The medical term hypoparathyroidism refers to a disease caused by underactive parathyroid glands, which leads to calcium deficiency due to insufficient release of the so-called parathyroid hormone . Parathyroid hypofunction, which is caused in most cases by surgical intervention on the thyroid gland, manifests itself in symptoms such as: hair loss, brittle skin, muscle cramps, dementia or the formation of cataracts.
What is hypoparathyroidism?
The treatment of hypoparathyroidism usually proceeds without complications. It quickly leads to a positive course of the disease and the symptoms disappear again. See AbbreviationFinder for abbreviations related to Hypoparathyroidism.
Hypoparathyroidism is defined by parathyroid hormone deficiency . The parathyroid glands, which usually consist of four small bodies, are located directly on the thyroid gland under the larynx and produce the parathyroid hormone.
This messenger substance, which in the case of hypoparathyroidism is only present in small amounts or not at all, ensures on the one hand that the amount of calcium in the blood is increased and on the other that it lowers its phosphate concentration.
The parathyroid hormone deficiency caused by the parathyroid gland underfunction has various negative effects, with which hypoparathyroidism can worsen and endanger both the physical and the psychological condition of those affected.
Causes
One of the most common causes of hypoparathyroidism is thyroid surgery, in which the parathyroid glands are removed either in error or intentionally (due to radical thyroidectomy).
Because the parathyroid glands are located immediately adjacent to the thyroid gland, inadvertent removal of the intact parathyroid glands (or parts of them) is relatively common. The blood flow to the parathyroid glands can also be disturbed during the course of the surgical procedure, which impairs the blood supply and, in the worst case, they die off, resulting in hypoparathyroidism.
However, excessive intake of vitamin D over a longer period of time also inhibits the production of parathyroid hormone in the parathyroid glands and thus leads to hypoparathyroidism in the long term.
Furthermore, radiation in the neck area (e.g. in the case of a malignant tumor) or a long-lasting lack of magnesium as well as the so-called DiGeorge syndrome (caused by defective parathyroid glands) are among the triggers of hypoparathyroidism.
Symptoms, Ailments & Signs
The symptoms of hypoparathyroidism are easy to spot. Due to the lack of calcium, the transmission of stimuli between nerves and muscles is impeded, resulting in painful muscle cramps (spasms). These are called tetanic seizures. First, there are abnormal sensations such as tingling, prickling, painful burning, numbness or fur on the forearms, hands or mouth region.
In the further course, muscle cramps occur with a pawed position of the hands, which is typical of hypoparathyroidism, and more rarely with a pointed foot position. The spasm of the facial muscles creates a characteristic fish-mouth position. If other muscles are affected by the tetanic seizures, other symptoms may appear.
This can lead to shortness of breath if the respiratory muscles are affected. If the muscles of the internal organs such as the urinary bladder or the intestines cramp, this can trigger abdominal pain, diarrhea and an increased urge to urinate. Anxiety, irritability, restlessness or depressive moods can also occur. In rare cases, those affected also experience epileptic seizures.
If hypofunction of the parathyroid glands is not treated adequately in childhood, long-term effects such as changes to the hair, skin and fingernails, cataracts, hair loss, dental anomalies, motor disorders, calcification of the brain, inner ear, kidneys or heart muscle as well as growth and development disorders up to and including to mild mental retardation.
Diagnosis & History
Diagnosis of hypoparathyroidism is based on the presenting symptoms and assessment of calcium levels, as well as examinations of the muscles and nerves.
The calcium deficiency caused by hypoparathyroidism causes various physical symptoms. Muscle cramps and sensory disturbances (tetanic syndrome) occur, which can lead to a so-called tetanic attack. Typical signs of such life-threatening seizures caused by hypoparathyroidism are tingling sensations in the hands and mouth and the urge to urinate, abdominal pain and diarrhea, followed by severe muscle spasms, which are manifested by an involuntarily contracted mouth (fish mouth), cramped hands and feet (pawed position and pointed foot) express themselves, whereby those affected are usually fully conscious.
The sometimes also occurring spasm of the larynx can lead to life-threatening shortness of breath, especially in children suffering from hypoparathyroidism.
The phosphate excess also manifests itself in the easily excitable muscles and nerves as well as in itching and reddened eyes. In addition, calcium deficiency and excess phosphate in untreated hypothyroidism lead to a wide variety of symptoms such as hair loss, brittle skin, calcification of the lens of the eye (cataracts) and the brain (dementia), whereby the excess water that is also present in hypoparathyroidism can suddenly impair vision.
Complications
Hypoparathyroidism causes various symptoms and symptoms, which usually depend on the severity of the disease. In most cases, however, patients suffer from brittle skin and hair loss. Dementia and disturbances in concentration and coordination also occur. The patient suffers from cataracts and severe pain in the muscles.
