How Hypoparathyroidism Is Treated

Hypoparathyroidism happens when your body doesn’t make enough parathyroid hormone because the parathyroid glands have been surgically removed, are damaged, or the body resists the hormone.

Parathyroid hormone is important for controlling essential vitamins and minerals in the body, including calcium. A major symptom of hypoparathyroidism is hypocalcemia, low calcium levels.

Your body needs calcium to keep your muscles, nerves, and heart working correctly. Low levels of calcium can cause symptoms that range from mild to severe and include muscle spasms, paresthesia (pins and needles), heart and breathing problems, and seizures.

Hypoparathyroidism is lifelong, but it is treatable and manageable. Treatment mainly focuses on making sure the body’s calcium levels are regulated, which you can do by taking calcium and vitamin D supplements, taking prescribed treatments, eating a balanced diet, and getting your calcium levels checked routinely.

In this article, we will discuss how hypoparathyroidism is treated, including home remedies and lifestyle changes, over-the-counter therapies, prescription therapies, and more.

Home Remedies and Lifestyle

Your diet is a good place to start when managing the effects of hypoparathyroidism. This includes adding more calcium, vitamin D, and magnesium-rich foods to your diet and reducing your phosphorus intake.

Adding Calcium-Rich Foods to Your Diet

The primary treatment for hypoparathyroidism involves increasing your calcium intake to keep calcium levels balanced. You can do this by naturally including foods in your diet that are rich in calcium. This includes foods such as milk and other dairy products, dark leafy greens, fortified juices, sardines, beans, and almonds.

Adding Vitamin D–Rich Foods to Your Diet

You might also consider adding vitamin D-rich foods to your diet because vitamin D allows the body to better absorb calcium. Without vitamin D, the body can absorb no more than 10%–15% of dietary calcium. When vitamin levels are sufficient, intestinal calcium absorption increases to up to 40%.

There are plenty of foods that are rich in vitamin D. Rich sources of vitamin D include salmon, herring, sardines, canned tuna, egg yolks, mushrooms, and vitamin D–fortified cereals and juices.

Reducing Your Phosphorus Intake

In addition to low calcium levels, hypoparathyroidism also causes high phosphorus levels, a condition called hyperphosphatemia. The hormone produced by your parathyroid glands is responsible for regulating your blood phosphorus levels.

Some people with hyperphosphatemia, especially those with kidney disease, can lower their phosphorus levels by reducing their intake of phosphorus-rich foods. Foods high in phosphorus include eggs, red meat, refined fats, organ meats, processed and fast foods, sodas, and baked goods.

Eating More Magnesium-Rich Foods

Magnesium deficiency (hypomagnesemia) is common when parathyroid hormone is impaired. It can lead to many different health problems, including diabetes, poor absorption, celiac disease (an intolerance to gluten that causes damage to the small intestine), chronic diarrhea, and a condition called hungry bone syndrome that is characterized by prolonged and significant hypocalcemia, hypophosphatemia (low serum phosphate levels), and hypomagnesemia.

Magnesium is responsible for over 300 biochemical reactions throughout the body. Functions of magnesium in the human body include managing muscle and nerve function, regulating blood pressure, and supporting immune system function.

Some good food sources for magnesium are almonds, wheat germ, wheat bran, seafood, fruit, leafy green vegetables, and soybeans.

Over-the-Counter (OTC) Therapies

The goal of hypoparathyroidism treatment is to relieve symptoms and normalize calcium and phosphorous. For most people, diet alone isn’t enough to achieve this, and doctors will recommend mineral and vitamin supplements to help manage the effects of the condition.

Oral Calcium

Calcium carbonate and calcium citrate are the most common forms of oral calcium used to manage hypocalcemia.

Calcium carbonate is made of up 40% of elemental calcium, while calcium citrate contains 21%. Calcium carbonate is best taken with meals, whereas calcium citrate is well absorbed without meals.

Your doctor will let you know what type of calcium supplement might help you to manage your calcium levels and at what dosage to start.

Vitamin D

Vitamin D helps the body to absorb calcium and eliminate phosphorous. Your doctor might recommend an over-the-counter vitamin D with your calcium supplements.

