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.

Treatment

The goal of treatment is to relieve symptoms and to normalize levels of calcium and phosphorus in your body. A treatment regimen typically 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.
  • Parathyroid hormone (Natpara). The Food and Drug Administration has approved this once-daily injection for treatment of low blood calcium due to hyperparathyroidism. 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 (chronic) disorder, treatment generally is lifelong, as are regular blood tests to determine whether calcium in particular is at normal levels. Your doctor will adjust your dose of supplemental calcium if your blood-calcium levels rise or fall.

Preparing for your appointment

You'll likely start by seeing your primary care provider. You might then be referred to a doctor who specializes 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?