Hypoparathyroidism Overview and Mechanism of Disease

Hypoparathyroidism is is an endocrine disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH). PTH plays a key role in regulating and maintaining a balance of your body’s minerals, namely calcium and phosphorus.

The low production of PTH in hypoparathyroidism leads to abnormally low ionized calcium levels in your blood and bones and to an increase of serum phosphorus. Current treatment consists of taking supplements to normalize your calcium and phosphorus levels.

Hypoparathyroidism is an inadequate production of parathormone and is most often related to the removal of the parathyroid glands during thyroid surgery. Parathyroid hormone (PTH) is responsible for the regulation of calcium and phosphorus levels in the blood. Calcium and phosphorus levels must be maintained within normal limits to have adequate nerve function. Bone density is also maintained by parathormone. Signs and symptoms of hypoparathyroidism include the following:

Decreased blood calcium
Increased blood phosphorus
Neuromuscular hyperexcitability
Carpopedal spasms (Trousseau’s sign)
Positive Chvostek’s sign
Urinary frequency
Mood changes (depression)
Dry, scaly skin and thin hair
Changes in teeth (cavities)
Changes in EKG (prolonged Q-T intervals and inverted T waves)

Management of the client with hypoparathyroidism involves the administration of IV calcium gluconate and long-term use of calcium salts. If calcium gluconate is administered intravenously, the rate should be monitored carefully because rapid administration can result in cardiac arrhythmias. Phosphate binders such as calcium acetate (Phoslo) can be used to bind with phosphates. This will result in a rise in the calcium level. Vitamin D supplements can be given to increase the absorption of calcium preparations as well as calcium in the diet.