Hypoparathyroidism

To find out if you have hypoparathyroidism, your healthcare professional may start by asking you about your medical history. You're also given a physical exam. Your care professional may suggest blood and urine tests too.

Blood tests

The following blood test results might suggest hypoparathyroidism:

• A low level of calcium in the blood.
• A low level of parathyroid hormones.
• A high level of phosphorous in the blood.

The level of magnesium in your blood also might be checked. A low level of magnesium may cause a low blood-calcium level.

Urine test

Parathyroid hormones act on the kidneys to prevent too much calcium from going into in the urine. A urine test can tell whether your body is getting rid of too much calcium.

Other tests

Your healthcare professional may suggest more tests. These might include other blood tests or a test to check your heart's rhythm, called an electrocardiogram.

Hypoparathyroidism treatment aims to ease symptoms and bring calcium and phosphorus levels in your body back into healthy ranges.

Treatments include:

• Oral calcium. These calcium supplements are taken by mouth as tablets, chews or liquid. They can raise calcium levels in your blood. In high amounts, they can cause side effects such as constipation in some people.
• Vitamin D. High amounts of vitamin D can help your body absorb calcium and get rid of phosphorus. Often, this vitamin D is a prescription supplement called calcitriol. It's different from the usual supplements you can get without a prescription.
• Magnesium. If your magnesium level is low and you have symptoms of hypoparathyroidism, you may need to take a magnesium supplement.
• Thiazide diuretics. These medicines may be used if your calcium levels stay low even with treatment. They also might be used if the amount of calcium in your urine is very high. Thiazide diuretics can help lessen the amount of calcium lost in urine.
• Parathyroid hormone replacement. A type of medicine that replaces parathyroid hormones, called Natpara, has been available to treat hypothyroidism. But that medicine is being phased out. A newer type of medicine that replaces parathyroid hormones has been tested in clinical trials. It hasn't yet been approved in the United States.

Diet

Your healthcare professional might recommend that you talk with a registered dietitian. The dietitian is likely to suggest a diet that's:

• Rich in calcium. This includes dairy products, green leafy vegetables and broccoli. It also includes foods with added calcium, such as some orange juices and breakfast cereals.
• Low in phosphorus. This means you don't have carbonated soft drinks, which contain phosphorus in the form of phosphoric acid. You also limit processed foods, meats, hard cheeses, nuts and whole grains.

Calcium infusion

If you need symptom relief right away, you may receive calcium through a needle in a vein. This is called an intravenous (IV) infusion. Most often, it's done in the hospital. You'll likely also take vitamin D tablets by mouth. After you leave the hospital, you keep taking calcium and vitamin D tablets.

Monitoring

Your healthcare professional likely will do blood tests to check your calcium and phosphorus levels on a regular basis. At first, these tests probably will be weekly to monthly. In time, you may need blood tests just once or twice a year. Regular testing lets your care professional change the amount of calcium you take if your levels rise or fall.

Because hypoparathyroidism most often is a long-lasting disorder, testing and treatment tends to be lifelong.

You'll likely start by seeing your primary care professional. You might then be referred to a doctor called an endocrinologist, who treats hormone disorders.

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. For example, you may be told not to eat for a certain number of hours the night before a test. Take a family member or friend with you to the appointment if you can. A loved one can help you remember the information you're given.

Before your appointment, make a list of:

• Your symptoms. Include any that don't seem related to the reason for your appointment. Note when the symptoms began
• Key personal information. Include major stresses or recent life changes and your medical history as well as your family's medical history.
• All medicines, vitamins, herbs and other supplements you take. Include the doses you take.
• Questions to ask your healthcare professional.

Questions to ask may include:

• What is the likely cause of my symptoms? Are there other possible causes?
• What tests do I need?
• Is my condition likely short-term or long-term?
• What treatments are available, and which do you recommend?
• Are there alternatives to the main treatment approach you're suggesting?
• How can I best manage this condition with my other health conditions?
• Should I see a specialist?
• Do I need to change my diet?
• Are there brochures or other printed material I can take? What websites do you recommend?

Feel free to ask other questions during your checkup.

What to expect from your doctor

Your healthcare professional is likely to ask you questions such as:

• Have you recently had surgery involving your neck?
• Have you received radiation therapy to your head or neck or therapy for treatment of thyroid problems?
• Has anyone in your family had symptoms like yours?
• Do your symptoms happen all the time of just some of the time?
• How bad are your symptoms?
• What, if anything, seems to make your symptoms better?
• What, if anything, seems to make your symptoms worse?