Hypoparathyroidism

Hypoparathyroidism

What is hypoparathyroidism? — Hypoparathyroidism is a rare condition of the parathyroid glands in your neck (figure 1). These glands make a hormone that helps control the amount of calcium in the blood. The hormone is called "parathyroid hormone," or "PTH."
You get hypoparathyroidism when you have too little PTH in your body. This causes the levels of calcium in your blood to get too low.
Neck surgery on the thyroid or parathyroid glands or major surgery for head and neck cancer is the most common cause of hypoparathyroidism. After this surgery, some people have hypoparathyroidism that lasts only a short time. Other people have hypoparathyroidism for the rest of their lives, but this is less common. Other conditions can also cause hypoparathyroidism.
What are the symptoms of hypoparathyroidism? — The symptoms are different depending on the cause of hypoparathyroidism.
People who develop hypoparathyroidism after neck surgery can have the following symptoms:
Tingling in the hands or feet, or around the mouth
Unusual muscle movements, such as jerking, twitching, or spasms
Muscle cramps
Feeling tired, irritable, anxious, or depressed
People with long-lasting hypoparathyroidism caused by other medical conditions can have:
Eye problems, especially cataracts
Dry, thick skin
Coarse hair that breaks easily and can fall out, causing bald spots
Fingernails that break easily, with ridges that go from left to right
Is there a test for hypoparathyroidism? — Yes. A doctor or nurse should be able to tell if you have hypoparathyroidism by doing blood tests to measure your calcium and PTH levels. They might also test the levels of other minerals and vitamin D in your blood. You might have tests to measure calcium and magnesium levels in your urine.
How is hypoparathyroidism treated? — Taking calcium and vitamin D supplements is the main treatment for hypoparathyroidism. Your doctor might also give you medicines, such as diuretics (water pills) to prevent too much calcium from leaving your body in your urine.
When you start taking supplements, your doctor or nurse will test your blood and urine every week. The tests will show if your calcium level is coming back to normal. Your doctor or nurse can also check that the supplements are not causing other health problems. When your calcium level is normal again, you only need blood and urine tests every 3 to 6 months.
If you have permanent hypoparathyroidism, you will need to take supplements for life. If your parathyroid glands stop working for a short time, such as after surgery, you might only need treatment until the glands start working again.
If you have permanent hypoparathyroidism and supplements are not enough to keep your calcium levels up, your doctor might give you another medicine, too. This is called "parathyroid hormone" and is given as a shot once or twice each day. It is very expensive.
What if I want to get pregnant? — If you want to get pregnant, talk to your doctor, nurse, or midwife about your hypoparathyroidism. They will measure your levels of calcium, PTH, and vitamin D while you are pregnant and after you give birth. Testing is especially important in the later months of pregnancy and while you are nursing your baby. Your doctor, nurse, or midwife can help you get the right supplements and any medicines you need to have a healthy baby.
What will my life be like? — Most people with hypoparathyroidism are able to live normal lives. If your doctor or nurse gives you supplements or medicines, take them the way they tell you to. Make sure you get any tests you need on time. If you have questions, ask your doctor or nurse. They will watch for problems and treat them if they happen.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 17220 Version 7.0
Release: 28.2.2 - C28.105
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