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Health Information Center


  • Cynthia M. Johnson, MA
Publication Type:



(Underactive Parathyroid)


The parathyroid glands are four pea sized glands next to the thyroid gland in the neck. The glands send out parathyroid hormone (PTH) to help control the level of calcium in the blood.

Hypoparathyroidism is when the glands do not send out enough PTH. This causes low levels of calcium in the blood known as hypocalcemia.

Thyroid and Parathyroid Glands: Posterior (Back) View.

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Hypoparathyroidism may be caused by:

  • Removal of the parathyroid glands
  • Damage to the parathyroid glands
  • Problems with the immune system
  • A parathyroid gland that was missing since birth
  • Genetics conditions, such as 22q11.2 deletion syndrome
  • Low levels of magnesium due to problems like alcohol use disorder and malnutrition
  • Metal overload from iron, magnesium, or aluminum

The exact cause is not always found.

Risk Factors

Things that may raise the risk of hypoparathyroidism are:

  • Multiple autoimmune disorders
  • Thyroid or parathyroid surgery
  • Having other family members with hypoparathyroidism


Hypoparathyroidism does not always cause symptoms. If symptoms do develop, they may include:

  • Tingling around the mouth, fingers, and toes
  • Weakness
  • Muscle cramps or twitching
  • Abnormal heart rhythm
  • Excessive nervousness or anxiety
  • Difficulty with breathing due to spasm of breathing tubes
  • Mood swings
  • Loss of memory and confusion
  • Blurred vision due to cataracts
  • Thin, brittle nails
  • Dry and scaly skin
  • Seizures


The doctor will ask about symptoms and past health. A physical exam will be done.

Blood and urine tests will be done. They can show PTH and calcium levels.


The goal of treatment is to ease symptoms and correct imbalances in the body. This can be done with:


There are no current guidelines to prevent hypoparathyroidism.

The parathyroid glands can be damaged during thyroid surgery. The surgeon may remove the parathyroid glands and place them in a new spot in neck or arm. This may prevent damage.

Calcium and Vitamin D Supplements

Calcium and vitamin D is often needed. They are often taken as pills. Injections of calcium may be needed if symptoms are severe.





  • Hypoparathyroidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypoparathyroidism.
  • Hypoparathyroidism. National Organization for Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/hypoparathyroidism.


  • Nicole S. Meregian, PA
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.