Unlike most other hormonal deficits, hypoparathyroidism is not treated with replacement of the missing hormone, parathyroid hormone (PTH).
Currently, the standard treatment for hypoparathyroidism consists of activated vitamin D (calcitriol) and calcium supplements. Some people may also need magnesium supplementation. Conventional therapy requires many pills taken throughout the day.1,2
Diet recommendations usually include eating foods high in calcium, such as dairy products, breakfast cereals, fortified orange juice, and green, leafy vegetables, or avoiding foods high in phosphorus, such as meat, poultry, fish, nuts, whole grains, and beans.3,4
Conventional therapy with vitamin D and calcium may lead to a buildup of calcium in the kidneys. This buildup may lead to problems, including kidney stones and deposits of calcium, reduced kidney function, tissue damage, or even kidney failure.
The development of PTH as a replacement therapy in patients with hypoparathyroidism was first explored by NICHD investigators beginning in 1992. Since then, NICHD researchers have conducted a series of classic studies evaluating PTH 1-34 regimens, including once-daily and twice-daily PTH injections without concurrent use of calcitriol or calcium supplements in adults and children. Recently, these NICHD researchers introduced PTH delivery by an insulin pump in two landmark studies in adults5 and in children.6,7,8,9,10 In January 2015, the U.S. Food and Drug Administration approved PTH 1-84 for adult hypoparathyroidism patients who do not respond well to standard treatment, as an add-on to that treatment.11