Hypoparathyroidism
Hypoparathyroidism occurs when the parathyroid glands produce insufficient parathyroid hormone (PTH), leading to abnormally low calcium levels in the blood. It is an uncommon but chronic condition that requires long-term management to keep calcium within a safe range.
Key points
- Low PTH lets calcium fall too far, causing tingling in the hands, feet and mouth along with cramps and, in severe cases, tetany.
- Because PTH itself is not replaced, treatment instead relies on calcium supplements and an activated form of vitamin D such as alfacalcidol.
- Regular blood tests guide dose adjustments so calcium is corrected without swinging too high or too low.
What low calcium feels like
The hallmark symptoms arise from nerve and muscle overexcitability caused by hypocalcaemia. These include tingling or numbness around the mouth and in the hands and feet, muscle cramps, and, in severe cases, painful involuntary muscle spasms called tetany. Some people also notice anxiety, brain fog, or fatigue. A sudden worsening with severe muscle spasms or difficulty breathing warrants urgent medical attention.
Managing calcium over the long term
Because PTH itself is not routinely replaced, treatment focuses on raising calcium through supplemental calcium and activated vitamin D analogues. Alfacalcidol is a commonly used option: it bypasses the kidney activation step that PTH normally drives, making it particularly suitable when PTH is absent. These medicines fall under bone health management, and doses are adjusted based on regular blood tests to avoid both under- and over-correction.