How is hypoparathyroidism treated?

Treatment is aimed at raising blood calcium levels high enough to provide symptom relief without causing abnormally high levels of calcium in the urine (hypercalciuria). The only therapies that are approved by the Food and Drug Administration (FDA) for hypoparathyroidism (from any cause) are synthetic forms of vitamin D and calcium supplements.

The main form of active vitamin D used for individuals with hypoparathyroidism is calcitriol (1,25-hydroxy vitamin D₃). Two synthetic forms of vitamin D that are often used are cholecalciferol and dihydrotachysterol. These forms of vitamin D have a longer duration of action than calcitriol. Some individuals receive a combination of shorter- and longer-acting vitamin D analogs.

Some individuals with hypoparathyroidism are encouraged to eat foods high in calcium such as dairy products, breakfast cereals, fortified orange juice, and green, leafy vegetables.¹

Investigational Therapies

Hypoparathyroidism is one of the few hormone deficiency diseases that are not usually treated with the missing hormone. However, greater availability of various forms of PTH has led to several studies of PTH treatment for this condition.²

A synthetic human N-terminal fragment of PTH (PTH 1-34) with full biological activity has been used as an investigational hormonal replacement therapy for chronic hypoparathyroidism over the past two decades at the NICHD. Initial studies have shown decreased urinary calcium excretion compared to conventional therapy.^3,4

Additionally, PTH replacement therapy using a subcutaneous pump shows great promise for adults and children with hypoparathyroidism.⁵

1. University of Maryland Medical Center. (2011). Hypoparathyroidism. Retrieved June 22, 2012, from http://www.umm.edu/altmed/articles/hypoparathyroidism-000091.htm [top]
2. Sikjaer, T., Rejnmark, L., & Mosekilde, L. (2011). PTH treatment in hypoparathyroidism. Current Drug Safety, 6, 89-99. [top]
3. Winer, K. K., Yanovski, J. A., & Cutler, G. B., Jr. (1996). Synthetic human parathyroid hormone 1-34 vs calcitriol and calcium in the treatment of hypoparathyroidism: results of a randomized crossover trial. Journal of the American Medical Association, 276, 631-636. [top]
4. Winer, K. K., Yanovski, J. A., Sarani, B., & Cutler, G. B., Jr. (1998). A randomized, crossover trial of once-daily vs twice-daily human parathyroid hormone 1-34 in the treatment of hypoparathyroidism. Journal of Clinical Endocrinology and Metabolism, 83, 3480-3486. [top]
5. Winer, K. K., Zhang, B., Shrader, J. A., Peterson, D., Smith, M., Albert, P. S., et al. (2012). Synthetic human parathyroid hormone 1-34 replacement therapy: A randomized crossover trial comparing pump versus injections in the treatment of chronic hypoparathyroidism. Journal of Clinical Endocrinology and Metabolism, 97, 391-399. [top]