DISEASE APPROACH
How doctors are involved in hypopara care
- Because hypoparathyroidism is a rare condition, diagnosis can take time, and some people may face being misdiagnosed initially.
- The undiagnosed patient will ideally be referred by their family doctor or primary care physician to an endocrinologist for diagnosis. This referral may follow a blood test indicating low blood calcium levels. If a person has had recent neck or thyroid surgery, it is also possible that a diagnosis may come from their surgeon.
- Hypopara will usually be managed by an endocrinologist. You may initially see the endocrinologist fairly regularly to manage your symptoms, then less regularly after that.
- As it is a rare condition, diagnosis with hypopara can be an isolating and frightening experience. It is therefore important to receive support, either from healthcare professionals, family members, or other individuals affected by the disease.
Hypocalcaemic crash
- Many patients take unplanned trips to accident and emergency departments, or have extended stays in hospital, due to the severity of their symptoms. This can be highly disruptive to individuals trying to establish a routine in their lives.
- Patients with severe hypopara are more likely to make an unplanned visit to the emergency department than those with mild hypopara.
- Severe, sudden-onset hypopara symptoms, such as hypocalcaemic crash, may require urgent management. This can be a major disruption to a patient’s life if it requires a visit to the A&E department.
Disease Management
Most people with hypopara will have to take some medication every day for the rest of their lives. Most people with hypopara will be given medication that helps to increase blood calcium levels. Some people may be given medication that manages the other effects of having hypopara.
The most common treatment is calcium supplements, which directly increase blood calcium levels. Sometimes these will be supplements you can buy over the counter, but some may need to be prescribed by a doctor.
If your blood calcium falls to a dangerously low level, or you keep having muscle spasms, this could be a medical emergency that requires calcium through a drip directly into your vein. In this situation, your heart rhythm will also be monitored until it is stable, and your symptoms will be monitored until they go away.
The active form of vitamin D acts on the intestine to increase the amount of calcium absorbed into the blood. Vitamin D supplements may be prescribed by a doctor to help increase blood calcium levels in hypopara.
Diet affects your calcium levels. Vitamin D supplements work by helping your body to absorb calcium from your diet. You may be advised to ensure that you have regular meals with good calcium content to keep levels stable. Dairy products contain high levels of calcium, however, there are many other foods which contain calcium that may be more suitable for people who aren’t able to or choose not to eat dairy. Always consult your doctor before making diet changes.
Individuals with hypopara may have hyperphosphataemia; this means individuals should avoid sources of phosphate in their diet, such as fizzy drinks and processed foods.
Other pharmacological treatments are available, for more information discuss this with your physician.
