Hypoparathyroidism

The four parathyroid glands are behind the thyroid gland at the front of the neck. The parathyroid glands produce PTH, which regulates the amount of calcium, Vitamin D, and phosphorus in your body. Calcium is important for strong bones and healthy nerve conduction, heart function, blood pressure, and muscle movement. Phosphorus assists calcium with these functions. One of the roles of Vitamin D is to help replenish calcium levels in the body.

The causes of hypoparathyroidism are:

1. Surgery – removal of parathyroid glands during parathyroid, thyroid gland surgeries/neck surgeries.
2. Hereditary
3. Autoimmune disease (when your body’s defense system attacks your cells)

1. Radiation therapy to your head or neck (e.g., as part of therapy for cancer)
2. Low levels of magnesium (a mineral) in the blood
3. Damage of parathyroid glands due to inflammatory disorders (e.g., Sarcoidosis, Amyloidosis)
4. Mineral buildup (copper or iron)
5. Transiently due to severe illness

• Muscle spasms or cramps in the extremities
• Pain in your legs, feet, stomach, or face
• Generalized weakness, hair loss
• Dry hair and dry skin
• Tingling in fingers, toes, and lips
• Headaches, memory problems, and depression.

Children with hypoparathyroidism can develop failure to thrive and tooth problems; they might grow poorly, have tooth problems such as delayed tooth development and dental cavities, and have slow mental development.

Adults with hypoparathyroidism can have kidney problems (such as kidney stones and kidney failure), heart problems, and calcium deposits in the brain. Calcium in the brain can cause tremors, slowed movement, balance problems, and seizures.

Hypoparathyroidism can be linked to other health problems, such as cataracts, adrenal insufficiency (problems with your adrenal glands), and pernicious anemia (low vitamin B12 levels).

In pregnancy, calcium requirements increase to meet the developing baby’s needs, mainly during the 3rd trimester. Hypoparathyroidism during pregnancy can increase the risk of preterm labor or miscarriage in the mother and respiratory distress (difficulty breathing) in the baby.

Dr Reena Thomas will help diagnose this condition by performing a comprehensive medical evaluation.  She will order blood tests and urine studies to evaluate the metabolic panel, including calcium, phosphorous, and parathyroid hormone levels. Getting the appropriate tests is important to determine why you have this condition and guide the appropriate treatment.

The goals of treatment for this condition are to provide relief of symptoms, raise the serum calcium level to low normal levels, avoid low phosphorus levels and increased loss of calcium in the urine, and prevent formation of kidney stones. Dr Reena Thomas will discuss the results of the blood tests and urine studies and formulate an individualized treatment plan.

The treatments depend on the severity and the cause of your hypoparathyroidism. Dr Thomas will choose the most appropriate therapy that you will need to treat this condition.

You will need life-long calcium and vitamin D supplements to keep the blood calcium levels normal. You may need PTH replacement therapy. This is needed if the calcium level in the blood does not normalize or you continue having symptoms despite taking large doses of calcium and vitamin D supplements. Injecting PTH may decrease the need to take too many calcium and vitamin D supplements. You may also need diuretics (water pills) to prevent too much calcium from leaving your body in your urine. A doctor will closely monitor your calcium, phosphorus, and magnesium levels and kidney function during pregnancy. In severely low blood calcium levels, Dr. Thomas will refer you to the hospital to get intravenous calcium administration in the hospital.