But vitamin D supplementation for hypoparathyroidism is usually given as calcitriol, a synthetic and active version of vitamin D3. It is available as an oral capsule, oral solution, and injection. Research shows calcitriol is the most effective way to balance out calcium and phosphorous in your body.

Your doctor will let you what type of vitamin D strength might best help you manage symptoms of hypoparathyroidism.

Magnesium

If your magnesium is low and you are experiencing other symptoms of hypoparathyroidism, your doctor may recommend you take a magnesium supplement.

There are some instances of hypoparathyroidism where replacing magnesium alone can help to correct the condition and eliminate the need for calcium supplementation.

Prescriptions

When OTC therapies and at-home treatment aren’t helpful to manage hypoparathyroidism symptoms, your doctor may recommend different prescription therapies.

Prescription Supplements

Some minerals and vitamins might be prescribed in higher strengths and your doctor will need to write you a prescription. For example, hypocalcemia is treated with extremely high doses of vitamin D3, which your doctor must prescribe.

Thiazide Diuretics

If calcium levels continue to be low even with calcium and vitamin D supplements, your doctor might prescribe thiazide diuretics. This is only done after checking calcium in 24-hour urine. These drugs can help your body to increase the calcium it has lost through urine.

Thiazide diuretics should not be prescribed to people with autoimmune hypoparathyroidism.

Parathyroid Hormone

In 2015, the Food and Drug Administration (FDA) approved Natpara recombinant human parathyroid hormone (rhPTH (1-84) as a once-daily injection for the treatment of low blood calcium due to hypoparathyroidism.

Some animal studies have found an increased risk for bone cancer with the use of Natpara. Therefore, doctors will prescribe it only for people whose calcium levels can’t be managed with calcium and vitamin D supplementation alone. When prescribing Natpara, it is important for doctors to find ways to manage the risks associated with this drug.

Surgeries and Specialist-Driven Procedures

There are no recommended surgical treatments for managing hypoparathyroidism.

However intravenous (IV) infusion calcium therapy might be recommended for people whose calcium levels are extremely low or who are not responding to oral calcium and vitamin D supplements. This is often the case for people who experience severe muscle spasms and/or seizures.

IV calcium therapy uses calcium gluconate 10%, which contains 93 milligrams of elemental calcium per 10-milliliter vials. The adult dosage is usually 186 milligrams of elemental calcium diluted in 50–100 milliliters of 5% dextrose infused. After the IV therapy, treatment will continue with oral calcium and vitamin D and/or recombinant human PTH.

For some IV calcium therapy needs to be given two or more times over a week to ensure the absorption of oral calcium. Vitamin D is often recommended with calcium therapy to help improve calcium absorption.

Complementary and Alternative Medicine (CAM)

Complementary and alternative medicine (CAM) is the term used to describe therapies that are not part of standard medicine. Currently, there are no CAM therapies that have been studied and found to be safe or effective for treating hypoparathyroidism.

If you have hypoparathyroidism, your doctor is your best source for information on CAM therapies. Never start a CAM therapy without first speaking to your treating physician.

Summary

Hypoparathyroidism is a rare condition that occurs when the parathyroid glands in the neck have been removed or do not make enough parathyroid hormone, the hormone responsible for regulating calcium and phosphorous in the blood. The main treatment for hypoparathyroidism is to restore levels of calcium in the body.

People with hypoparathyroidism will likely need calcium and vitamin D (which is needed to absorb the calcium) supplements for the rest of their lives. Your doctor might also recommend diuretics to reduce the amount of calcium that your body expels through urine.

Recombinant human parathyroid hormone is considered in cases in which calcium and vitamin D therapies aren’t enough to get your calcium levels within normal range.

A Word From Verywell

Hypoparathyroidism is a lifelong condition that requires supplemental calcium and vitamin D. Your doctor will regularly check your blood to monitor your calcium and phosphorus levels to confirm that treatments are helping or if your treatment plan needs adjusting. 

Get emergency medical care immediately if you or your child experiences severe or life-threatening symptoms of hypoparathyroidism, including seizures and difficulty breathing. These severe symptoms are also a sign your treatment plan might not be helping and should be modified to better manage your condition.