Hypoparathyroidism is a medical condition in which the parathyroid glands do not produce enough parathyroid hormone (PTH), which helps regulate the levels of calcium and phosphorus in the body. The parathyroid glands are four small glands located in the neck that are responsible for producing PTH.

Hypoparathyroidism can be caused by damage to the parathyroid glands during surgery, autoimmune disorders, or genetic factors. Symptoms of hypoparathyroidism may include tingling in the fingers and toes, muscle cramps, seizures, and weakened tooth enamel.

Treatment for hypoparathyroidism may involve calcium and vitamin D supplementation to help restore normal levels of calcium and phosphorus in the body. In some cases, PTH replacement therapy may be necessary to help restore normal levels of the hormone. It is important for people with hypoparathyroidism to work closely with their healthcare provider to manage the condition and prevent complications.

If you or someone you know is experiencing symptoms of hypoparathyroidism, it is important to speak with a healthcare provider for an accurate diagnosis and appropriate treatment. Untreated or poorly managed hypoparathyroidism can lead to serious complications, including seizures and bone damage.

Hypoparathyroidism occurs when your parathyroid glands don't secrete enough parathyroid hormone. You have four small parathyroid glands in your neck behind your thyroid gland.

Factors that can cause hypoparathyroidism include:

• Neck surgery. This most common cause of hypoparathyroidism develops after accidental damage to or removal of the parathyroid glands during surgery. Neck surgery may be done to treat conditions of the thyroid gland, or to treat throat or neck cancer.
• Autoimmune disease. In some cases, your immune system attacks parathyroid tissues as if they were foreign bodies. In the process, the parathyroid glands stop producing their hormone.
• Hereditary hypoparathyroidism. In this form, either you're born without parathyroid glands or they don't work properly. Some types of hereditary hypoparathyroidism are associated with deficiencies of other hormone-producing glands.
• Low levels of magnesium in your blood. Low magnesium levels can affect the function of your parathyroid glands. Normal magnesium levels are required for normal production of parathyroid hormone.
• Extensive cancer radiation treatment of your face or neck. Radiation can result in destruction of your parathyroid glands. In rare cases, radioactive iodine treatment for hyperthyroidism may lead to hypoparathyroidism.

There are no specific actions to prevent hypoparathyroidism. However, if you're scheduled to have thyroid or neck surgery, talk to your surgeon about the risk of damage to your parathyroid glands during the procedure. Your doctor may choose to test your calcium, parathyroid hormone and vitamin D levels and have you begin supplementation if needed before surgery.

If you've had surgery involving your thyroid or neck, watch for signs and symptoms that could indicate hypoparathyroidism, such as a tingling or burning sensation in your fingers, toes or lips, or muscle twitching or cramping. If they occur, your doctor might recommend prompt treatment with calcium and vitamin D to minimize the effects of the disorder.

The goal of treatment is to relieve symptoms and to normalize levels of calcium and phosphorus in your body. A treatment regimen usually includes:

• Oral calcium carbonate tablets. Oral calcium supplements can increase calcium levels in your blood. However, at high doses, calcium supplements can cause gastrointestinal side effects, such as constipation, in some people.
• Vitamin D. High doses of vitamin D, generally in the form of calcitriol, can help your body absorb calcium and eliminate phosphorus.
• Magnesium. If your magnesium level is low and you're experiencing symptoms of hypoparathyroidism, your doctor may recommend that you take a magnesium supplement.
• Thiazide diuretics. If your calcium levels remain low even with treatment, thiazide diuretics can help decrease the amount of calcium lost through your urine. However, some people with hypoparathyroidism, including people who inherited the condition, shouldn't take thiazide diuretics.
• Parathyroid hormone (Natpara). The U.S. Food and Drug Administration has approved this once-daily injection for treatment of low blood calcium due to hypoparathyroidism. Because of the potential risk of bone cancer (osteosarcoma), at least in animal studies, this drug is available only through a restricted program to people whose calcium levels can't be controlled with calcium and vitamin D supplements and who understand the risks.

Diet

Your doctor might recommend that you consult a dietitian, who is likely to advise a diet that's:

• Rich in calcium. This includes dairy products, green leafy vegetables, broccoli and foods with added calcium, such as some orange juice and breakfast cereals.
• Low in phosphorus. This means avoiding carbonated soft drinks, which contain phosphorus in the form of phosphoric acid, and limiting meats, hard cheeses and whole grains.

Intravenous infusion

If you need immediate symptom relief, your doctor might recommend hospitalization so that you can receive calcium by intravenous (IV) infusion, as well as oral calcium tablets. After hospital discharge, you'll continue to take calcium and vitamin D orally.

Monitoring

Your doctor will regularly check your blood to monitor levels of calcium and phosphorus. Initially, these tests will probably be weekly to monthly. Eventually, you'll need blood tests just twice a year.

Because hypoparathyroidism is usually a long-lasting disorder, treatment generally is lifelong, as are regular blood tests to determine whether calcium is at normal levels. Your doctor will adjust your dose of supplemental calcium if your blood-calcium levels rise or fall.