Hypoparathyroidism

What is Hypoparathyroidism?

Hypoparathyroidism is a condition where there is insufficient production of parathyroid hormone by the parathyroid glands, which regulate calcium and phosphorus levels in metabolism. This results in increased calcium absorption in the bones and enhanced phosphorus excretion in the kidneys. In hypoparathyroidism, there is a low level of calcium and a high level of phosphorus in the body.

Hypoparathyroidism can be either congenital or acquired, often associated with diseases affecting the thyroid or parathyroid glands.

It may also occur as a result of damage to the parathyroid glands during thyroid surgery, leading to temporary hypoparathyroidism due to nutritional issues after the operation. Symptoms of hypoparathyroidism include tingling sensations, cramps, palpitations, numbness, muscle spasms, as well as skin, hair, and nail problems. In such cases, treatment involves the administration of calcium and vitamin D supplements.

What Causes Hypoparathyroidism?

The parathyroid glands are usually four pea-sized glands located behind the upper and lower poles of the thyroid gland. They produce parathormone, which regulates calcium and phosphorus levels in metabolism. Hypoparathyroidism arises due to issues in these glands, leading to insufficient production of parathormone.

Hypoparathyroidism can result from dysfunction or damage to the parathyroid glands. Common causes include:

• Surgical Procedures: Hypoparathyroidism may occur after thyroid or parathyroid gland surgeries, where the parathyroid glands are removed, damaged, or their blood supply is compromised, leading to impaired function.
• Congenital Factors: It can also be congenital, arising from underdeveloped parathyroid glands that fail to produce sufficient parathyroid hormone, resulting in hypoparathyroidism symptoms.
• Autoimmune Diseases: Autoimmune disorders, where the immune system mistakenly attacks and damages its own tissues, can lead to hypoparathyroidism by affecting the parathyroid glands.
• Other Causes: Hypoparathyroidism may be associated with factors such as infections, radiation therapy, cancer, magnesium deficiency, and certain genetic syndromes.

In cases of hypoparathyroidism, the inadequate production of parathyroid hormone can lead to imbalances in calcium and phosphorus levels, resulting in various symptoms.

What are the symptoms of Hypoparathyroidism?

Hypoparathyroidism is a condition characterized by the insufficient secretion of parathyroid hormone. In this situation, blood calcium levels decrease, and phosphorus levels in the blood rise. Consequently, spasms, cramps, and tremors may occur in the muscles of the body.

Symptoms affecting the nervous system, such as sensory loss, numbness, and cramps, can be observed. By impacting brain functions, symptoms like memory loss and concentration difficulties may arise. Dryness, cracking, and itching, particularly in the hands and feet, are common skin manifestations. It can also contribute to gum diseases.

Eye-related symptoms may include redness, burning, watering, and light sensitivity. Additionally, hypoparathyroidism can lead to heart and rhythm abnormalities as well as bone weakness. While these symptoms vary from person to person, they can range from mild to absent.

How is the diagnosis of Hypoparathyroidism made?

The diagnosis of hypoparathyroidism can be established through a physical examination, medical history, and blood tests. Hypoparathyroidism is typically diagnosed through blood tests that measure levels of calcium, phosphorus, and parathyroid hormone. In hypoparathyroidism, blood calcium levels are low, and phosphorus levels are high.

Parathyroid hormone levels may be lower than normal or within the normal range. Imaging techniques such as thyroid ultrasound or parathyroid scintigraphy can support the diagnosis. Once hypoparathyroidism is diagnosed, treatment options may include calcium and vitamin D supplementation or parathyroid hormone replacement therapy.

Treatment is generally adjusted based on the severity of the disease. The goals of treatment are to restore the balance of calcium and phosphorus, alleviate symptoms, and prevent potential complications.

Types of Hypoparathyroidism

Hypoparathyroidism is a condition that arises from the insufficient production of parathyroid hormone by the parathyroid glands or the inadequate effectiveness of the produced parathyroid hormone.

1. Idiopathic Hypoparathyroidism: Idiopathic hypoparathyroidism occurs without a known cause. It often manifests in childhood or adolescence and may have a hereditary component.
2. Pseudohypoparathyroidism: In pseudohypoparathyroidism, even though parathyroid hormone levels are normal, there is an imbalance in blood calcium and phosphorus. This can be due to a condition affecting the tissues around the parathyroid glands or a disorder in the kidneys.
3. Acquired Hypoparathyroidism: Acquired hypoparathyroidism develops later in life in individuals who were previously healthy. It is often a result of damage to the parathyroid glands following procedures such as thyroid surgery or radiotherapy targeting the thyroid.

The types of hypoparathyroidism vary based on the underlying causes and symptoms, leading to different approaches in their management and treatment.

How is Hypoparathyroidism treated?

The treatment of hypoparathyroidism is determined based on the underlying causes of the disease, the symptoms presented, and the individual patient's condition. The primary goals of treatment are to correct the balance of calcium and phosphorus in the blood, alleviate symptoms, and prevent potential complications. The most commonly used treatment method involves calcium and vitamin D replacements. The aim here is to increase blood calcium levels and enhance calcium absorption.

If the cause of hypoparathyroidism is a deficiency of parathyroid hormone, parathyroid hormone replacement therapy may be administered. In addition to these treatments, medications such as diuretics that enhance calcium absorption, bisphosphonates that reduce calcium excretion, or, in the case of hypoparathyroidism resulting from an autoimmune disease, drugs like corticosteroids may be utilized. During the course of treatment, the patient's symptoms and blood calcium levels are regularly monitored, and adjustments to the dosage are made accordingly.

Nutritional Recommendations for Hypoparathyroidism

• Calcium and Vitamin D Intake: Since calcium and vitamin D intake is crucial for individuals with hypoparathyroidism, it is advisable for them to include foods rich in calcium and vitamin D in their diets. This includes dairy products, cheese, yogurt, broccoli, almonds, dried apricots, and orange juice.
• Vitamin D Sources: Consuming foods rich in vitamin D, such as milk, eggs, and fish, is important as vitamin D enhances calcium absorption.
• Magnesium Intake: Magnesium is also important for bone health and assists in calcium absorption. Therefore, incorporating foods like whole grains, almonds, pumpkin seeds, cashews, and spinach is recommended.
• Limiting Sodium and Processed Foods: It is advisable to reduce the consumption of high-sodium foods and processed foods.
• Alcohol Consumption: Alcohol can be detrimental to bone health and may lower calcium levels. Therefore, it is important to reduce or limit alcohol consumption.