from this test can tell your doctor if you have an abnormal heart rhythm, which can be caused by calcium deficiency.
- X-rays and bone density tests can help your doctor determine if low calcium levels have affected your bones.
The doctor will also check for abnormal tooth development and delayed milestones to diagnose this condition in children.
There are several treatment options for hypoparathyroidism. They include the following:
Calcium and Mineral Restoration
Treatment for this condition is designed to help restore the proper levels of calcium and minerals in your body. Initial treatment involves taking calcium carbonate and vitamin D supplements in pill form.
Vitamin D is given because it helps the body absorb calcium and eliminate phosphorus. Your doctor will determine the amount of calcium and vitamin D you need. They’ll monitor the following levels periodically to ensure they’re within the normal range:
Your doctor may suggest taking supplements throughout the day to help stabilize your calcium level. Most individuals need to take supplements for the rest of their lives to treat this condition.
If your calcium levels are life-threatening or if you’re having troubling muscle spasms, intravenous (IV) calcium will be given. This relieves your symptoms more quickly because the calcium goes directly into your bloodstream.
Your doctor may also order diuretics to help decrease the amount of calcium secreted in your urine.
If you have hypoparathyroidism, your diet should be rich in calcium and low in phosphorus. Drinking 6 to 8 glasses of water per day may also help ensure that your body doesn’t lose necessary nutrients. Calcium-rich foods include:
- dark green, leafy vegetables
- dairy products
- fortified breakfast cereals
- fortified orange juice
Certain phosphorus-rich foods can significantly decrease calcium levels and should be avoided. These include:
- soft drinks
- red meat
- refined foods, such as white bread and pasta
- trans fats, which can be found in baked goods
Always discuss dietary changes and supplements with your doctor to ensure that you get the amount of vitamins and nutrients you need.
Early diagnosis and treatment can significantly reduce the risk of complications from hypoparathyroidism. Complications due to low calcium levels may still occur, but they can be improved with treatment. Reversible complications include:
- tetany, or prolonged cramp-like spasms in the hands and fingers
- malformed teeth
- a heart arrhythmia, or irregular heartbeat
- paresthesias, or tingling sensations in the lips, tongue, fingers, and feet
If they’re not diagnosed early, however, certain irreversible complications may occur. These can include:
- cataracts, which is a condition that involves clouding of the lens of the eye
- calcium deposits in the brain
- stunted growth in children
- slow mental development in children
Your doctor will monitor levels of calcium and phosphorus through regular blood tests. These tests will be weekly or monthly after diagnosis. Once your condition is stabilized with treatment, your blood will be tested twice per year. If there are any changes in your calcium or phosphorus levels, your doctor will adjust the dosage of supplemental calcium accordingly.
Because hypoparathyroidism is a chronic condition, treatments and dietary changes will have to be maintained throughout your life. Most people can keep their symptoms under control with proper long-term treatment.