Hypoparathyroidism

Symptoms of hypoparathyroidism often are related to low calcium levels in the blood. The symptoms can include:

• Tingling or burning in the finger, toes and lips.
• Muscle aches or cramps in the legs, feet, stomach or face.
• Twitching or spasms of muscles, mainly around the mouth but also in the hands, arms and throat.
• Tiredness or weakness.
• Headaches.
• Trouble with memory.

Get a healthcare checkup if you think you might have symptoms of hypoparathyroidism. Call your healthcare professional right away if you have a seizure or trouble breathing. Hypoparathyroidism can lead to either of these medical problems.

Hypoparathyroidism happens when the parathyroid glands don't make enough parathyroid hormone. There are four small parathyroid glands in the neck near the thyroid gland.

Parathyroid hormone controls the levels of calcium and phosphorus in the body. So, too little parathyroid hormone causes irregular levels of:

• Calcium. This mineral is stored in bones and teeth, and it makes them hard. Calcium also plays other key roles. It's needed for muscles to work. It helps the nerves and brain work properly. And it's needed to control heart rhythm and blood pressure.
• Phosphorus. This mineral is found in all cells, but mostly in the bones. Phosphorus is needed to help the body create energy from food. Phosphorus also helps the muscles, nerves, heart and kidneys work.

Causes of hypoparathyroidism can include:

• Neck surgery. This is the most common cause of hypoparathyroidism. The condition can happen after the parathyroid glands get damaged by mistake or removed during surgery. Neck surgery may be done to treat conditions of the thyroid gland, or to treat throat or neck cancer.
• Autoimmune disease. With this type of condition, the body's defenses attack healthy tissue by mistake. When the parathyroid glands are attacked, they stop making their hormone.
• Hereditary hypoparathyroidism. This condition runs in families. It can result from being born without parathyroid glands or with glands that don't work correctly. Some types of hereditary hypoparathyroidism are linked with deficiencies of other glands that make hormones.
• Low levels of magnesium in the blood. Low magnesium levels can affect how well the parathyroid glands work. Healthy magnesium levels are needed for the parathyroid glands to make enough PTH hormones.
• Extensive cancer radiation treatment of the head or neck. Radiation can destroy the parathyroid glands. Rarely, a type of radiation treatment for thyroid diseases called radioactive iodine may lead to hypoparathyroidism.

Factors that can raise the risk of hypoparathyroidism include:

• Recent neck surgery, especially if the thyroid was involved.
• A family history of hypoparathyroidism.
• Having certain autoimmune or hormone-related conditions, such as Addison's disease. Addison's disease causes the adrenal glands to make less of their hormones.

Hypoparathyroidism can lead to other health conditions. Some of these conditions can be reversed with treatment. Others can't be reversed.

Complications that can be reversed

Some conditions that stem from hypoparathyroidism are due to low calcium levels. These may get better with treatment. They include:

• Cramp-like spasms of the hands and fingers that can be painful and last a long time.
• Muscle pain and twitches or spasms of the muscles of the face, throat or arms. When these spasms happen in the throat, they can make it harder to breathe. This may require emergency medical care.
• Tingling or burning feelings in the lips, tongue, fingers and toes. They may feel like pins and needles.
• Seizures.
• Problems with kidney function, such as kidney stones and kidney failure.
• Irregular heart rhythms and fainting. Hypoparathyroidism also can cause the heart to have trouble pumping enough blood. This is a condition called heart failure. Most often, it can't be cured.

Complications that often can't be reversed

Treatment might prevent these health conditions or keep them from getting worse. But once they happen, taking calcium and vitamin D most often doesn't reverse the damage. These complications include:

• Hardening and changes in the shape of bones, and poor growth.
• Delayed mental development in children.
• Calcium buildups in the brain. These can cause trouble with balance and movement. They also can cause seizures.
• Clouded vision due to cloudy areas in the lenses of the eyes, called cataracts.
• Teeth that don't form properly, affecting dental enamel and roots. This can happen when hypoparathyroidism happens at an early age when teeth are coming in.

There are no specific steps to take to prevent hypoparathyroidism. But if you're scheduled to have thyroid or neck surgery, talk to your surgeon. Ask about the risk of damage to your parathyroid glands during the procedure. Before surgery, your healthcare professional may choose to test your calcium, parathyroid hormone and vitamin D levels. Your care professional also may have you start taking supplements if needed.

If the risk for hypoparathyroidism after surgery is high, your surgeon may suggest a procedure to lower the risk. It involves moving one or two of the parathyroid glands into a muscle toward the front of the neck. The procedure is called parathyroid autotransplantation, and it's done during the surgery. Sometimes, the surgeon may need to move parathyroid tissue to another area of the body, such as the forearm. Transplanted parathyroid tissue does not always work properly.

If you've had surgery or radiation involving your thyroid or neck, be aware of possible hypoparathyroidism symptoms. These can include a tingling or burning feeling in the fingers, toes or lips, or muscle twitching or cramping. If you get symptoms, your healthcare professional might recommend prompt treatment with calcium and vitamin D. This can lessen the effects of hypoparathyroidism.