Hypoparathyroidism: Treatment, symptoms, advice and help
Hypoparathyroidism is an endocrinal condition in which there is diminished secretion of the parathyroid hormone (PTH). PTH is a hormone which is secreted by the glands located behind the thyroid gland in the neck. It is responsible for maintaining adequate levels of calcium and phosphorus levels in the blood. Decreased PTH secretion leads to low calcium levels in blood.
Hypoparathyroidism: Incidence, age and sex
Hypoparathyroidism is a rare endocrinal disorder which may affect an individual of any age group. Congenital causes hypoparathyroidism since birth, whereas other causes may lead to hypoparathyroidism later in life.
Signs and symptoms of hypoparathyroidism: Diagnosis
Hypoparathyroidism leads to diminished calcium levels in the blood which subsequently lead to muscle cramps, brittle nails, dryness of hair and skin, tingling sensation in fingers and toes. As the blood calcium level dips, there may be abdominal pain and intense muscular spasms of the hands and feet (tetany). Hypoparathyroidism since birth may also manifest as delayed mental milestones and also delay in tooth formation. Very low blood calcium levels can lead to disturbances in heart rhythm which can be fatal.
Decreased PTH levels leads to decreased calcium absorption from the intestines and increased excretion in urine which reduces blood calcium levels (hypocalcemia). This in turn results in the above mentioned clinical features.
Diagnosis is suspected by finding decreased calcium levels in the blood. Blood levels of PTH along with phosphorous and magnesium are measured for establishment of diagnosis. ECG may be required to detect any abnormality in the heart rhythm.
Causes and prevention of hypoparathyroidism
Hypoparathyroidism can be congenital or acquired. Acquired hypoparathyroidism usually results from injury to the gland during head and neck surgery and is considered the most common cause. The gland can also get damaged by radioiodine therapy used for thyroid gland. On the other hand, congenital causes of hypoparathyroidism include DiGeorge syndrome and family history of any parathyroid disorder.
Hypoparathyroidism can cause persistent and severe hypocalcaemia which may lead to cardiac arrhythmias which may further progress to coma. Eye involvement can be seen with the appearance of cataract. Hypoparathyroidism right from birth may result in stunted growth, slow mental development and delayed or malformed teeth formation.
Individuals with mildly reduced calcium levels and without any symptoms can be followed up without any treatment. They require periodic monitoring of blood calcium levels and heart functions.
The primary aim of treatment is to re-establish calcium balance in blood by prescribing calcium and vitamin D supplements which need to be taken life-long. Individuals may also consult a dietician for advice in following a high calcium and low phosphorus diet. Most affected individuals respond well with treatment.