Hypoparathyroidism

(Underactive Parathyroid)

Definition

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

Copyright © Nucleus Medical Media, Inc.

Causes

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 alcohol use disorder and/or malnutrition
  • Other causes, such as metal overload from iron, magnesium, or aluminium

In some cases, a cause cannot be found.

Risk Factors

Risk Factors

Factors that may increase your chance of hypoparathyroidism include:

  • Multiple autoimmune disorders
  • Thyroid or parathyroid surgery
  • Family history of hypoparathyroidism

Symptoms

Symptoms

Hypoparathyroidism does not always cause 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

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine test

Images may be taken of your bodily structures. This can be done with:

Treatment

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

Prevention

There are no current guidelines to prevent hypoparathyroidism.

RESOURCES:

Hypoparathyroidism Association, Inc. https://www.hypopara.org

NORD—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 September 30, 2014.

Hypoparathyroidism. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated June 2, 2014. Accessed September 30, 2014.

Hypoparathyroidism. National Organization for Rare Disorders website. Available at:
http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/703/viewFullReport
Updated April 2, 2014. Accessed September 30, 2014.

Marx SJ. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med. 2000;343(25):1863-1875.

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

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

Thakker RV. Genetic developments in hypoparathyroidism. Lancet. 2001;357(9261):974-976.

Winer KK, Ko CW, Reynolds JC, 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(9):4214-4220.

Last reviewed September 2015 by James Cornell, MD
Last Updated: 9/30/2014

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