Hypoparathyroidism means that a person’s parathyroid glands do not produce enough parathyroid hormone. This is a relatively rare condition that usually happens because of an injury to or the surgical removal of the parathyroid glands.
People with hypoparathyroidism usually develop low blood calcium (hypocalcemia) and high blood phosphate (hyperphosphatemia). They may also have muscle pain or muscle spasms.
Some people have no symptoms, or only very mild symptoms, such as tingling in the hands. In severe cases, a person can develop significant muscle spasms or seizures.
Read on to learn more about hypoparathyroidism.
The parathyroid glands are two pairs of glands that sit behind the thyroid gland in the neck. Some people may have additional parathyroid glands, though the typical number is four.
These glands help regulate blood calcium levels by stimulating the release of calcium when levels drop too low. They also regulate phosphorus and vitamin D levels.
When the parathyroid glands are injured or removed, they do not make enough parathyroid hormone. This can cause too little blood calcium and too much phosphorus. Over time, this may cause:
- damage to bones
- kidney stones
- muscle spasms or chronic pain
People with hypoparathyroidism have a range of symptoms — from few or none to severe.
Symptoms might include:
- tingling or other unusual sensations
- muscle pain
- dry skin
- yeast infections
- tetany, or uncontrolled twitching and cramping of muscles in the body
- changes in mood
In chronic hypoparathyroidism, people may experience:
One of the most common causes of hypoparathyroidism is the removal of the parathyroid glands — often as a treatment for another condition.
Other causes include:
- damage to the parathyroid glands during thyroid surgery
- genetic changes, such as a mutation in the CASR gene that affects the secretion of parathyroid hormones
- trauma to the neck, such as from an injury during a car wreck or fall
- diseases present at birth that affect the development and function of the parathyroid glands
- atypically low levels of magnesium in the body
- in relation to other syndromes, such as DiGeorge syndrome
Some rare causes of this condition include:
- extensive radiation therapy to treat primarily head and neck cancer
- atypically high levels of magnesium
- autoimmunity, where the body attacks its own cells
Some risk factors for hypoparathyroidism are:
- thyroid disease since it may require thyroid surgery
- surgery to the neck
- physical injuries to the neck
- certain autoimmune diseases that damage the parathyroid glands
- medications, such as newer classes of immune checkpoint inhibitors for cancer therapy, can affect the glands
Next, they may perform additional tests to rule out other potential causes and to check for complications.
Some tests a doctor may perform include:
- tests of nerve function, these measure electrical activity in muscles and nerves
- urinalysis, which involves assessing the appearance, and contents of the urine
- electrocardiogram, which assesses a person’s heart health
- additional blood tests to check for various substances in the blood, including:
Calcium and vitamin D supplements
Diuretics may also help prevent a person from urinating out too much calcium.
In some cases, a doctor may also recommend replacement parathyroid hormone treatment. This treatment only became available in 2015. Doctors usually recommend it for people who do not respond well to calcium and vitamin D alone.
A person will need ongoing monitoring of calcium and phosphorus blood levels to reduce the risk of complications. As part of this, the doctor may also recommend other tests, such as tests of kidney function.
Low blood calcium, or hypocalcemia, is the main complication of hypoparathyroidism. Hypocalcemia may lead to lead to symptoms such as weakness, muscle cramps, and uncontrollable twitching, among others.
- kidney damage
- calcification in some regions of the brain, especially the basal ganglia
- eye damage such as cataracts
- arrhythmias, or atypical heart rate
- seizures and convulsions
- intracranial hypertension, which leads to severe headaches and vision changes
No specific lifestyle strategies will prevent hypoparathyroidism. This is because injuries to the parathyroid gland are the most common cause. The following strategies may reduce the risk:
- If undergoing neck surgery, choose a highly experienced surgeon with experience protecting the parathyroid glands.
- Ask about alternatives to neck surgery.
- Adopt strategies to reduce the risk of neck injuries, such as driving at a safe speed, wearing a seatbelt, and wearing a helmet when cycling.
People with hypoparathyroidism should ask a healthcare professional if they need to make dietary changes.
A person may find it beneficial to eat foods high in calcium, such as:
- dairy products
- dark leafy greens
Eliminating carbonated beverages can reduce phosphorus intake without reducing other nutrients. A person may also need to limit their intake of some high-phosphorus vegetables.
It is also important to follow an otherwise healthy diet, such as avoiding trans fats and red meat.
A doctor may recommend regular blood testing for calcium and phosphorus. They may also make additional dietary recommendations depending on test results.
Below are some common questions and answers about hypoparathyroidism.
What is it like living with this condition?
Most people with this condition have normal, relatively healthy lives. They may need to take calcium supplements or replacement parathyroid hormone.
People should note that certain lifestyle changes, such as eating a healthy diet, may help ease some of the symptoms of hypoparathyroidism.
What is pseudohypoparathyroidism?
Hypoparathyroidism means that the parathyroid glands are absent or do not produce enough parathyroid hormone.
Conversely, pseudohypoparathyroidism means that a person’s body does not respond to the parathyroid hormone. It is a genetic disease and is present at birth. Hypoparathyroidism usually develops later in life.
Pseudohypoparathyroidism can also be autoimmune, where the gland becomes resistant to parathyroid hormones.
What is hyperparathyroidism, and how is it different?
Hypo is a prefix indicating under or low, while hyper is a prefix that means excess. So hypoparathyroidism refers to the low production of parathyroid hormone. Hyperparathyroidism refers to the high production of parathyroid hormone.
Hypoparathyroidism often responds well to calcium supplements and simple lifestyle changes. In many people, symptoms are minor. In most people, the prognosis is good. A person can expect to live a healthy life with an average life expectancy.
People at risk for hypoparathyroidism should talk with a doctor, seek blood testing, and ask for guidance on managing symptoms and preventing complications.
The right ongoing care can improve a person’s quality of life and prevent or reduce symptoms.