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Hypoparathyroidism

Also listed as: Parathyroid - underactive


Hypoparathyroidism is a rare condition that occurs when the parathyroid glands, located in your neck, do not make enough parathyroid hormone. Parathyroid hormone helps regulate the levels of calcium and phosphorus in your blood. If you have hypoparathyroidism, your body has too little calcium and too much phosphorus. Hypoparathyroidism may be either inherited or acquired (from injury to the glands or, more rarely, from surgery on the thyroid gland).


Signs and Symptoms

Most symptoms of hypoparathyroidism are a result of the following signs of having too little calcium in the blood:

The following signs and symptoms often appear in children with hypoparathyroidism:


What Causes It?

There are a number of causes of hypoparathyroidism:


Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing hypoparathyroidism:


What to Expect at Your Provider's Office

Your health care provider will check for muscle spasms, twitching, and seizures. Your health care provider will examine the skin for problems such as dry skin, thinning hair, and fungal infections. In children, the health care provider will ask about and check for tooth development and developmental progress. Blood tests can check levels of calcium, phosphate, magnesium, and parathyroid hormone.


Treatment Options

Prevention

There is no way to prevent inherited hypoparathyroidism. Thyroid and parathyroid surgery once resulted in damage to parathyroid glands, often causing hypoparathyroidism. Today's surgical techniques, however, make this much less likely.

Treatment Plan

The main treatment for hypothyroidism is aimed at restoring the levels of calcium in the body. If you have hypoparathyroidism, you will probably have to take calcium and vitamin D (which is required for the body to absorb calcium) supplements for the rest of your life. To treat tetany (muscle spasms), calcium will be given intravenously (IV). You may also be prescribed diuretics (water pills) to prevent losing too much calcium in the urine and to reduce the amount of calcium and vitamin D needed.

It is important to get regular checkups so your doctor can monitor the levels of calcium and phosphorus in your blood over time.

Complementary and Alternative Therapies

Calcium and vitamin D supplements are the main treatment for hypoparathyroidism. Your doctor will prescribe the right dose based on your blood tests. Do not change your dose without your doctor's supervision. Your doctor will also recommend taking calcium in divided doses several times a day, to help your body absorb it properly.

Nutrition and Supplements

The following supplements may help in the treatment of hypoparathyroidism. Do not take these supplements without your doctor's supervision.

Foods rich in calcium include:

Your doctor may recommend you take calcium with a glass of orange juice -- some forms of calcium are better absorbed in an acidic environment. You can also add acid to your diet by squeezing over lemon juice over leafy greens. The following recommendations may also help you keep calcium levels steady:

Herbs

Herbs rich in minerals such as silica have been used historically to support normal bone growth. If you take a calcium supplement, do not take these herbs without your doctor's supervision:

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of hypoparathyroidism based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.


Prognosis/Possible Complications

If hypoparathyroidism is diagnosed early, the prognosis is good. If it is not diagnosed early, complications may occur, including acute muscle spasms leading to breathing problems; cataracts; muscle, ligament, and nervous system disorders; and stunted growth, tooth malformations, and mental retardation in childhood.


Following Up

People with hypoparathyroidism require lifelong monitoring by a health care provider.


Supporting Research

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1252-1253.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: McGraw-Hill Book Co; 1998.

Gupta MM. Calcium imbalance in hypoparathyroidism. J Assoc Physicians India . 1991;39(8):616-618.

Han YH. Hypoparathyroidism. Medical College of Wisconsin. Accessed on October 27, 2000.

Reber PM, Heath H III. Hypocalcemic emergencies. Med Clin North Am . 1995;79(1):93-106

Stuckey BG, Lim EM, Kent GN, Ward LC, Gutteridge DH. Bisphosphonate therapy for Paget's disease in a patient with hypoparathyroidism: profound hypocalcemia, rapid response, and prolonged remission. J Bone Miner Res. 2001 Sep;16(9):1719-23.


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