Diagnosis

A doctor who suspects hypoparathyroidism will take a medical history and conduct a physical exam.

Blood tests

These findings on blood tests might indicate hypoparathyroidism:

  • A low blood-calcium level
  • A low parathyroid hormone level
  • A high blood-phosphorus level
  • A low blood-magnesium level

Your doctor might also order a urine test to determine whether your body is excreting too much calcium.

More Information

Treatment

The goal of treatment is to relieve symptoms and to normalize levels of calcium and phosphorus in your body. A treatment regimen usually includes:

  • Oral calcium carbonate tablets. Oral calcium supplements can increase calcium levels in your blood. However, at high doses, calcium supplements can cause gastrointestinal side effects, such as constipation, in some people.
  • Vitamin D. High doses of vitamin D, generally in the form of calcitriol, can help your body absorb calcium and eliminate phosphorus.
  • Magnesium. If your magnesium level is low and you're experiencing symptoms of hypoparathyroidism, your doctor may recommend that you take a magnesium supplement.
  • Thiazide diuretics. If your calcium levels remain low even with treatment, thiazide diuretics can help decrease the amount of calcium lost through your urine. However, some people with hypoparathyroidism, including people who inherited the condition, shouldn't take thiazide diuretics.
  • Parathyroid hormone (Natpara). The U.S. Food and Drug Administration has approved this once-daily injection for treatment of low blood calcium due to hypoparathyroidism. Because of the potential risk of bone cancer (osteosarcoma), at least in animal studies, this drug is available only through a restricted program to people whose calcium levels can't be controlled with calcium and vitamin D supplements and who understand the risks.

Diet

Your doctor might recommend that you consult a dietitian, who is likely to advise a diet that's:

  • Rich in calcium. This includes dairy products, green leafy vegetables, broccoli and foods with added calcium, such as some orange juice and breakfast cereals.
  • Low in phosphorus. This means avoiding carbonated soft drinks, which contain phosphorus in the form of phosphoric acid, and limiting meats, hard cheeses and whole grains.

Intravenous infusion

If you need immediate symptom relief, your doctor might recommend hospitalization so that you can receive calcium by intravenous (IV) infusion, as well as oral calcium tablets. After hospital discharge, you'll continue to take calcium and vitamin D orally.

Monitoring

Your doctor will regularly check your blood to monitor levels of calcium and phosphorus. Initially, these tests will probably be weekly to monthly. Eventually, you'll need blood tests just twice a year.

Because hypoparathyroidism is usually a long-lasting disorder, treatment generally is lifelong, as are regular blood tests to determine whether calcium is at normal levels. Your doctor will adjust your dose of supplemental calcium if your blood-calcium levels rise or fall.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Preparing for your appointment

You'll likely start by seeing your primary care doctor. You might then be referred to a doctor trained in treating hormone disorders (endocrinologist).

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting for a specific test. Make a list of:

  • Your symptoms, including those that seem unrelated to the reason for which you scheduled the appointment, and when they began
  • Key personal information, including major stresses or recent life changes and your and your family's medical history
  • All medications, vitamins and other supplements you take, including doses
  • Questions to ask your doctor

Take a family member or friend with you, if possible, to help you remember the information you're given.

For hypoparathyroidism, questions to ask your doctor include:

  • What is likely causing my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What treatments are available, and which do you recommend?
  • What are the alternatives to the primary approach you're suggesting?
  • How can I best manage this condition with my other health conditions?
  • Do I need to change my diet?
  • Are there brochures or other printed material I can take? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • Have you recently had surgery involving your neck?
  • Have you received radiation therapy to your head or neck or for treatment of thyroid problems?
  • Has anyone in your family had similar symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
March 14, 2020
  1. Hypoparathyroidism. Eunice Kennedy Shriver National Institute of Child Health and Human Development. http://www.nichd.nih.gov/health/topics/hypopara/Pages/default.aspx. Accessed Jan. 27, 2020.
  2. Goltzman D. Hypoparathyroidism. https://www.uptodate.com/contents/search. Accessed Jan. 27, 2020.
  3. Hypoparathyroidism. The Hormone Health Network. https://www.hormone.org/diseases-and-conditions/hypoparathyroidism. Accessed Jan. 27, 2020.
  4. Gafni R, et al. Hypoparathyroidism. New England Journal of Medicine. 2019; doi:10.1056/NEJMcp1800213.
  5. Tecilazich F, et al. Treatment of hypoparathyroidism. Best Practice and Research: Clinical Endocrinology and Metabolism. 2018; doi:10.1016/j.beem.2018.12.002.
  6. Ferri FF. Hypoparathyroidism. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 27, 2020.
  7. Orloff LA, et al. American Thyroid Association statement on postoperative hypoparathyroidism: Diagnosis, prevention and management in adults. Thyroid. 2018; doi:10.1089/thy.2017.0309.
  8. Clarke BL, et al. Epidemiology and diagnosis of hypoparathyroidism. Journal of Clinical Endocrinology and Metabolism. 2016; doi:10.1210/jc.2015-3908.

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