Information From Your Health Care Provider

HYPOPARATHYROIDISM

Basic information

description

Hypoparathyroidism occurs when the parathyroid glands fail to produce enough PTH (parathyroid hormone). The parathyroids are 4 pea-sized glands located in the neck (usually by the thyroid glands). They help regulate the calcium, phosphorus, and vitamin D levels in the body. Hypoparathyroidism is rare and can affect all ages. Hyperparathyroidism (an excess of PTH) is a more common disorder.

FREQUENT SIGNS & SYMPTOMS

Symptoms are due to low calcium levels. A decrease in PTH leads to low levels of calcium in the blood (hypocalcemia).
Tingling or burning (paresthesias) in fingertips, toes, and lips. Twitching of the facial muscles.
Muscle cramps or pain (legs, feet, abdomen, or face).
Muscle spasms called tetany (often around the mouth, but also in hands, arms, and throat). In the throat, they may interfere with breathing.
Fatigue or weakness.
Painful menstruation.
Dry hair and patchy hair loss.
Dry, coarse skin; brittle nails.
Anxiety, nervousness, depression, and mood swings.
Headaches.
Memory problems.

causes

Most often, the cause is an injury to the parathyroid glands during neck surgery. Symptoms may begin days or up to years after the surgery.
There are other more rare causes and in some cases, the parathyroids are absent from birth.

risk increases with

Surgery on the parathyroid glands, the thyroid glands, or other neck tissues.
Autoimmune disorders.
Rarely, radiation of the thyroid gland.
Family history of parathyroid diseases.
Low magnesium level in the body.

PREVENTIVE MEASURES

There are no specific preventive measures.

expected outcomes

With early diagnosis and treatment, the outlook is good. It is a chronic disorder, so lifelong treatment is needed. In some cases, outcome depends on underlying cause.

possible complications

Overtreatment with calcium or vitamin D.
Cataracts, seizures, heart problems, or kidney stones.
In children may lead to stunted growth, malformed teeth, and slow mental development.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms and surgery history. Medical tests include blood and urine studies. An ECG (electrocardiogram—method of diagnosing heart diseases), CT, and x-rays of bones may be done.
Treatment typically involves vitamin D and calcium supplements. Diet changes may be recommended.
If symptoms are severe, hospital care may be needed for calcium injections to provide quick relief.
Get periodic medical tests to check calcium levels in your blood. It is important to remember to have these tests done on time. Get regular eye exams.
Wear medical identification (e.g., bracelet or chain) that shows you have hypoparathyroidism.

medications

Vitamin D and calcium supplements are normally prescribed. A lifelong course of these drugs is necessary.
Intravenous (IV) calcium may be given for severe muscle spasms.
Other drugs for treating muscle spasms may be prescribed.

activity

No limits.

diet

A high-calcium, low-phosphorus diet may be helpful. Your health care provider will advise you of special diet needs.

notify our office if

You or a family member has hypoparathyroidism symptoms.
Symptoms do not improve with treatment.
Illnesses that cause diarrhea occur or you are unable to take prescribed supplements by mouth.
Severe symptoms develop (numbness, tingling, cramping-spasms, especially of the toes and fingers or mouth), seek emergency care.