The role of the parathyroid glands
The parathyroid glands are four small glands attached to 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. They produce parathyroid hormone which regulates blood calcium levels. These glands may be accidentally damaged during surgery. It can also happen from autoimmune attacks on the glands.
The consequence of this is low blood calcium levels. The damage to the parathyroid glands may be temporary or long term. The use of calcium and vitamin D supplements to normalise the blood calcium level is the mainstay of treatment in these people but the precise nature, dose and duration of these treatments vary across centres.
Why are calcium and phosphorus so important?
Calcium and phosphorus are the elements most abundant in the human body. Most of the body’s calcium is stored in the bones and teeth. The rest circulates through the bloodstream or resides in soft tissue. Calcium is important for normal functioning of almost every physiologic process. It affects nerve conduction, muscle contraction, forms cell membranes and regulates the activity of enzymes.
Only one percent of the total amount of calcium in the body is found outside of bone; however, this form of calcium is critical for communicating information among cells. For example, blood calcium stabilizes blood pressure and promotes normal brain function.
Phosphorus helps the body absorb and utilize calcium. In addition to aiding calcium in nerve conduction, muscle contraction and formation of cell membranes, phosphorus regulates the body’s pH levels and plays an important role in the development of genetic material. Phosphorus is just as important as calcium in the formation of strong bones and teeth.
With hypoparathyroidism, low production of PTH causes an imbalance: the calcium levels in your blood decrease (hypocalcemia) and serum phosphorus increases (hyperphosphatatemia). Simply put, low levels of PTH disrupt the calcium/phosphorus balance. It’s the low level of circulating blood calcium that causes the symptoms of hypoparathyroidism.
Treatments hypoparathyroidism by consuming calcium
There are several treatment options for hypoparathyroidism. 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:
- calcium
- phosphorus
- magnesium
- PTH
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.
Some individuals with severe hypoparathyroidism that do have a high urinary calcium level may be treated with thiazide diuretics. These drugs enhance calcium absorption in the kidneys and can help control or prevent hypercalciuria in individuals taking vitamin D and calcium.
High doses of calcium can cause gastrointestinal side effects such as constipation and should only be taken at the instruction of a physician.
Some individuals with hypoparathyroidism may be encouraged to make dietary changes to help treat their condition.
Hypoparathyroidism diet
If you have hypoparathyroidism, your diet should be rich in calcium and low in phosphorus. Drinking six to eight glasses of water per day may also help ensure that your body doesn’t lose necessary nutrients. Calcium-rich foods include:
- beans
- almonds
- dark green, leafy vegetables
- dairy products
- fortified breakfast cereals
- oats
- prunes
- apricots
Certain phosphorus-rich foods can significantly decrease calcium levels and should be avoided. These include:
- alcohol
- eggs
- red meat
- refined foods, such as white bread and pasta
- trans fats, which can be found in baked goods
- coffee
- tobacco
Always discuss dietary changes and supplements with your doctor to ensure that you get the amount of vitamins and nutrients you need.
References
https://www.healthline.com/health/hypoparathyroidism#outlook
https://rarediseases.org/rare-diseases/hypoparathyroidism/
