Hypoparathyroidism: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hypoparathyroidism?
An endocrinologist, a doctor who treats hormone problems, usually manages hypoparathyroidism. Your regular doctor may first find the problem on a blood test. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hypoparathyroidism?
Hypoparathyroidism is a disorder in which the parathyroid glands in the neck do not make enough parathyroid hormone, or PTH. It is a rare condition. There are 4 tiny parathyroid glands, near or attached to the back of the thyroid gland. PTH helps control calcium, phosphorus, and vitamin D levels in the blood and bones. With too little PTH, the blood calcium level falls and the phosphorus level rises.
Symptoms
The condition starts very gradually, and symptoms can be mild. Some people only find out after a screening blood test shows low calcium. Symptoms may include:
- Tingling lips, fingers, and toes, which is one of the most common symptoms.
- Muscle cramps, which are also one of the most common symptoms.
- Muscle spasms called tetany, which can affect the voice box. See the emergency note below.
- Belly pain.
- An abnormal heart rhythm.
- Brittle nails.
- Dry hair.
- Dry, scaly skin.
- Cataracts, which are clouding of the eye lens.
- Seizures.
- Teeth that do not grow in on time, or at all.
- Weakened tooth enamel in children.
The condition can also cause tiredness, weakness, muscle aches, anxiety, and headaches. In children, it may lead to poor growth, abnormal teeth, and slow mental development.
Causes and who gets it
The most common cause is injury to the parathyroid glands during thyroid or neck surgery. Surgery for an overactive parathyroid can also remove too much parathyroid tissue. After surgery, the problem may be temporary or may become permanent.
Other causes include:
- An autoimmune attack, which means the body's defense system attacks the glands.
- A very low magnesium level in the blood, which can be reversed.
- Radioactive iodine treatment for an overactive thyroid, which is very rare.
- DiGeorge syndrome, in which all the parathyroid glands are missing at birth.
- Genetic causes.
How doctors diagnose it
Your provider will do a physical exam and ask about symptoms. Tests include a PTH blood test, a calcium blood test, a magnesium test, and a 24-hour urine calcium test. An electrocardiogram (ECG) can check for an abnormal heart rhythm. A CT scan can check for calcium deposits in the brain. An eye exam should also be done to check for cataracts.
Treatment
The goal of treatment is to reduce symptoms and restore the calcium and mineral balance in the body. Treatment involves calcium and vitamin D supplements, which usually must be taken for life. Blood levels are measured regularly to make sure the dose is correct. A high-calcium, low-phosphorus diet is recommended.
Too much vitamin D and calcium can cause high blood calcium or high urine calcium. Too much treatment may sometimes harm the kidneys.
PTH injections may be recommended for some people. In 2015, the FDA approved a form of PTH for adults with long-lasting (chronic) hypoparathyroidism that is not controlled with calcium and activated vitamin D. In 2024, the FDA approved palopegteriparatide (Yorvipath) for adults with hypoparathyroidism.
People who have life-threatening attacks of low calcium are given calcium through a vein.
When to see a doctor
Contact your provider if you develop any symptoms of hypoparathyroidism. Seizures, breathing problems, or fainting are an emergency. Call 911 or the local emergency number right away. Muscle spasms in the throat can make it hard to breathe.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can order the first blood tests, watch calcium levels over time, and help coordinate care with an endocrinologist. They can also review your supplements and test results with you.
Common questions
Is hypoparathyroidism permanent?
It can be, but it does not have to be. After thyroid or neck surgery, it may be temporary or it may become permanent. When calcium and vitamin D supplements are needed, they usually must be taken for life.
What is the most common cause of hypoparathyroidism?
Injury to the parathyroid glands during thyroid or neck surgery is the most common cause.
Which tests find hypoparathyroidism?
Blood and urine tests help diagnose it. A PTH blood test and a calcium blood test are done, along with magnesium and a 24-hour urine calcium test.
Are there newer medicines for hypoparathyroidism?
Yes, the FDA has approved PTH medicines for adults. A form of PTH was approved in 2015 for adults not controlled with calcium and activated vitamin D.
Sources
- MedlinePlus - Hypoparathyroidism
- Eunice Kennedy Shriver National Institute of Child Health and Human Development - Hypoparathyroidism
- National Organization for Rare Disorders (NORD) - Hypoparathyroidism
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
