Does exercise affect my calcium level?
Calcium is needed to make your muscles contract and also regulates the rate at which your heart contracts. Every action you make uses up the calcium in your blood. Normally, when this runs low the body will use the calcium stored in your bones but without PTH, this mechanism is reduced so you need to replace your calcium you’ve used up with food or calcium supplements
During exercise you may feel the usual symptoms of low calcium such as tingling and cramps but you may also experience fatigue. Not having enough calcium in your muscles can also limit your endurance and strength.
Will I be able to exercise?
Hypopara is a very individual condition. Some people find exercising very difficult because they get so tired or crampy and then have to spend a day recovering. Others are strong enough to compete in marathons. Most of us are somewhere in between. You can learn to build up your strength gradually as long as you take care to take on board enough calcium and maintain good levels of alfacalcidol, magnesium and vitamin D3 to aid absorption. Even if you can’t do much try to keep as active as you can and move around every hour.

I went armed with information from the Hypopara facebook group and asked if my calcium tablets could be reduced, alfacalcidol increased and could I have some prescription vitamin D3 please? To my delight, my endo was very happy to comply.
What and when should I eat?
If you are planning to exercise (or have a more strenuous day ahead than usual) a starchy, low fat meal 2-3 hours before will help you to keep going.
About an hour before, eat a calcium rich snack or take some extra calcium. (You will learn how much you need as you get more practiced).
Afterwards, a snack within an hour of stopping will help your recovery. A banana, a handful of nuts or a glass of low fat milk will work well.
Remember to keep hydrated throughout the day as exercise as you can lose calcium through sweat.
The British Nutrition Foundation has some excellent advice on what you should eat when exercising but remember to factor in your calcium needs. https://www.nutrition.org.uk/healthyliving/an-active-lifestyle/eating-for-sport-and-exercise.html?showall=1&limitstart=
Athletes
There are athletes among us who run marathons and take part in Iron man and Tough Mudder. Some of them were athletes before their diagnosis but others weren’t and have built up their strength and endurance from scratch. If you are keen to build up your fitness levels there are currently facebook groups you can join for support called ‘Athletes Beating Hypopara’ and ‘Hypopara Athletes Training Club’. (These are not run by Hypopara UK).