HYPOPARATHYROIDISM

General Information

DEFINITION--Decreased production of hormones by the parathyroid glands (which lie behind the thyroid glands in the neck), causing a low level of calcium in the blood. The parathyroid hormone along with vitamin D and calcitonin (a thyroid produced by the thyroid gland) regulates the calcium level in the body.

BODY PARTS INVOLVED--Parathyroid glands (4 pea-sized glands located on the back and side of the thyroid gland); teeth; blood, which affects all body tissues, especially the heart, blood vessels, bones, kidneys, gastrointestinal tract, central nervous system and skin.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Acute phase:

• Tetany (painful cramplike spasms of the face, hands, arms and sometimes feet).
• Tingling and numbness in feet or hands.

Chronic phase:

• Scaling skin.
• Splitting nails.
• Poor tooth development.
• Seizures.
• Mental retardation in children.
• Psychosis in adults.

CAUSES

• Complication of surgery on the parathyroid glands, the thyroid glands or other neck tissues.
• Genetic autoimmune disorder (possibly).
• Radiation of the thyroid gland.
• Hemochromatosis (See Glossary).
• No apparent reason (sometimes).
• Occasionally the parathyroids are absent from birth.

RISK INCREASES WITH--Neck surgery or trauma.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood and urine studies.
• ECG (See Glossary).
• X-rays of bones to detect increased bone density.

APPROPRIATE HEALTH CARE

• Doctor's treatment during the acute stage.
• Self-care after diagnosis during the chronic stage.
• Hospitalization for severe muscle spasms.

POSSIBLE COMPLICATIONS

• Cataracts.
• Brain damage.
• Heartbeat abnormalities and congestive heart failure.
• Difficulty breathing.
• Malformation of teeth.
• Seizures.

PROBABLE OUTCOME--This condition is currently considered incurable. It requires lifelong replacement therapy to control symptoms. Without treatment, it is fatal. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• If you are suffering an acute attack of tetany (see Symptoms) you may need hospitalization for calcium injections to provide quick relief.
• For self-care, if muscle cramps start, place a paper bag over your mouth. Blow into it and rebreathe your breath. This will raise carbon-dioxide levels in the blood and decrease muscle spasms.
• Apply lubricating creams or ointments to dry, scaling skin.
• Keep nails trimmed to prevent splitting.
• Get periodic laboratory tests to check calcium levels in your blood. It is important to remember to have these tests on time.

MEDICATION--Your doctor may prescribe:

• Vitamin D and calcium supplements in high doses. A lifelong course of these medications is necessary.
• Intravenous calcium supplements during hospitalization for severe muscle spasms.
• Sedatives and anticonvulsants for frequent muscle spasms.

ACTIVITY--No restrictions.

DIET--High calcium, low-phosphorous diet. Your doctor or dietitian will provide specific instructions.

Call Your Doctor If

• You have unexplained muscle spasms of the hands, feet or throat, or numbness or tingling in the hands or feet.
• Muscle spasms don't decrease in 1 week, despite treatment.