What is hypoparathyroidism?
Hypoparathyroidism is a rare endocrine disorder in which the parathyroid glands do not produce enough parathyroid hormone (PTH). Parathyroid hormone plays an important role in regulating calcium, phosphorus and vitamin D levels in the blood and bones. Lack of this hormone can lead to a decrease in blood calcium level (hypocalcemia) and an increase in blood phosphorus level (hyperphosphatemia). In the following article, you will learn more about the symptoms, diagnosis and treatment of hypoparathyroidism.
Symptoms of hypoparathyroidism
Symptoms of hypoparathyroidism are caused by a decrease in the level of parathyroid hormone, followed by a decrease in the level of calcium in the blood. These symptoms can range from mild to severe. Some of the most important symptoms of hypoparathyroidism are:
- Muscle spasms and cramps: Low blood calcium can lead to painful muscle spasms and cramps, especially in the arms and legs.
- Tingling and numbness: Tingling or numbness in the fingers and toes and around the lips is one of the common symptoms.
- Weakness and fatigue: Patients may feel constant fatigue and general weakness.
- Heart problems: Decreased calcium levels can cause heart problems such as irregular heartbeat (arrhythmia).
- Anxiety and depression: psychological problems such as anxiety, depression and irritability may also occur.
- Convulsions and convulsive attacks: In severe cases of calcium deficiency, convulsions and convulsive attacks may occur.
- Dry skin and hair: A decrease in calcium levels can cause dry skin and brittle and dry hair.
- Brittle nails: Nails may become thin and brittle and break easily.
- Dental problems: problems such as tooth decay and tooth enamel problems may also occur.
- Digestive problems: Patients may experience problems such as abdominal pain and indigestion.
What is the cause of hypothyroidism?
Causes of hypoparathyroidism can occur for a variety of reasons, mainly including surgical complications, autoimmune disorders, genetic conditions, and other factors. Below are the main causes of this disorder:
Neck or thyroid surgeries
- Thyroidectomy: The most common cause of hypoparathyroidism is thyroid or other neck surgery that may damage or remove the parathyroid glands.
- Parathyroidectomy: Surgery to remove parathyroid tumors may also cause hypofunction of these glands.
Autoimmune disorders
- Autoimmune parathyroiditis: the body’s immune system mistakenly attacks the parathyroid glands and destroys them.
- Autoimmune polyglandular syndrome type 1: This rare disease that can affect multiple endocrine glands is often associated with hypoparathyroidism.
Genetic conditions
- DiGeorge Syndrome (DiGeorge Syndrome): a genetic defect that causes insufficient development or no development of the parathyroid glands.
- Familial hypoparathyroidism: genetic disorders that can be inherited and disrupt the function of the parathyroid glands.
radiation therapy
Radiation therapy to the neck area to treat cancers can damage the parathyroid glands and disrupt their function.
Other medical conditions
- Hemochromatosis: excessive accumulation of iron in the body, which can damage various tissues, including the parathyroid glands.
- Wilson: a disorder of copper metabolism that can damage the parathyroid glands.
- Magnesium deficiency: Low levels of magnesium in the body can disrupt the production of parathyroid hormone.
Infections and inflammations
Severe and chronic infections and inflammations can damage the parathyroid glands and disrupt their function.
Idiopathic causes (no known cause)
In some cases, hypoparathyroidism occurs without a known cause and is known as idiopathic hypoparathyroidism.
Which people are more at risk of underactive parathyroid?
The risk of contracting this disease is higher in some people than others. Factors that can increase the risk of developing this disorder include:
- Neck or thyroid surgery: People who have had neck or thyroid surgery, especially if the surgery involves removing or damaging the parathyroid glands, are at higher risk.
- Autoimmune disorders: People with autoimmune diseases, such as autoimmune thyroiditis (Hashimoto’s), are at increased risk of developing hypoparathyroidism. In this condition, the body’s immune system mistakenly attacks its own tissues, including the parathyroid glands.
- Family history: Having a family history of hypoparathyroidism or other endocrine disorders can increase the risk of developing this disease. Some types of hypoparathyroidism are inherited.
- Radiation therapy: People who have undergone radiation therapy in the neck area, especially for the treatment of head and neck cancers, are at a higher risk of damage to the parathyroid glands and its hypofunction.
