We humans are bestowed with 4 parathyroid glands, each of the size of a rice grain placed in the neck behind the thyroid. Despite the small size, its contribution in the body is beyond measure. The parathyroid glangs produces parathyroid hormone (PTH) which plays a significant part in maintaining adequate levels of calcium, phosphorus and vitamin D in the body.
Hypoparathyroidism is a disorder in which the production of PTH by the parathyroid gland is absent or inappropriately low. This leads to low calcium and high phosphate levels bringing about the classical triad of hypocalcemia, hypercalciuria, and hyperphosphatemia.
What Role PTH Plays in the Body?
- PTH plays a crucial role in balancing the minerals. It does this by helping in absorption of calcium and excretion of phosphate from the kidneys.
- PTH also aids in forming the active form of vitamin D (1,25-dihydroxyvitamin D) which increases the absorption of calcium and phosphate from the gastrointestinal tract.
- PTH is a significant regulator of bone turnover; the deficiency of PTH may lead to skeletal deformities.
What Causes Hypoparathyroidism?
1. Acquire
The most common cause which accounts for approximately 75% of hypoparathyroidism cases is damage to or removal of the parathyroid glands during neck surgery, or after chemotherapy or radiation.
2. Autoimmune
Another reason is autoimmunity, where the body’s cells consider the parathyroid hormone as foreign and mistakenly attack the gland.
3. Genetic
Rarely, genetic disorders like DiGeorge syndrome, autosomal dominant hypocalcemia and autoimmune polyendocrine syndrome type 1 can also lead to hypoparathyroidism.
Top Ten Indicators of Hypoparathyroidism
There are many other indications that point towards hypothyroidism which affects the quality of life. Let’s check them out.
1. Numbness and Tingling: Low calcium level in the blood can cause numbness around the mouth, pins and needles feeling in the lips and tongue, and tingling (paresthesia) in the hands and feet.
2. Cramps and Spasms: Low calcium levels in the blood may also cause muscle cramps or spasms throughout the body. Some people with longstanding hypoparathyroidism can develop movement disorders of the arms or legs, writhing movements, muscle spasms, resting tremors, or slow shuffling movements while walking.
3. Seizures: Seizures or convulsions are common in severe hypoparathyroidism due to a very low calcium level in the blood.
4. Heart Issues: Changes in heart rhythm in severe hypoparathyroidism can lead to fluttering, palpitations or discomfort in the chest, abnormal heartbeats (cardiac arrhythmias) and congestive heart failure.
5. Dementia: Some people with longstanding hypoparathyroidism can develop confusion and forgetfulness.
6. Deformities: Hypoparathyroidism can lead to blurry vision and even cataracts over time. Some people can also develop an inflammation of the eye that can cause the eye to turn red and irritated.
7. Bone Deformities: People with hypoparathyroidism tend to develop thicker bones. Patients with hypoparathyroidism experience hypocalcemia, hyperphosphatemia, hypercalciuria, reduced levels of 1,25[OH]2 D, and abnormally low bone turnover, resulting in overly mineralized bone.
8. Kidney Dysfunction: Calcium deposition in their kidneys in hypothyroidism might eventually lead to impaired kidney function. There is also an increased risk for formation of kidney stones.
9. Intracranial Hypertension: Increased pressure of the cerebrospinal fluid in the skull due to hypoparathyroidism can cause severe headaches and lead to vision impairment.
10. Developmental Issues: Hypaparathyroidism can case delayed mental development in children. Affected dental enamel and roots can cause improper teeth formation when hypoparathyroidism occurs at an early age. In growing children this may give rise to abnormal formation of facial bones.
How to Evaluate Hypoparathyroidism?
Diagnosis of hypoparathyroidism may requires evaluation of certain blood and urine components that usually tend to go haywire. Few of these imbalances include-
1. Reduced calcium in blood
2. Undetectable or inappropriately low levels of endogenous PTH
3. Absence of magnesium in blood
4. Increased iron
5. Copper overload
6. Autoimmune status
To Sum Up
Establishing an early diagnosis of hypoparathyroidism is crucial as it is associated with the development of kidney stones, renal insufficiency, cataracts, brain calcifications, as well as a reduced quality of life.
The goal of treatment for hypoparathyroidism include symptomatic relief of hypocalcemia, to raise the level of calcium, and avoid elimination of calcium in urine by using high dose supplements of calcium and activated vitamin D. The addition of recombinant PTH is currently an option as well.
Agilus Diagnostics, a subsidiary of Fortis Healthcare Limited
