Categories: Endocrinology

World Hypoparathyroidism Awareness Day

Hypoparathyroidism is relatively a rare condition in which the parathyroid glands produce too little or no parathyroid hormone. The parathyroid hormone regulates various mineral levels (calcium and phosphorus) in our blood. The person with hypoparathyroidism may encounter hypocalcemia, hypomagnesemia, and hyperphosphatemia.

The parathyroid glands are four in number and located behind the thyroid gland at the bottom of our neck. Each gland is usually about the size of a pea. The parathyroid hormones play a crucial role in maintaining calcium and phosphorus levels.

Hypoparathyroidism is a lifelong condition, and it can be challenging to live with the disease. It affects a person’s livelihood, personal life, work-life, relationship, and attitude.

What are the causes of hypoparathyroidism?

Hypoparathyroidism is a complicated condition that can be due to various factors, including:

  • Injury to parathyroid glands
  • Accidental removal of the parathyroid gland during the neck surgery
  • An underdeveloped or total absence of the parathyroid glands from the birth
  • In autoimmune conditions, such as Addison’s disease and pernicious anemia, a person’s immune system attacks the body’s tissues and rejects them.
  • After radiotherapy to treat neck or throat cancer
  • Extremely-low levels of the magnesium, such as alcohol abuse

What are the symptoms and effects of hypoparathyroidism?

In hypoparathyroidism, the person suffers from emotional and physical symptoms due to the fall in blood calcium levels and high phosphorus levels. The symptoms of hypoparathyroidism can include:

  • Fatigue and lack of energy sometimes may be the main complaint of the patient
  • Presence of numbness, tingling, or burning sensation (paraesthesia) in your lips, toes, and fingertips
  • Muscle pains, cramps, and spasms in your hands, feet, and large muscles of your body
  • Twitching and spasm in facial muscles
  • Skin changes, particularly dry and coarsened skin
  • Rough and coarse hairs that break easily
  • Easily breakable fingernails
  • Mood changes include getting irritated, emotional, sadness, anxious, depressed, and feeling emptiness.
  • Episodes of brain fog, which impairs memory, focus, and concentration

How to diagnose hypoparathyroidism?

A healthcare provider analyzes your medical history and performs a physical examination, blood test, and urine analysis to diagnose hypoparathyroidism.

  • Blood test: The following tests are suggestive for diagnosis of hypoparathyroidism:
      • Blood calcium level (low level)
      • Parathyroid hormone level (low level)
      • Blood-phosphorus level (high level)
  • Urine analysis: Parathyroid hormone prevents too much calcium excretion from the kidneys. So, in hypoparathyroidism, urine analysis can tell if your body is excreting too much calcium.

What is the treatment of hypoparathyroidism?

Hypoparathyroidism is a chronic or long-term illness that affects many aspects of your life. The treatment includes:

  • Symptoms management: This treatment approach includes managing symptoms occurring due to low calcium and high phosphorus levels. The healthcare provider will recommend medicines to restore calcium levels, depending on your blood calcium level and symptoms. Calcium carbonate and vitamin D supplements restore calcium levels and decrease muscle cramps, twitching, and paraesthesia. You may need to take these medicines for life-long.

Regular monitoring of blood calcium levels, parathyroid hormone, and phosphorus levels is necessary. If you have too low calcium levels or chronic muscle spasms, you may need to receive calcium through an intravenous drip.

  • Dietary approach: Diet plays a crucial role in hypoparathyroidism. The healthcare providers recommend you to follow a high-calcium and low-phosphorus diet, such as:
      • Dairy products, including milk and cheese, are good sources of calcium
      • Some green vegetables,  such as okra, cabbage, and broccoli
      • Soya-rich food, such as soya milk, soya beans, and tofu, fortified with calcium
      • Nuts
      • Calcium-fortified flour
      • Fishes, including pilchards ad sardines
      • Avoid phosphorus-rich food, such as red meat, poultry products, rice, oats, and some fish.
  • Good sleep habits: Developing a regular sleep routine helps manage fatigue and anxiety.
  • Stay active: Keeping yourself active reduces tiredness and improves mood. You can indulge yourself in some exercise, short walks, or developing new hobbies. They make you feel more energetic and improve sleep.
  • Coping mood-related issues: To manage stress and depression, you should encourage healthy eating, practicing yoga, massaging cramped muscles, limiting alcohol consumption, meditation, or light exercising. If you still find it hard to cope with stress, consult your doctor or therapist for help.
  • Maintaining hydration: Drinking plenty of water keeps your brain and body hydrated and prevents further fluctuation of minerals levels. Avoid caffeinated beverages and alcohol, which affect mineral levels in our blood.

Hypoparathyroidism is a chronic condition that requires lifelong management. With the help of the appropriate information, support, and medical attention, you can cope with it. So, on this World Hypoparathyroidism Day, let’s spread awareness and all the necessary education for this rare and complex disorder.

Dr. K S Brar | Senior Consultant Diabetology, Endocrinology, Endocrinology – Paediatric | Dharamshila Narayana Superspeciality Hospital, Delhi and Narayana Superspeciality Hospital, Gurugram

Narayana Health

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