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 very 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
Several factors are known to cause hypoparathyroidism, including:
- Absence of the parathyroid glands at birth
- Damage to the parathyroid glands by radiation
- 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
Risk Factors
The following factors increase your chance of developing hypoparathyroidism:
- Thyroid or parathyroid surgery
- Family history of hypoparathyroidism
Symptoms
Many patients with hypoparathyroidism will have not symptoms. If symptoms do develop, they may include:
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to specialist. Endocrinologists focus on hormone disorders.
Your doctor may need to test your bodily fluids. This can be done with:
- Blood tests
- Urine test
Your doctor may need pictures of your body 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.
RESOURCES:
Hypoparathyroidism Association
http://www.hypoparathyroidism.org/
National Organization for Rare Disorders, Inc.
http://www.rarediseases.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca
Thyroid Foundation of Canada
http://www.thyroid.ca/
REFERENCES:
Definition of hypoparathyroidism and related disorders. The Hypoparathyroidism Association website. Available at: https://www.hypopara.org/about-hpth/definition.html . Accessed January 2, 2013.
Hypoparathyroidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated March 7, 2012. Accessed January 2, 2013.
Hypoparathyroidism. National Organization for Rare Disorders website. Available at: http://www.raredis... . Accessed January 2, 2013.
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, Lissidini G, Nacchiero M. Hypoparathyroidism after total thyroidectomy. 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.
Last reviewed March 2013 by Brian Randall, MD
Last Updated: 03/15/2013