About Hypoparathyroidism
The disease causes of hypoparathyroidism include:
- Parathyroid avoidance method during surgery: This happens when surgeons try to protect the parathyroid glands during neck surgery, but the glands may still be accidentally damaged or disrupted.
- Parathyroid autotransplantation during surgery: Surgeons sometimes move parathyroid tissue to another part of the body to save its function, but the glands may not work properly after being moved.
- Bilateral central neck lymph node dissection during surgery: Removing lymph nodes from both sides of the neck can sometimes damage or remove nearby parathyroid glands.
- Lymphatic metastasis: Cancer spreading to the lymph nodes near the parathyroid glands can harm the glands and affect their ability to work.
- Presence of parathyroid in the specimen: During surgery, part or all of a parathyroid gland might be accidentally removed and found in the tissue sample sent for testing. This can lead to a loss of parathyroid function.
Risk factors of hypoparathyroidism include:
- Genetic changes, such as mutations in the CASR gene or autoimmune regulator gene (AIRE)
- Trauma to the neck, such as from an injury during a car wreck or fall
- Diseases present at birth that affect the development and function of the parathyroid glands
- Atypically low levels of magnesium in the body
- Extensive radiation therapy to treat head and neck cancer
It is important to note that certain surgical procedures, such as total thyroidectomy (removal of the thyroid gland) with neck clearance (removal of lymph nodes and nearby tissues), have been associated with an increased risk of developing hypoparathyroidism.
Please consult with your healthcare professional for more information about risk factors and individualized recommendations.
The most common early symptoms of hypoparathyroidism include:
- Tingling sensation in the fingers, toes, and lips
- Muscle cramps
- Fatigue
- Brittle fingernails and hair
- Dry skin
As hypoparathyroidism progresses or becomes more severe, additional symptoms may occur, such as:
- Headaches
- Severe mood changes
- Twitching facial muscles
It's important to note that these symptoms can vary among individuals, and some people may experience different or additional symptoms. If you suspect you may have hypoparathyroidism or are experiencing any of these symptoms, it is recommended to consult with your doctor for a proper diagnosis and appropriate management. They can provide personalized guidance and treatment options based on your individual situation.
To diagnose hypoparathyroidism, healthcare providers commonly perform the following examinations, tests, and procedures:
- Physical exam: The healthcare provider will do a complete physical exam, which includes a neurological exam. They will look for signs like muscle cramps, tingling in the fingers or around the mouth, and unusual muscle twitches, which can indicate low calcium levels.
- Lab tests: Blood tests are typically performed to check levels of calcium and phosphorus. Abnormal levels may indicate hypoparathyroidism.
Additional tests: To rule out other potential causes and assess complications, healthcare providers may perform the following tests:
- Nerve function tests: These measure electrical activity in muscles and nerves.
- Urinalysis: It involves assessing the appearance and contents of urine.
- Electrocardiogram (ECG): It assesses a person's heart health.
- Additional blood tests: These may check for substances like magnesium, vitamin D, and parathyroid hormone levels.
To determine the severity of hypoparathyroidism, specific additional examinations, tests, and procedures may be recommended based on the gathered information and results of the initial evaluation. These can vary depending on the individual's symptoms and body system being evaluated. It is essential to follow up with your healthcare provider if any symptoms worsen or change after the initial evaluation.
Remember, only your healthcare provider can determine the appropriate examinations, tests, and procedures for your specific situation.
The goals of treatment for hypoparathyroidism are:
- Prevent symptoms of low calcium (hypocalcemia): Manage calcium levels to avoid issues like muscle cramps, tingling, or seizures
- Maintain calcium levels in the blood: Keep calcium levels within or slightly below the normal range
- Regulate calcium and phosphate balance: Ensure the calcium-phosphate product (a measure of how calcium and phosphate interact) stays below a safe level to avoid complication
- Avoid too much calcium in the urine (hypercalciuria): Prevent excess calcium excretion to protect kidney function
- Avoid too much calcium in the blood(hypercalcemia): Prevent high calcium levels that can harm organs and tissues
- Prevent renal and other extra-skeletal calcifications: Avoid calcium deposits in the kidneys or other areas outside the bones
The following treatments are recommended to achieve these goals:
- Conventional therapy: This includes oral calcium supplements (such as calcium carbonate or citrate) and active vitamin D treatments (such as calcitriol). Thiazide diuretics may also be prescribed to increase calcium reabsorption. Conventional therapy helps increase intestinal calcium absorption and correct hypocalcemia but does not replace all functions of parathyroid hormone (PTH).
- Adjunct PTH therapy: Subcutaneous injection of recombinant human PTH(184) has shown efficacy in reducing the need for active vitamin D and oral calcium while maintaining serum calcium levels within the normal range.
- Continuous infusion of PTH: In some cases, continuous infusion of PTH(134) via an insulin pump has been found to decrease urine calcium excretion and reduce the cumulative dose required to maintain normal calcium levels.
- Self-care and health behavior changes: Patients should monitor their clinical manifestations, laboratory data, and signs of chronic complications periodically. This helps in finding the ideal balance for each patient and avoiding situations that increase the risk of soft tissue calcifications.
Remember, these are general recommendations. The specific treatment plan should be discussed with a healthcare professional.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.