What is Hypoparathyroidism?
Hypoparathyroidism (hypopara) is a rare endocrine condition that can be temporary or permanent. There is no cure for permanent hypopara. It occurs when the parathyroid glands in the neck are underactive or fail to produce enough parathyroid hormone (PTH), leading to low calcium levels in the blood (hypocalcaemia).
Calcium is essential for the proper function of nerves, muscles, bones, kidneys, eyes, and the heart. If left untreated, hypocalcaemia can be serious, so calcium levels must be carefully managed and regularly monitored.
Causes of Hypopara
- Neck Surgery – The most common cause, often following thyroid or parathyroid surgery. This can be temporary or permanent.
- Autoimmune Disease – The body’s immune system mistakenly attacks the parathyroid glands.
- Genetic Causes – Some people are born with the condition.
- Unknown Causes (Idiopathic) – In some cases, the cause is unclear.
How rare is hypopara?
There are no official UK statistics, but a Danish study estimates that 27 in every 100,000 people have hypopara. It is more common in women, and rates of surgical hypopara are increasing as thyroid cancer cases rise.
What are the symptoms of hypopara?
Symptoms vary between individuals and fluctuate depending on calcium levels. Some people experience few or no symptoms when on the right treatment, while others may have ongoing issues.
Symptoms of low calcium (hypocalcaemia) include:
- Fatigue and weakness
- Tingling or numbness in the hands, feet, or face
- Muscle cramps and spasms (tetany)
- Dizziness or brain fog
- Blurred vision
- Irritability, anxiety, or low mood
- Sensitivity to noise
- Chills or internal trembling
If not managed properly, calcium levels can also become too high (hypercalcaemia) due to excessive medication.
Diagnosis
Post-surgical hypopara can develop within hours to days after surgery. If symptoms persist for more than six months, the condition is likely permanent. Non-surgical hypopara can take longer to diagnose as symptoms are non-specific and may be mistaken for other conditions.
Diagnosis involves blood tests to check:
- Calcium and PTH levels
- Phosphate levels (often raised in hypopara)
- Kidney function (as low calcium can affect kidney health)
- Magnesium and Vitamin D levels (important for calcium absorption)
If hypopara is suspected, referral to an endocrinologist—ideally one specialising in calcium or bone metabolism—is recommended for lifelong care.
What is the treatment?
Currently, there is no cure, but symptoms are managed with:
- Active Vitamin D (Alfacalcidol or Calcitriol) – Prescription-only supplements to help the body absorb calcium.
- Vitamin D3 – Available over the counter or on prescription, essential for bone health.
- Magnesium – Helps regulate calcium levels and reduce muscle cramps.
- Calcium supplements – Used for short-term boosts but not usually recommended for long-term management.
- Levothyroxine – Required if the thyroid gland has been removed or underactive.
Lifelong monitoring is essential, and regular blood tests will be needed to keep calcium levels stable.
Ongoing care
Hypopara is a rare condition that required lifelong care. You will be regularly monitored by your endocrinologist at your local hospital or your nearest specialist hospital. At these appointments you will be able to discuss how you’ve been feeling and have regular blood tests to check all is well. In between appointments you will be cared for by your GP under instruction from your endocrinologist.
Your site was the only site I could get the information I needed when I first went through all the trials and tribulations of post thyroidectomy hypocalcaemia, something I wasn’t prepared for and knew nothing about. The information on there was invaluable, and your brilliant communication helped me so much. Thank you again
Future Treatments & Research
New treatments are being developed, including:
- Parathyroid hormone (PTH) replacement therapy
- PTH auto-transplantation and stem cell research
- Improved surgical techniques to protect parathyroid glands
Managing Your Condition
Living with hypopara requires careful self-management. Many people learn to recognise their personal warning signs of calcium fluctuations, helping to prevent crises.
For more information, support, and updates on treatment options, visit our self-help guide and patient community.
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All hypoparathyroidism information on this website has been written by Liz Glenister CEO and reviewed by the Parathyroid UK Medical Advisory Team.
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