Hypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH).
There are 4 tiny parathyroid glands in the neck, located near or attached to the back side of the thyroid gland.
The parathyroid glands help control calcium use and removal by the body. They do this by producing parathyroid hormone (PTH). PTH helps control calcium, phosphorus, and vitamin D levels in the blood and bone.
Hypoparathyroidism occurs when the glands produce too little PTH. The blood calcium level falls, and the phosphorus level rises.
The most common cause of hypoparathyroidism is injury to the parathyroid glands during thyroid or neck surgery. It may also be caused by any of the following:
DiGeorge syndrome is a disease in which hypoparathyroidism occurs because all the parathyroid glands are missing at birth. This disease includes other health problems besides hypoparathyroidism. It is usually diagnosed in childhood.
Familial hypoparathyroidism occurs with other endocrine diseases such as adrenal insufficiency in a syndrome called type I polyglandular autoimmune syndrome (PGA I).
Onset of the disease is very gradual and symptoms can be mild. Many people diagnosed with hypoparathyroidism have had symptoms for years before they are diagnosed. Symptoms may be so mild that the diagnosis is made after a screening blood test that shows low calcium.
Symptoms may include any of the following:
The goal of treatment is to reduce symptoms and restore the calcium and mineral balance in the body.
Treatment involves calcium carbonate and vitamin D supplements. These usually must be taken for life. Blood levels are measured regularly to make sure that the dose is correct. A high-calcium, low-phosphorous diet is recommended.
Injections of PTH may be recommended for some people. Your doctor can tell you if this medicine is right for you.
People who have life-threatening attacks of low calcium levels or prolonged muscle contractions are given calcium through a vein (IV). Precautions are taken to prevent seizures or larynx spasms. The heart is monitored for abnormal rhythms until the person is stable. When the life-threatening attack has been controlled, treatment continues with medicine taken by mouth.
Michael Mannstadt is an Endocrinologist in Boston, Massachusetts. Dr. Mannstadt has been practicing medicine for over 31 years and is rated as an Elite doctor by MediFind in the treatment of Hypoparathyroidism. He is also highly rated in 12 other conditions, according to our data. His top areas of expertise are Hypoparathyroidism, Pseudohypoparathyroidism, Albright's Hereditary Osteodystrophy, and Idiopathic Hypercalciuria. He is licensed to treat patients in Massachusetts. Dr. Mannstadt is currently accepting new patients.
Lars Rejnmark-Nielsen is in Arhus, Denmark. Rejnmark-Nielsen is rated as an Elite expert by MediFind in the treatment of Hypoparathyroidism. He is also highly rated in 26 other conditions, according to our data. His top areas of expertise are Hypoparathyroidism, Pseudohypoparathyroidism, Albright's Hereditary Osteodystrophy, and Vitamin D Deficiency.
Bart Clarke is an Endocrinologist in Rochester, Minnesota. Dr. Clarke has been practicing medicine for over 36 years and is rated as an Elite doctor by MediFind in the treatment of Hypoparathyroidism. He is also highly rated in 22 other conditions, according to our data. His top areas of expertise are Hypoparathyroidism, Osteoporosis, Hyperparathyroidism, and Osteitis Fibrosa. He is licensed to treat patients in Minnesota. Dr. Clarke is currently accepting new patients.
The outcome is likely to be good if the diagnosis is made early. But changes in the teeth, cataracts, and brain calcifications cannot be reversed in children who have undiagnosed hypoparathyroidism during development.
Hypoparathyroidism in children may lead to poor growth, abnormal teeth, and slow mental development.
Too much treatment with vitamin D and calcium can cause high blood calcium (hypercalcemia) or high urine calcium (hypercalciuria). Excess treatment may sometimes interfere with kidney function, or even cause kidney failure.
Hypoparathyroidism increases the risk of:
Call your provider if you develop any symptoms of hypoparathyroidism.
Seizures or breathing problems are an emergency. Call 911 or the local emergency number right away.
Published Date : May 13, 2020
Published By : Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Clarke BL, Brown EM, Collins MT, et al. Epidemiology and diagnosis of hypoparathyroidism. J Clin Endocrinol Metab. 2016;101(6):2284-2299. PMID: 26943720 pubmed.ncbi.nlm.nih.gov/26943720/.
Reid LM, Kamani D, Randolph GW. Management of parathyroid disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngolog: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 123.
Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 232.