Hypoparathyroidism

Hypoparathyroidism

Introduction

The parathyroid glands are located on the posterior surface of the thyroid gland. The hormone they produce, parathyroid hormone (PTH), is crucial for regulating calcium and phosphorus levels in the body.

Hypoparathyroidism is a rare disorder in which the production of parathyroid hormone is impaired. Treatment typically involves supplements, and in some cases, parathyroid hormone replacement therapy.

Causes of Hypoparathyroidism:

  • Neck surgery, such as thyroid gland surgery

  • Autoimmune disease, where antibodies damage the parathyroid glands

  • Inherited hypoparathyroidism

  • Low magnesium levels in the blood

  • Radiation therapy to the face or neck due to malignancy

  • In rare cases, radioactive iodine therapy for hyperthyroidism may cause hypoparathyroidism

Symptoms

Signs and symptoms of hypoparathyroidism are mainly due to hypocalcemia and include:

  • Tingling or burning sensation in the fingers, toes, or lips

  • Pain or cramps in the arms, legs, face, or stomach

  • Muscle spasms or involuntary contractions

  • Fatigue and general weakness

  • Painful menstrual cycles

  • Patchy hair loss

  • Dry skin

  • Brittle nails

  • Depression or anxiety

Effects of Low Parathyroid Hormone Levels

  • Calcium: Essential for strong bones and teeth, muscle contraction, nerve cell function, brain activity, heart rhythm, and blood pressure regulation.

  • Phosphorus: Helps produce energy from food and plays a role in muscle, nerve, heart, and kidney function.

Diagnosis

To diagnose hypoparathyroidism, the doctor will review your medical history, perform a physical examination, and may recommend blood and urine tests.

Laboratory Tests:

  • Low blood calcium and parathyroid hormone levels

  • High blood phosphorus levels

  • Urine analysis

Treatment

The goal of treatment is to relieve symptoms and normalize blood calcium and phosphorus levels. Treatment may include:

  • Calcium supplements and active vitamin D (calcitriol)

  • Magnesium supplementation

Prevention

There are no specific ways to prevent hypoparathyroidism. However, before surgery, calcium, parathyroid hormone, and vitamin D levels may be tested, and supplements prescribed if necessary. In some cases, parathyroid autotransplantation is considered to reduce the risk of postoperative hypoparathyroidism.

Diet

Your doctor may recommend consulting a nutrition specialist for dietary adjustments.

  • Calcium-rich foods: Dairy products, leafy green vegetables, broccoli, calcium-fortified products like orange juice and certain cereals.

  • Low-phosphorus foods: Reduce intake of phosphorus-rich sodas, processed foods, meats, hard cheeses, nuts, and whole grains.

IV Infusion Therapy

If symptoms require urgent management, hospitalization may be necessary for intravenous calcium infusion.

Monitoring

Hypoparathyroidism is a chronic condition, requiring lifelong monitoring and treatment.

  • Initially, weekly or monthly blood tests may be needed.

  • Over time, testing twice a year may be sufficient.

  • Monitoring calcium levels helps in adjusting supplement doses appropriately.

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