- Genetic diseases: Some rare genetic conditions such as DiGeorge syndrome can cause hypoparathyroidism. These conditions are usually associated with other genetic and congenital disorders.
- Other diseases: Some other diseases such as hemochromatosis (iron storage disease) and Wilson’s disease (copper metabolism disorder) may also be associated with this parathyroid disease.
How to diagnose hypoparathyroidism
Diagnosis of hypoparathyroidism depends on a combination of clinical examination, medical history, and blood test results. Also, regular follow-up with a doctor and the necessary tests are necessary to properly manage this disorder. The main steps to diagnose this disorder are:
Examination of clinical symptoms
The doctor first examines the patient’s clinical symptoms. Symptoms that may indicate hypoparathyroidism include:
- Muscle spasms and cramps
- Tingling and numbness in the fingers and toes and around the lips
- Fatigue and weakness
- Anxiety and depression
- Heart problems such as irregular heartbeat
- Dry skin and hair
- Brittle nails
Medical history review
The doctor reviews the patient’s medical history, including:
- History of neck or thyroid surgeries
- Presence of autoimmune diseases in the patient or family
- Any radiation treatment in the neck area
- Any family history of endocrine disorders
Blood tests
Blood tests are done to measure the level of certain substances in the blood:
- Blood calcium: Low calcium level (hypocalcemia) is one of the main symptoms of hypoparathyroidism.
- Blood phosphorus: High phosphorus levels (hyperphosphatemia) may be another symptom.
- Parathyroid hormone (PTH) blood test: a low level of parathyroid hormone in the blood is a sign of hypofunction of this gland.
- Blood magnesium: Magnesium levels may also be checked because magnesium deficiency can lead to or worsen hypoparathyroidism.
- 24-hour urine test: This test is not used to diagnose hypothyroidism directly, but it is more used to check kidney function and measure the excretion of minerals and hormones through urine.
Additional tests
In some cases, additional tests may be done to confirm the diagnosis or to investigate the underlying cause of hypoparathyroidism:
- Imaging: such as ultrasound, CT scan, or MRI to examine the structure of the parathyroid glands and assess any damage or abnormalities.
- Genetic tests: to check for genetic conditions such as DeGeorge syndrome or other inherited disorders associated with hypoparathyroidism.
Check related factors
The doctor may also check other factors associated with the patient’s symptoms to make sure the symptoms are caused by hypoparathyroidism and not related to other diseases.
Treatment of hypoparathyroidism
The treatment of hypoparathyroidism focuses on compensating for the lack of parathyroid hormone and regulating blood calcium and phosphorus levels
At present, there is no definitive cure for hypoparathyroidism, but the symptoms of this disease can be controlled and the quality of life of patients can be improved by taking appropriate supplements, injecting synthetic parathyroid hormone (in certain cases) and regular medical monitoring. Some effective treatment methods include:
Taking calcium supplements
Calcium carbonate or calcium citrate: To maintain the proper level of calcium in the blood, it is recommended to take calcium supplements on a daily basis. The dosage and type of supplement varies depending on the individual needs of the patient.
Vitamin D supplements
Calcitriol (active vitamin D3): These supplements help to increase the absorption of calcium from the digestive system and regulate the level of calcium and phosphorus in the blood.
Synthetic parathyroid hormone
Synthetic PTH: In some cases, synthetic parathyroid hormone injections (such as Natpara) are used for patients who do not respond to conventional treatments. This treatment can improve blood calcium levels and reduce the need for calcium and vitamin D supplements.
Magnesium supplements
Magnesium supplements may be necessary if magnesium is deficient, as magnesium is essential for the proper functioning of parathyroid hormone.
proper diet
Foods rich in calcium and vitamin D: It is recommended to consume foods such as dairy products, fish, eggs, leafy vegetables and cereals enriched with calcium and vitamin D.
Regular medical supervision
Periodic tests: Patients should regularly check the level of calcium, phosphorus, magnesium and parathyroid hormone in their blood and adjust the dosage of their medications and supplements if necessary.
Follow-up with a doctor: continuous consultation with a doctor or endocrinologist is necessary to adjust the treatment and prevent possible complications.
