• 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:
    • Weakness
    • Muscle cramps or twitching
    • Pain
    • Difficulty with walking
    • Tingling around the mouth, fingers, and toes
    • Excessive nervousness
    • Loss of memory
    • Personality change or mood swings ( anxiety )
    • Blurred vision due to cataracts
    • Thin, brittle nails
    • Dry and scaly skin
    • Seizures

    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.

    Prevention

    There are no guidelines for preventing this condition.

    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.rarediseases.org/search/rdbdetail%5Fabstract.html?disname=Hypoparathyroidism . 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.

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