Your neck has four pea-sized glands called the parathyroid glands. Hyperparathyroidism happens when they don’t make enough parathyroid hormone (PTH).
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. Your body uses calcium to keep your nerves, muscles, and heart working. Low levels of calcium can result in symptoms ranging from mild to severe muscle spasms, tingling, heart problems, and seizures. The good news is you can treat the condition. 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.
Causes of hypoparathyroidism
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
- genetics
- autoimmune disease
- cancer radiation treatments
- low magnesium levels
Symptoms of hypoparathyroidism
Low calcium levels cause many of the symptoms of this condition. They can include:
- Muscle cramps or spasms in your legs, feet, lower back, or face
- Tingling in your fingers, toes, or lips
- Anxiety and depression
- Heart failure
- An irregular heartbeat
- Low blood pressure
- Seizures
Low calcium in the long term can lead to:
- Cataracts
- Dental problems
- Movement disorders like tremors
- Hair loss and brittle nails
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.
Diagnosis of hypoparathyroidism
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:
- calcium
- phosphorus
- magnesium
- PTH
- 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.
- Doctors will also check for abnormal tooth development and delayed milestones to diagnose this condition in children.
Treatments for hypoparathyroidism
There are several treatment options for hypoparathyroidism. Unlike most other hormonal deficits, hypoparathyroidism is not treated with replacement of the missing hormone, parathyroid hormone (PTH). Treatment for this condition is designed to help restore the proper levels of calcium and minerals in your body.
Oral calcium carbonate tablets and Vitamin D
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
Magnesium
Some people may also need magnesium supplementation. If your magnesium level is low and you’re experiencing symptoms of hypoparathyroidism, your doctor may recommend that you take a magnesium supplement.
Parathyroid hormone
Conventional therapy with vitamin D and calcium may lead to a buildup of calcium in the kidneys. This buildup may lead to problems, including kidney stones and deposits of calcium, reduced kidney function, tissue damage, or even kidney failure.The development of PTH as a replacement therapy in patients with hypoparathyroidism was first explored by NICHD investigators beginning in 1992. The U.S. Food and Drug Administration has approved this once-daily injection for treatment of low blood calcium due to hypoparathyroidism. Because of the potential risk of bone cancer (osteosarcoma), at least in animal studies, this drug is available only through a restricted program to people whose calcium levels can’t be controlled with calcium and vitamin D supplements and who understand the risks.
Intravenous infusion
If you need immediate symptom relief, your doctor might recommend hospitalization so that you can receive calcium by intravenous (IV) infusion, as well as oral calcium tablets. After hospital discharge, you’ll continue to take calcium and vitamin D orally.
Diet
Diet recommendations usually include eating foods high in calcium, such as dairy products, breakfast cereals, fortified orange juice, and green, leafy vegetables, or avoiding foods high in phosphorus, such as meat, poultry, fish, nuts, whole grains, and beans
References
https://www.nichd.nih.gov/health/topics/hypopara/conditioninfo/treatment
https://www.healthline.com/health/hypoparathyroidism
https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/diagnosis-treatment/drc-20355381
https://emedicine.medscape.com/article/122207-medication#2
https://www.webmd.com/women/hypoparathyroidism-rare#2