Definitive treatment of hypothyroidism
Currently, there is no definitive treatment for hypoparathyroidism. Treatments aim to manage symptoms and maintain electrolyte balance in the body. Research in the field of new treatments and medical advances continues, and new methods may be introduced in the future to definitively treat this disorder.
Complications of hypoparathyroidism
Hypoparathyroidism can have serious and far-reaching complications, especially if not properly managed and treated. Some of the main complications of this disorder are:
Chronic hypocalcemia
- Muscle convulsions: Chronic low blood calcium can lead to painful muscle convulsions and spasms (tetany).
- Tingling and numbness: in the fingers and toes and around the lips, caused by chronic hypocalcemia.
Seizures: In severe cases, low calcium levels can cause seizures.
heart problems
- Cardiac arrhythmia: Decreased calcium levels can cause irregular heartbeat and other heart problems.
- Cardiomyopathy: weakening of the heart muscles due to long-term hypocalcemia.
Nervous and mental problems
- Anxiety and depression: Calcium deficiency can affect the functioning of the nervous system and lead to psychological problems such as anxiety and depression.
- General fatigue and weakness: General weakness and persistent fatigue due to low calcium levels.
Skin and hair problems
- Dry skin: A decrease in calcium can cause dry and cracked skin.
- Brittle nails: Nails may become thin and brittle.
- Hair loss: Calcium deficiency can lead to thinning and hair loss.
dental problems
- Tooth decay: A decrease in calcium can weaken tooth enamel and increase the risk of tooth decay.
- Delayed teeth development: In children with hypoparathyroidism, teeth development may be delayed or incomplete.
kidney stones
- Hypercalciuria: excessive consumption of calcium supplements can increase calcium in the urine and lead to the formation of kidney stones.
Bone diseases
- Osteopenia and osteoporosis: long-term calcium deficiency can lead to a decrease in bone density (osteopenia) and an increase in the risk of osteoporosis (osteoporosis).
- Seizures and bone pain: Calcium deficiency can cause bone pain and bone cramps.
eye problems
- Cataracts: Chronic calcium deficiency can lead to the formation of cataracts, which may lead to vision loss.
Prevention of hypoparathyroidism
Prevention of hypoparathyroidism (hypoparathyroidism) involves actions that can reduce the risk of developing the disease, especially in people who are at higher risk.
Although complete prevention is not always possible, the possibility of this disease can be reduced by observing the following:
Careful care during surgery: In thyroid and other neck surgeries, doctors must be extra careful not to damage or remove the parathyroid glands. Experienced and specialized surgeons in this field can reduce the risk of hypoparathyroidism after surgery.
Caring for autoimmune disorders: Patients with autoimmune disorders should be under the care of a doctor so that in case of symptoms, diagnosis and treatment can be done in time. Taking medications and regular follow-up with a doctor to control autoimmune diseases that can damage the parathyroid glands.
Avoidance of unnecessary radiation therapy: If possible, radiation therapy to the neck should be avoided or minimized. When necessary, clinicians should use appropriate protective techniques to reduce the risk of damage to the parathyroid glands.
Blood magnesium level monitoring: In people who are exposed to magnesium deficiency, the blood magnesium level should be checked regularly and magnesium supplements should be taken if needed.
Proper diet and adequate intake of calcium and vitamin D: A diet rich in calcium and vitamin D can help maintain the health of the parathyroid glands. Consumption of foods such as dairy products, fish, eggs, and leafy vegetables is recommended.
Regular medical follow-up: Patients should consult their doctor regularly and have periodic examinations to check the health of the parathyroid glands and blood calcium levels.
Diagnostic tests: Have blood tests to measure calcium, phosphorus, and parathyroid hormone levels regularly, especially in people who are at higher risk.
FAQ
Hypoparathyroidism is usually a chronic, permanent condition, especially when it results from thyroid or neck surgeries that damage or remove the parathyroid glands. Some cases of hypoparathyroidism may be temporary, such as after thyroid surgery. But if the parathyroid glands are completely damaged or removed, this condition will be permanent.
Medical treatment of hypoparathyroidism includes calcium supplements (such as calcium carbonate), vitamin D (such as calcitriol) and, in some cases, synthetic parathyroid hormone.
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