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Hypoparathyroidism

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Definition

Hypoparathyroidism is a clinical condition characterized by a deficiency of parathyroid hormone. Deficiency of parathyroid hormone causes disturbance in the metabolism of calcium and phosphorus in the body.

There are four small parathyroid glands located in the neck, behind the thyroid gland. These glands regulate the amount of very important minerals in the body i.e. calcium and phosphorus in the blood. There is an inverse relationship between levels of calcium and phosphorus in the body; when calcium levels fall phosphorus levels rise.

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Causes

  • Congenital absence of parathyroid glands.
  • Injury to the parathyroid glands due to direct trauma to the neck area
  • Head and neck surgery.
  • Thyroid surgery
  • Side effect of radioactive iodine treatment for hyperthyroidism.
  • Familial or hereditary hypothyroidism
  • Autoimmune diseases

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Symptoms

  • Tingling sensation of lips, hands and feet
  • Muscle cramps or muscle spasms
  • Spasm or prolonged muscle contractures in hand or feet
  • Face pain
  • Pain in legs and feet
  • Abdominal pain
  • Dry hair
  • Dry, scaly skin
  • Hard and brittle nails
  • Spasm of larynx
  • Difficulty breathing
  • Cataracts
  • Seizures
  • Dysmenorrhea (Painful menstruation)
  • Decreased level of consciousness (in severe or acute deficiency)

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Implications

Acute spasm of laryngeal muscles (tetany) can lead to respiratory obstruction. This is an emergency requiring a tracheostomy to allow the air to enter the lungs and restore ventilation. Congenital absence or underdevelopment of parathyroid glands can cause mental retardation, stunted growth and deformed teeth with lack of tooth enamel. Timely diagnosis and appropriate treatment of this condition can probably slow down these processes and have a good outcome. However, taking calcium and vitamin D in large doses can cause irreversible impairment of kidney functions. People with hypothyroidism are at a high risk of developing pernicious anemia, Addison's and Parkinson's disease. Complications like dental changes, cataracts, and brain calcifications are irreversible.

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What You Can Do

  • Intravenous infusion of calcium

  • Oral calcium carbonate and vitamin D supplements

  • A high-calcium, low-phosphorous diet is recommended.

  • Be ready for supportive care in case of a life threatening emergency like seizures, difficulty breathing or hypothyroid tetany (prolonged muscle contractions).

  • Your heart rhythm should constantly be monitored by your physician as over treatment with calcium (hypercalcemia) can cause arrhythmias and death.

  • Hypothyroidism can be prevented with prompt treatment with calcium and vitamin D supplements if the thyroid glands have been injured or accidentally removed during a thyroid or neck surgery.

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Hypoparathyroidism