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Acquired Hypoparathyroidism - Causes, Symptoms, Diagnosis and Treatment

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Acquired Hypoparathyroidism - Causes, Symptoms, Diagnosis and Treatment

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Hypoparathyroidism occurs when parathyroid glands fail to produce a sufficient amount of parathyroid hormones in the body.

Written by

Dr. K. Shobana

Medically reviewed by

Dr. Zulfiqar Ahmed

Published At August 5, 2022
Reviewed AtNovember 16, 2023

What Is Hypoparathyroidism?

Parathyroid glands are a part of the endocrine system. Parathyroid glands are present in four numbers next to the thyroid gland in the neck. Each one resembles the size of a rice grain. Hypoparathyroidism occurs when parathyroid glands fail to produce enough parathyroid hormones. This condition also occurs when parathyroid hormones released do not work well. These parathyroid glands secrete hormones into the bloodstream and travel to other body organs. These glands help regulate chemical processes that enhance the functioning of other organs and activities within the body.

Parathyroid hormones regulate heart rate, body temperature, blood pressure, cell differentiation, and growth. It also promotes the functions of calcium and phosphorus in the blood. Deficiency of parathyroid hormone causes hypocalcemia, where the affected individuals experience low serum calcium levels. Hypocalcemia can cause weakness, muscle cramps, nervousness, uncontrolled twitching, and cramping of the muscles of the hand, feet, arms, legs, and face, and numbness and tingling around the nose, fingers, and toes.

Why Does the Body Require Calcium and Phosphorus?

Calcium and phosphorus mingle together to form calcium phosphate in the body. Calcium phosphate provides hardness and strength to the bones and teeth. Calcium and phosphorus also help in blood formation after an injury. They are also needed for the proper functioning of muscles and nerves.

What Is Meant by Acquired Hypoparathyroidism?

Damage or removal of parathyroid glands causes acquired hypoparathyroidism. As parathyroid glands are small and fragile, they are damaged easily by an accidental injury done during head or neck surgery. Chemotherapy or radiotherapy for the treatment of neck cancer may also damage parathyroid glands, resulting in acquired hypoparathyroidism.

What Causes Acquired Hypoparathyroidism?

The common cause behind acquired hypoparathyroidism is neck surgery. During the surgical procedure, the thyroid gland and parathyroid glands may get damaged or removed accidentally. Sometimes, parathyroid glands are removed due to cancer or treatment for overactive parathyroid glands.

Radiotherapy treatment given for cancer in the neck or chest can damage parathyroid glands and make them under-reactive. Certain medications used in the treatment of cancer can also cause the same.

Parathyroid glands can also be replaced and destroyed by cancer cells in other body organs. This condition can also result in reduced production of parathyroid hormone, causing acquired hypoparathyroidism.

What Are the Other Causes of Hypoparathyroidism?

Hypoparathyroidism can also occur due to transient, congenital, and inherited causes. Transient hypoparathyroidism often occurs in babies who are born soon. It can occur in healthy babies, too.

This condition develops in babies when the mother develops diabetes and overactive parathyroid glands during or before pregnancy. Parathyroid hormones always remain in the gland, and this hormone is not released generally after the baby is born. When this hormone is released, all other parameters return to normal.

Congenital hypoparathyroidism is a condition where hypoparathyroidism occurs from birth. It results from mutations in the genes involved in parathyroid hormone production. Some children are born without parathyroid glands. This condition is also known as idiopathic congenital hypoparathyroidism, where the cause is unknown.

Familial hypoparathyroidism occurs in a person with a family history of hypoparathyroidism. This condition also appears in the absence of other endocrine diseases or developmental problems.

What Are the Symptoms of Hypoparathyroidism?

The symptoms of hypoparathyroidism are shown mainly due to low calcium levels in the blood. The mild symptoms of hypoparathyroidism are tingling and numbness in the fingers, toes, lips and severe muscle cramps. The other symptoms of hypoparathyroidism are fatigue, generalized weakness, anxiety, and headaches.

Affected individuals may also have dry skin, brittle nails, and patchy hair loss. Some individuals affected with hypoparathyroidism may also experience abnormalities in their teeth. In chronic hypoparathyroidism, voice changes, wheezing, and difficulty breathing can also occur. Sudden muscular spasms can happen in the larynx and bronchial tubes. Depression, irritability, confusion, mood swings, and memory loss are also faced in hypoparathyroidism.

Severe complications can arise when hypoparathyroidism is left untreated. The difficulties faced are seizures, fainting, abnormal heartbeats, cataracts, and signs of congestive heart failure. Some individuals may also develop calcifications in the kidney and brain. If left untreated, children with chronic hypoparathyroidism develop stunted growth and slow mental development.

How to Diagnose Hypoparathyroidism?

Hypoparathyroidism is diagnosed through physical evaluation and a review of family history. Physical examination involves asking the patient about the previous neck surgery, thyroid surgery or looking for a scar that indicates the surgery. In some cases, blood and urine tests are done.

Detailed family history is also helpful in diagnosing hypoparathyroidism. A complete record of three generations in a family is taken. The existence of hypoparathyroidism in a family indicates a genetic cause.

Blood tests examine parathyroid, calcium, phosphorus, magnesium, and Vitamin D. Hypoparathyroidism is often diagnosed when the blood test shows low parathyroid, Vitamin D, calcium, magnesium, and high phosphorus levels.

A urine test examines the level of calcium excreted. An unusual loss of calcium through urine indicates hypoparathyroidism. Additional tests are also done when a person experiences other health problems along with hypoparathyroidism.

How to Treat Hypoparathyroidism?

Whether hypoparathyroidism occurs due to hereditary or acquired causes, it is managed by taking calcium and Vitamin D supplements to maintain normal serum calcium levels. Vitamin D is needed as it helps the body to absorb calcium. Affected people are advised to take these supplements for the rest of their lifetime.

The affected person needs regular calcium and Vitamin D monitoring by blood tests. Doctors prescribe diuretics to prevent calcium loss through urine. Diuretics also reduce the amount of calcium and Vitamin D supplements needed for the body. Episodes of tetany (involuntary muscle contraction caused due to hypocalcemia) are managed by taking calcium intravenously.

How to Prevent Acquired Hypoparathyroidism?

The doctor needs to identify parathyroid glands during thyroid or neck surgery to avoid damaging them. The doctor may monitor patients undergoing thyroid or neck surgery, radiotherapy, or chemotherapy to the neck or chest (a cancer treatment), for developing any symptoms and signs of low calcium levels. Prioritizing a healthy lifestyle, such as eating a balanced diet, regular exercise, and managing stress helps in maintaining overall health.

Conclusion

People affected with hypoparathyroidism need a continuous intake of medications given by the doctor to lead a healthy life. Regular blood test monitoring is required to adjust the dosage taken for thyroid daily. To know more about the acquired hypoparathyroidism, seek professional advice from a specialist who specializes in the same.

Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed

Diabetology

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parathyroid hormonehypoparathyroidism
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