There are no symptoms caused by hypoparathyroidism (low parathyroid hormone levels).
The symptoms you feel are caused by hypocalcaemia (low calcium levels) or hypercalcamia (high calcium levels).
Individuals may feel different symptoms in different ways and will often have their own (quite narrow) individual range within the normal reference range where they feel symptom free.
LOW CALCIUM (hypocalcaemia)
Symptoms are those of tetany and develop along a spectrum ranging from mild to more severe.
Asymptomatic
Many people have no symptoms at all once their calcium and vitamin D levels are properly adjusted. as levels do fluctuate , blood tests are still important so that occasional blips may be adjusted. People with Idiopathic forms of hypoparathyroidism, once on medication, seem to be able to tolerate lower levels of calcium than post surgical types who may experience more fluctuations.
Mild symptoms
Many people experience only mild symptoms which may require no action or just an occasional minor adjustment. These usually take the form of paraesthesias – tingling in the hands, fingers, and around the mouth, and twitching muscles.
Severe symptoms
These are more unusual but may occur post operatively or when medication has been inadequate over a period of time or in Brittle hypoparathyroidism where levels remain constantly unstable. Symptoms may develop over time if ignored or unrecognised, or they may come on rapidly suddenly requiring urgent action to avoid a crisis.
Warning signs may be a drop in temperature, sensitivity to sound, shakiness, irritability, anxiety, diarrhea and gradually worsening muscle spasms.
Early symptoms of tetany may include:
- Tingling or numbness in the hands and/or feet
- Tingling or numbness in the face especially around the mouth
- Irritability
- Brain fog
- Tiredness
- Headache
- Diarrhea
- Twitching or trembly muscles
- Sudden temperature drop
If not treated , more severe symptoms may develop and can include:
- Increasing brain fog, feeling ‘out of it
- Worsening tetany, feeling very trembly and vibrating inside (not visible)
- Hard to function or move around
- Carpopedal spasm (painful muscle spasms or cramps of the hands and feet)
- Painful muscle spasms all over the body
- HIgh anxiety
- Confusion
- Severe muscle cramps
- Seizures (this is rare)
Other symptoms may develop over time
- Memory loss
- Depression
- Dry skin and itching, dry hair
- Cataracts and eye problems
- Dental problems
- Kidney stones
- Kidney failure
HIGH CALCIUM (hypercalcaemia)
Vitamin D and calcium treatment requires regular blood testing as calcium levels can fluctuate in response to many factors and medication occasionally needs to be adjusted. This can also involve a certain amount of guesswork as well. So people with Hypoparathyroidism can sometimes develop high calcium levels and you should be aware of the symptoms to look out for.
Early warning signs can include:
- Extreme tiredness (fatigue) and lethargy
- Feeling weak
- Not wanting to eat much (anorexia)
- Constipation
- Loss of concentration and interest in doing things
- Mild confusion
If the hypercalcaemia is not treated then the symptoms become much worse and can include
- Feeling and being sick
- Drowsiness
- Passing large amounts of urine
- Feeling very thirsty
- Dehydration
- Confusion
- Agitation
- Muscle spasms, tremors.
- Bone pain and weakness
- Irregular heart beat
- Difficulty thinking and speaking clearly
If you have any of these symptoms you should contact your doctor immediately to arrange a blood test. Left untreated this can be a life threatening condition.