A hormone called parathyroid hormone (PTH) regulates the amount of calcium and phosphorus in bone and blood. Four small glands called parathyroid glands make PTH. The parathyroid glands are located behind the thyroid gland in the neck.
Hypoparathyroidism is the clinical condition caused by a lack of parathyroid hormone. Calcium levels in the blood fall, and phosphorus levels rise. Low blood calcium levels may cause muscle cramping and tetany, and pain in face, legs or feet, among other symptoms.
The most common cause of hypoparathyroidism is injury to the parathyroid glands during head and neck surgery. Rarely, hypoparathyroidism is a side effect of radioactive iodine treatment for hyperthyroidism. PTH secretion may be impaired when blood levels of the element magnesium are low or when blood pH is too high, a condition called metabolic alkalosis.
DiGeorge syndrome is a childhood disease in which hypoparathyroidism occurs due to congenital absence of the parathyroid glands. Familial hypoparathyroidism occurs with other endocrine diseases such as adrenal insufficiency in a syndrome called Type I polyglandular autoimmune syndrome (PGA I).
Risk factors for hypoparathyroidism include recent thyroid or neck surgery, family history of parathyroid disorder, or history of certain autoimmune endocrine diseases such as Addison’s disease. The incidence is about 4 out of 100,000 people.
Supportive care is necessary for an acute life-threatening attack or hypoparathyroid tetany (prolonged muscle contractions). Calcium is administered by intravenous infusion. Precautions are taken to prevent seizures or larynx spasms. Heart monitoring for abnormal rhythms is continued until the person is stabilized. When the life-threatening attack has been controlled, treatment continues with oral preparations.
The probable outcome is good if the diagnosis is made early. Dental changes, cataracts, and brain calcifications are irreversible changes.
Signs, symptoms & indicators of Hypoparathyroidism
Abdominal pain
Dry hair
Leg pain from long walks
Brittle fingernails
Numb/tingling/burning extremities
Facial burning/tingling
Conditions that suggest Hypoparathyroidism
Susceptibility To Cavities
Hypoparathyroidism causes weakened tooth enamel in children.
Risk factors for Hypoparathyroidism
Hyperphosphatemia
Hypocalcemia
Magnesium Requirement
When magnesium levels are too low, calcium levels may also fall. It appears that magnesium is important for parathyroid cells to make PTH normally. Once recognized, this is usually very easy to fix.
Absence of parathyroid problem
Hypoparathyroidism can lead to
Recommendations for Hypoparathyroidism
Test Electrolytes, Serum
Calcium is the most closely controlled substance in the blood. For patients with hypoparathyroidism, calcium monitoring involves the measurement of total calcium and free (ionic) calcium.
Calcium
The goal of treatment for hypoparathyroidism is to restore the calcium and associated mineral balance within the body. Oral calcium and vitamin D supplements are usually a life-long therapy. Blood levels of calcium require periodic monitoring to ensure proper dosage. A high-calcium, low-phosphorous diet is recommended.
Vitamin D
See the link between Hypoparathyroidism and Calcium.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Highly recommended |
Glossary
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Parathyroid Hormone
A hormone released by the parathyroid glands that acts to keep a constant level of calcium in body tissues.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Phosphorus
The second most abundant mineral in the body found in every living cell. It is involved in the proper functioning of both muscles and nerves. It is needed for metabolic processes of all cells, to activate many other nutrients, and to form energy-storage and energy-releasing compounds. The phosphorus content of the body is approximately one percent of total body weight. Phosphorus combines with fats to form phospholipids.
Thyroid
Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.
Tetany
A condition of physiologic calcium imbalance marked by tonic spasm of muscles and often associated with deficient parathyroid secretion.
Iodine
A essential mineral that is an integral part of the thyroid hormones, thyroxin and triiodothyronine which have important metabolic roles and govern basal metabolism. The best known iodine deficiency symptom is goiter. Other iodine deficiency problems are reduced vitality, hypothyroidism, inability to think clearly, low resistance to infection, loss of control of the muscles of the mouth resulting in mouth contortion and drooling, defective teeth, tendency to obesity and cretinism which is a congenital abnormal condition marked by physical stunting and mental deficiency.
Hyperthyroidism
An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
pH
A measure of an environment's acidity or alkalinity. The more acidic the solution, the lower the pH. For example, a pH of 1 is very acidic; a pH of 7 is neutral; a pH of 14 is very alkaline.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Adrenal Insufficiency
Also known as Adrenal Exhaustion or Low Adrenal Function, this is a condition where the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.
Autoimmune Disease
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Intravenous Infusion
(IV): A small needle placed in the vein to assist in fluid replacement or the giving of medication.
Seizure
While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.
Cataract
A steadily worsening disease of the eye in which the lens becomes cloudy as a result of the precipitation of proteins. Most cataracts are caused by the functions of the body breaking down. Eye trauma, such as from a puncture wound, may also result in cataracts.