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Hypoparathyroidism

(Underactive Parathyroid)

Definition

The parathyroid glands are four pea-sized glands. They are located next to the thyroid gland in the neck. The glands secrete the parathyroid hormone (PTH). PTH helps to regulate the level of calcium in the blood.

In hypoparathyroidism, there is not enough PTH secreted. This causes low levels of calcium in the blood. Low blood calcium is known as hypocalcemia.

Thyroid and Parathyroid Glands: Posterior (Back) View

Causes

Hypoparathyroidism may be caused by:

Removal of the parathyroid glands

Underlying autoimmune disorders

Absence of the parathyroid glands at birth

Damage to the parathyroid glands

Genetics conditions such as DiGeorge syndrome

Magnesium deficiency due to alcoholism, and/or malnutrition

Other causes, such as metal overload from iron, magnesium, or aluminium

In some cases, a cause cannot be found.

Risk Factors

Factors that increase your chances of hypoparathyroidism include:

Multiple autoimmune disorders

Thyroid or parathyroid surgery

Family history of hypoparathyroidism

Symptoms

Many patients with hypoparathyroidism will have not symptoms. If symptoms do develop, they may include:

Weakness

Muscle cramps or twitching

Pain

Difficulty with walking

Tingling around the mouth, fingers, and toes

Excessive nervousness

Loss of memory

Mood swings

Anxiety

Blurred vision due to cataracts

Thin, brittle nails

Dry and scaly skin

Seizures

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may need to test your body fluids. This can be done with:

Blood tests

Urine test

Your doctor may need pictures of your body structures. This can be done with:

X-ray

CT scan

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Calcium and Vitamin D Supplementation

Calcium and vitamin D will usually be taken indefinitely. They are often taken by mouth.

Calcium may be given by injection. This is done when immediate symptom relief is needed.

Prevention

There are no current guidelines to prevent hypoparathyroidism.

RESOURCES:

Hypoparathyroidism Association

http://www.hypoparathyroidism.org

National Organization for Rare Disorders

http://www.rarediseases.org

CANADIAN RESOURCES:

Canadian Society of Endocrinology & Metabolism

http://www.endo-metab.ca

Health Canada

http://www.hc-sc.gc.ca

References:

Definition of hypoparathyroidism and related disorders. The Hypoparathyroidism Association website. Available at: https://www.hypopara.org/about-hpth/definition.html . Accessed June 4, 2013.

Hypoparathyroidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 7, 2012. Accessed June 4, 2013.

Hypoparathyroidism. National Organization for Rare Disorders website. Available at: http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/703/viewFullReport. Updated July 7, 2011. Accessed June 4, 2013.

Marx SJ. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med . 2000;343:1863.

Moffett JM, Suliburk J. Parathyroid autotransplantation. Endocr Pract . 2011 Mar-Apr;17 Suppl 1:83-89.

Testini M, Gurrado A, Lissidini G, Nacchiero M. Hypoparathyroidism after total thyroidectomy. Minerva Chir . 2007 Oct;62(5):409-415.

Thakker RV. Genetic developments in hypoparathyroidism. Lancet . 2001;357:974.

Winer KK, Ko CW, et al. Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone (1-34) versus calcitriol and calcium. J Clin Endocrinol Metab . 2003;88:4214-4220.

Last reviewed June 2013 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.