Hypoparathyroidism
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Hypoparathyroidism

En Español (Spanish Version)

Definition

Hypoparathyroidism is a disorder in which insufficient parathyroid hormone (PTH) is secreted from the parathyroid glands, resulting in abnormally low levels of calcium in the blood. The parathyroid glands are four pea-sized glands located next to the thyroid gland in the neck; they secrete PTH, which regulates the level of calcium in the blood.

Thyroid and Parathyroid Glands: Posterior (Back) View

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© 2008 Nucleus Medical Art, Inc.

Causes

Several factors are known to cause hypoparathyroidism, including:

  • Absence of the parathyroid glands at birth
  • Damage to the parathyroid glands by radiation
  • Drugs (cimetidine, aluminium, doxorubicin)
  • Removal of the parathyroid glands
  • Underlying autoimmune disorders
  • Genetics
  • DiGeorge syndrome
  • Magnesium deficiency (due to alcoholism , malnutrition)
  • Autoimmune: polyglandular autoimmunity type 2 or autoimmune hypoparathyroidism
  • Other causes: metal (iron, magnesium, aluminium) overload, cancer , or infectious diseases (eg, HIV )

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing hypoparathyroidism:

  • Thyroid or parathyroid surgery
  • Family history of hypoparathyroidism
  • Age: under 16 years old or over 40 years old

Symptoms

If you experience any of these symptoms, do not assume it is due to hypoparathyroidism. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.

  • Weakness
  • Muscle cramps or twitching
  • Pain
  • Difficulty with walking
  • Tingling around the mouth, fingers, and toes
  • Excessive nervousness
  • Loss of memory
  • Personality change or mood swings ( anxiety )
  • Blurred vision due to cataracts
  • Hoarseness
  • Thin, brittle nails
  • Dry and scaly skin
  • Seizures
  • Wheezing or shortness of breath
  • Symptoms similar to Parkinson's disease

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in hormone disorders (endocrinologist).

Tests may include the following:

  • Blood tests—to measure calcium, magnesium, phosphorus, vitamin D, and/or PTH
  • Urine test—to measure calcium excretion
  • X-ray or CT scan of the skull and bones

Treatment

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

Calcium and Vitamin D Supplementation

Hypoparathyroidism is treated by oral calcium and vitamin D supplementation, which usually must be taken indefinitely. In addition, calcium may be administered by injection when immediate symptom relief is necessary.

Parathyroid Gland Transplantation

Transplantation of previously preserved parathyroid gland is a successful procedure in approximately 25% of cases with normalization of blood calcium.

Prevention

There are no guidelines for preventing hypoparathyroidism.

RESOURCES:

American Association of Clinical Endocrinologists
http://www.aace.com

Hypoparathyroidism Association
http://www.hypoparathyroidism.org

National Organization for Rare Disorders, Inc.
http://www.rarediseases.org

CANADIAN RESOURCES:

Canada Health Portal
http://www.canadian-health-network.ca/

Canadian Society of Endocrinology and Metabolism
http://www.csem.mcgill.ca/

References:

Hypoparathyroid information. The Hypoparathyroidism Association website. Available at: http://www.hypoparathyroidism.org/definition.php . Accessed July 4, 2005.

Hypoparathyroidism. National Organization for Rare Disorders website. Available at: http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Hypoparathyroidism . Accessed July 4, 2005.

Hypoparathyroidism, familial isolated; FIH. Online Mendelian Inheritance in Man website. Available at: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=146200 . Accessed July 4, 2005.

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

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 camparing parathyroid hormone (1-34) versus calcitriol and calcium. J Clin Endocrinol Metab. 2003;88:4214-4220.



Last reviewed March 2008 by David Juan, 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.

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