Hypoparathyroidism

Diagnosis

To diagnose hypoparathyroidism, your healthcare professional will begin by reviewing your medical history and performing a physical examination. Blood and urine tests are often recommended to confirm the diagnosis and assess how well your body regulates calcium and phosphorus.

Blood tests may show the following results that suggest hypoparathyroidism:

• Low calcium levels in the blood

• Low parathyroid hormone levels

• High phosphorus levels in the blood

Your magnesium level might also be tested since low magnesium can contribute to low calcium levels.

Urine tests help determine whether your body is losing too much calcium through urine. Parathyroid hormones normally act on the kidneys to prevent calcium loss, so an abnormal result may indicate impaired hormone function.

Other tests may be suggested, such as:

• An electrocardiogram (ECG or EKG) to check your heart rhythm

• X-rays or bone density tests to assess bone health

Treatment

The main goal of treating hypoparathyroidism is to relieve symptoms and restore calcium and phosphorus levels to a healthy range. Treatment is often lifelong and typically includes a combination of supplements, medications, and dietary adjustments.

Common treatments include:

• Oral calcium supplements: Taken as tablets, chews, or liquids to increase calcium levels in the blood. High doses may cause constipation in some individuals.

• Vitamin D supplements: Prescription-strength vitamin D, such as calcitriol, helps your body absorb calcium and excrete excess phosphorus.

• Magnesium supplements: Used if magnesium levels are low and contributing to symptoms.

• Thiazide diuretics: These may be prescribed if calcium levels remain low or if urine calcium levels are high. They help reduce calcium loss through urine.

• Parathyroid hormone replacement: A newer treatment that replaces missing hormones has been studied but is not yet widely approved in the United States.

Dietary management plays a key role in controlling symptoms. Your healthcare provider may refer you to a registered dietitian, who will recommend a diet that is:

• High in calcium: Including dairy products, leafy greens, broccoli, and calcium-fortified foods like orange juice and cereal.

• Low in phosphorus: Avoiding carbonated beverages, processed foods, meats, hard cheeses, nuts, and whole grains.

Calcium infusion may be needed for immediate relief from severe symptoms. This involves receiving calcium intravenously (through an IV) in a hospital setting, often combined with oral vitamin D supplementation.

Monitoring

Regular blood tests are essential to track calcium and phosphorus levels. At first, tests may be done weekly or monthly, but over time, they may be reduced to once or twice a year. Ongoing monitoring ensures your healthcare provider can adjust your calcium and vitamin D intake as needed.

Because hypoparathyroidism is typically a lifelong condition, consistent treatment and follow-up care are necessary to maintain long-term health and prevent complications.