Hypoparathyroidism
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 regulates 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
Causes
Several factors are known to cause hypoparathyroidism, including:
- Absence of the parathyroid glands at birth
- Damage to the parathyroid glands by radiation
- Drugs ( cimetidine , aluminium, doxorubicin )
- 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 , or infectious diseases (eg, HIV )
Risk Factors
The following factors increase your chance of developing hypoparathyroidism:
- Thyroid or parathyroid surgery
- Family history of hypoparathyroidism
- Age: under 16 years old or over 40 years old
Symptoms
If you experience any of these, do not assume it is due to hypoparathyroidism. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.
- 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
- Hoarseness
- Thin, brittle nails
- Dry and scaly skin
- Seizures
- Wheezing or shortness of breath
- Symptoms similar to Parkinson's disease
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to specialist. Endocrinologist focus on hormone disorders.
Tests may include the following:
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.
RESOURCES:
Hypoparathyroidism Association
http://www.hypoparathyroidism.org/
National Organization for Rare Disorders, Inc.
http://www.rarediseases.org/
CANADIAN RESOURCES:
Canada Health Portal
http://www.canadian-health-network.ca/
Canadian Society of Endocrinology and Metabolism
http://www.csem.mcgill.ca/
References:
Hypoparathyroid information. The Hypoparathyroidism Association website. Available at: http://www.hypoparathyroidism.org/definition.php . Accessed July 4, 2005.
Hypoparathyroidism. National Organization for Rare Disorders website. Available at: http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Hypoparathyroidism . Accessed July 4, 2005.
Hypoparathyroidism, familial isolated; FIH. Online Mendelian Inheritance in Man website. Available at: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=146200 . Accessed July 4, 2005.
Marx SJ. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med . 2000;343:1863.
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 camparing parathyroid hormone (1-34) versus calcitriol and calcium. J Clin Endocrinol Metab. 2003;88:4214-4220.
Last reviewed January 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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