The everyday life of those affected is restricted by hypoparathyroidism. Sensory disturbances can also occur in different regions of the body. In the worst case, paralysis and restricted movement can even occur. The eyes are often red and itchy and the patient suffers from shortness of breath. The shortness of breath can lead to loss of consciousness or damage to the organs as the disease progresses.
The treatment of hypoparathyroidism usually proceeds without complications. It quickly leads to a positive course of the disease and the symptoms disappear again. Complications usually only occur if the treatment starts too late and damage to organs has already occurred. In most cases, life expectancy is not affected by this disease.
When should you go to the doctor?
If muscle cramps, sensory disturbances and other typical symptoms are noticed, a doctor should be consulted in the next few days. Other warning signs that need to be clarified quickly are abdominal pain, diarrhea and tingling sensations in the hands and mouth, often accompanied by severe cramps that manifest themselves in cramped hands, feet and mouth. Those affected usually feel severe pain and shortness of breath – symptoms that must be clarified immediately.
Hypoparathyroidism is a life-threatening disease that can lead to dementia and various other complications as it progresses. Those affected should go to the family doctor with the symptoms mentioned and, if necessary, visit a specialist clinic. If the disease is treated early, it is usually positive and the symptoms subside quickly. People who suffer from parathyroid disease or who have had too much vitamin D over a long period of time are particularly susceptible to developing hypoparathyroidism. Anyone who counts themselves among these risk groups must always seek medical advice.
Treatment & Therapy
If the parathyroid glands have been accidentally removed, causing hypoparathyroidism, they can be regrown by transplanting them into the patient’s muscle tissue (usually the neck or arm) and making them “ready” again.
This procedure, also known as autotransplantation, is also used preventively in the event of radiation to the neck area, insofar as damage (hypoparathyroidism) is to be expected. If this method is successful, the patient is considered cured for the time being, even if in some cases it is only a temporary solution.
If this form of treatment for hypoparathyroidism is not possible or does not work, then the use of medication is resorted to. In order to compensate for the undersupply of calcium caused by parathyroid hormone deficiency, the person suffering from hypoparathyroidism is given special calcium tablets with a low vitamin D content, which normalizes the amount of calcium in the blood and the symptoms caused by hypoparathyroidism usually disappear.
Prevention
Since hypoparathyroidism in most cases is not caused by a poor diet or lifestyle, it is difficult to prevent. In any case, even if there are no signs of hypoparathyroidism, a possible magnesium deficiency and an excess of vitamin D should be ruled out and examined by a doctor.
Aftercare
The main purpose of follow-up care for hypoparathyroidism is to ensure that the calcium deficiency is compensated. Therefore, patients suffering from hypothyroidism are prescribed appropriate calcium tablets with vitamin D. These remedies should be taken consistently during the aftercare phase so that the calcium level in the blood normalizes and the previous symptoms subside.
In order to promote healthy development after the actual therapy, those affected should change their diet. Calcium-rich foods help prevent the disease. Patients soon feel more comfortable with dairy products, green vegetables and many types of nuts.
Too much fat and phosphates, on the other hand, are taboo because they put an unnecessary strain on the organism. Those affected should also avoid alcohol. Light activities in the fresh air are also part of a healthy life. This increases well-being. Mindfulness and good health awareness ensure that those affected also feel better mentally.
This also applies in the case of a slight hypofunction of the parathyroid glands, which can quickly lead to distressing symptoms. Close observation of the physical warning signals helps to identify an acute worsening of the condition at an early stage and to effectively avoid it. For this reason, patients should deal thoroughly with the typical signs of the disease in order to ensure successful follow-up care.
You can do that yourself
Parathyroid insufficiency complicates everyday life mainly due to symptoms that can be traced back to hypocalcemia. The best possible prophylactic option is a conscious diet rich in calcium. Calcium-supplying foods such as dairy products, green vegetables (daisy and cruciferous) and certain types of nuts should be the main part of meals. A diet high in fat and phosphate, as well as alcohol, should be avoided. Calcium is only bioavailable in the presence of sufficient vitamin D, so daily, moderate outdoor exercise is advisable.
The general quality of life of patients improves several times through mindful nutrition. Mild hypocalcemia leads to moderate but psychologically distressing symptoms. These symptoms can be significantly reduced with the right diet in combination with drug therapy. Severe hypocalcemia can usually only be treated in hospital. If those affected pay close attention to their physical warning signs, acute conditions can be effectively avoided.
Strenuous, sweaty activities deprive the body of important minerals. With increased physical activity, long trips or working days, the consumption of calcium-containing mineral water or calcium supplements can be used. Carrying it with you and consuming it not only reduces the risk of an acute deficiency, but also reduces possible fears. As with any chronic illness, it helps to seek contact with other sufferers or to seek therapeutic help.
