In considering treatment for hypoparathyroidism, doctors take into account your symptoms, including their severity, and your overall health. The goal of treatment is to normalize the levels of calcium and phosphorus in your body. A treatment regimen typically includes:
- Oral calcium carbonate tablets.
- Vitamin D, which can help your body absorb calcium and eliminate phosphorus. The forms of vitamin D called ergocalciferol or calcitriol are recommended most often because they have a longer duration of action or are more potent than are other forms of this vitamin. Often, the required doses of vitamin D are much higher than are those used for a typical daily vitamin supplement.
At high doses, calcium supplements can cause gastrointestinal side effects, such as constipation, in some people. For that reason, take these pills only with the guidance of your doctor.
Some studies have shown promising effects of treatment with recombinant human parathyroid hormone (PTH), currently used to treat the bone-thinning disease osteoporosis. More study is needed.
Your doctor may recommend that you consult a dietitian, who is likely to advise a diet that is:
- Rich in calcium. This includes dairy products, green leafy vegetables, broccoli, kale, and fortified orange juice and breakfast cereals.
- Low in phosphorus-rich items. This means avoiding carbonated soft drinks, which contain phosphorus in the form of phosphoric acid. Eggs and meats also tend to be high in phosphorus.
In some cases, when you need immediate relief of symptoms, your doctor may recommend hospitalization to administer calcium by intravenous (IV) infusion. These IV infusions may be important if you're having severe spasms associated with tetany. After hospital discharge, you can continue to take calcium and vitamin D as an oral supplement.
Your doctor will regularly check your blood to monitor levels of calcium and phosphorus. Initially, these tests will be weekly to monthly. Eventually, you'll need blood tests just twice a year.
Because hypoparathyroidism is a long-lasting (chronic) disorder, treatment strategies are generally recommended for the rest of your life, along with regular blood tests to determine whether calcium in particular is at normal levels. Your doctor will adjust your dose of supplemental calcium if your blood-calcium levels rise or fall.
If calcium in your blood remains low, despite treatment, your doctor may add a prescription diuretic medication specifically, a thiazide diuretic such as hydrochlorothiazide or metolazone. While some other types of diuretics (loop diuretics) decrease calcium levels in your bloodstream, the thiazides can increase blood-calcium levels.
Most people who are treated for hypoparathyroidism can keep their symptoms under control if they continue to receive treatment long term. Early diagnosis and treatment can help prevent complications of hypoparathyroidism, some of which are permanent.