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
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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

Hypoparathyroidism does not always cause symptoms. If symptoms do develop, they may include:
  • Weakness
  • Muscle crampsor 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

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

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.

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Prevention

There are no current guidelines to prevent hypoparathyroidism.

RESOURCES

Hypoparathyroidism Association, Inc.
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 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;343:1863.

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

Testini M, Gurrado A, et al. Hypoparathyroidism after totalthyroidectomy. 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.

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