Hypoparathyroidism – Symptoms and Causes
Overview
Hypoparathyroidism happens when the parathyroid glands don’t make enough parathyroid hormone (PTH). This hormone helps control calcium and phosphorus levels in the blood.
When there’s not enough PTH, calcium levels drop too low, which causes many of the symptoms linked to this condition.
Some people may have mild symptoms at first, like tingling in the fingers or muscle cramps. Others may develop more serious problems if calcium levels keep dropping. These can include muscle spasms, seizures, or heart rhythm changes.
Blood tests are used to check calcium, phosphorus, and PTH levels. Treatment usually includes calcium and vitamin D supplements. Most people can manage hypoparathyroidism well with regular care and monitoring.
Signs and Symptoms
Hypoparathyroidism often shows itself through several recognizable signs. These symptoms happen because of low calcium levels in the blood, a condition called hypocalcemia.
Early symptoms might include tingling or burning sensations in the fingertips, toes, and lips. Some people also experience muscle cramps or twitching, especially in the hands, feet, and face.
More serious symptoms can develop as calcium levels drop further:
- Muscle pain and stiffness
- Painful muscle spasms called tetany
- Seizures in severe cases
- Fatigue and weakness
- Dry, scaly skin and brittle nails
- Patchy hair loss
- Dental problems including weak tooth enamel
Many patients experience what doctors call “Chvostek’s sign” – facial muscle twitching when tapping the facial nerve in front of the ear.
Another common finding is “Trousseau’s sign” – hand and finger spasms when a blood pressure cuff is inflated on the arm.
Mental symptoms might include:
- Anxiety or nervousness
- Mood changes
- Depression
- Brain fog or difficulty concentrating
- Memory problems
Some people with hypoparathyroidism develop cataracts at a younger age than normal. Others might notice increased pressure inside the eye (glaucoma).
In children, hypoparathyroidism can lead to poor growth and delayed development. Teeth may come in late or have problems with enamel formation.
Symptoms can vary greatly from person to person. Some individuals have mild symptoms while others experience more severe problems that significantly affect daily life.
Causes
Hypoparathyroidism happens when the parathyroid glands cannot make enough parathyroid hormone (PTH). This hormone helps control calcium levels in the blood. Without enough PTH, calcium levels drop too low.
The most common cause is damage to the parathyroid glands during neck surgery. This happens in about 75% of cases. Surgeries for thyroid problems, cancer, or other neck issues can hurt these small glands.
Other causes include:
- Autoimmune Disorders: The body’s immune system attacks the parathyroid glands by mistake.
- Genetic Conditions: Some people are born with problems that affect their parathyroid glands.
- Radiation Treatment: Radiation to the neck can damage the glands.
- Low Magnesium Levels: The body needs magnesium for the parathyroid glands to work right.
Sometimes doctors cannot find the exact cause. This is called idiopathic hypoparathyroidism.
Some rare genetic disorders linked to hypoparathyroidism include DiGeorge syndrome and autoimmune polyglandular syndrome type 1. These conditions affect how the parathyroid glands develop or work.
Certain medications can also cause temporary problems with parathyroid function. These include some cancer drugs and medicines that bind to calcium.
When to Get Help Right Away
Contact your doctor if you notice signs of low calcium in your blood. These may include:
- Tingling in your fingers, toes, or lips
- Muscle cramps or spasms
- Severe muscle pain
- Facial twitching
- Seizures
- Irregular heartbeat
Seek emergency medical care if you experience severe symptoms such as seizures, difficulty breathing, or fainting. These could be signs of a dangerously low calcium level.
Tell your doctor about any new symptoms or side effects from medications. Some treatments for hypoparathyroidism can cause kidney problems over time, so your kidney function needs regular checking.
If you’re planning to become pregnant, talk to your doctor first. Hypoparathyroidism can require special management during pregnancy to keep both mother and baby healthy.
Prevention Measures
There are no specific ways to prevent hypoparathyroidism completely. However, patients preparing for thyroid or neck surgery should discuss risks with their surgeon beforehand.
Before surgery, your doctor might test calcium, parathyroid hormone, and vitamin D levels.
Parathyroid autotransplantation is one option to reduce post-surgery hypoparathyroidism risk. During this procedure, surgeons try to preserve parathyroid tissue in the neck.
Sometimes, they may need to move this tissue to another body area like the arm or chest muscle. It’s important to note that transplanted tissue doesn’t always function properly.
For those who’ve had thyroid or neck surgery or radiation, watching for warning signs is crucial. Look for:
- Tingling or burning in fingers, toes, or lips
- Muscle twitching
- Muscle cramping
If these symptoms appear, contact your healthcare provider immediately. Prompt treatment with calcium and vitamin D supplements can help minimize the disorder’s effects and prevent complications.
