Hypoparathyroidism Treatment & Management

  • Author: Joseph Michael Gonzalez-Campoy, MD, PhD, FACE; Chief Editor: George T Griffing, MD   more...
 
Updated: Jan 3, 2012
 

Medical Care

  • PTH is commercially available for use in the treatment of osteoporosis. Its use for patients with hypoparathyroidism is not approved by the Food and Drug Administration.
  • Currently, treatment of patients with hypoparathyroidism involves correcting the hypocalcemia by administering calcium and vitamin D.[8]
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Surgical Care

  • Patients undergoing parathyroidectomy for parathyroid hyperplasia are at high risk of developing permanent primary hypoparathyroidism.
  • Patients may be treated with an autotransplant of a segment of parathyroid gland to prevent hypoparathyroidism.[5] This autotransplant is usually placed subcutaneously in the forearm or in the neck.
  • If the autotransplantation fails, patients receive the same treatment that is administered to other patients with hypoparathyroidism.
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Consultations

An endocrinologist should be involved in the care of all patients who have primary hypoparathyroidism or who are at risk of developing it.

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Diet

A diet rich in calcium content (ie, emphasizing dairy products) is recommended for patients with primary hypoparathyroidism.

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Activity

Patients with symptomatic hypocalcemia develop tetany. Otherwise, no restriction in activity for these patients is necessary.

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Contributor Information and Disclosures
Author

Joseph Michael Gonzalez-Campoy, MD, PhD, FACE  Medical Director and CEO, Minnesota Center for Obesity, Metabolism, and Endocrinology

Joseph Michael Gonzalez-Campoy, MD, PhD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, Association of Clinical Researchers and Educators (ACRE), and Minnesota Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

David S Schade, MD  Chief, Division of Endocrinology and Metabolism, Professor, Department of Internal Medicine, University of New Mexico School of Medicine and Health Sciences Center

David S Schade, MD is a member of the following medical societies: American College of Physicians, American Diabetes Association, American Federation for Medical Research, Endocrine Society, New Mexico Medical Society, New York Academy of Sciences, and Society for Experimental Biology and Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Yoram Shenker, MD  Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison

Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Mark Cooper, MBBS, PhD, FRACP  Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References
  1. Bhadada SK, Bhansali A, Upreti V, Subbiah S, Khandelwal N. Spectrum of neurological manifestations of idiopathic hypoparathyroidism and pseudohypoparathyroidism. Neurol India. Jul-Aug 2011;59(4):586-9. [Medline].

  2. Assfaw Z, Assefa G. Basal ganglia calcification with hypoparathyroidism: a case report. Ethiop Med J. Jul 2011;49(3):273-7. [Medline].

  3. Goswami R, Goel S, Tomar N, et al. Prevalence of clinical remission in patients with sporadic idiopathic hypoparathyroidism. Clin Endocrinol (Oxf). Jun 22 2009;[Medline].

  4. Rubin MR, Dempster DW, Zhou H, et al. Dynamic and structural properties of the skeleton in hypoparathyroidism. J Bone Miner Res. Dec 2008;23(12):2018-24. [Medline].

  5. Ebrahimi H, Edhouse P, Lundgren CI, et al. Does autoimmune thyroid disease affect parathyroid autotransplantation and survival?. ANZ J Surg. May 2009;79(5):383-5. [Medline].

  6. Brown EM. Anti-parathyroid and anti-calcium sensing receptor antibodies in autoimmune hypoparathyroidism. Endocrinol Metab Clin North Am. Jun 2009;38(2):437-45, x. [Medline].

  7. Goltzman D, Cole DEC. Hypoparathyroidism. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Philadelphia, Pa: Lippincott-Raven; 1996:220-3.

  8. Cheung M. Drugs used in paediatric bone and calcium disorders. Endocr Dev. 2009;16:218-232. [Medline].

  9. Brown EM, Harris HW, Vassilev PM. The biology of the extracellular Ca2+-sensing receptor. In: Bilezikian JP, ed. Principles of Bone Biology. San Diego, Calif: Academic Press; 1996:243-62.

  10. Cole DEC, Hendy GN. Hypoparathyroidism and pseudohypoparathyroidism. Endotext.com. 2005, Available at. [Full Text].

  11. Marx SJ. Hyperparathyroid and hypoparathyroid disorders. N Engl J Med. Dec 21 2000;343(25):1863-75. [Medline].

  12. Thakker RV. Molecular basis of PTH underexpression. In: Bilezikian JP, et al, eds. Principles of Bone Biology. San Diego, Calif: Academic Press; 1996:837-51.

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