Hypopara

1. Hypoparathyroidism
2. More about hypoparathyroidism
3. Symptoms
4. History
5. Resources
6. Facebook
7. Bibliography

Hypoparathyroidism is a condition in which there is insufficient parathyroid hormone function. Nearly 3/4 of the incidences of hypopara result from neck surgeries while the other 1/4 come from a variety of conditions such as congenital anomalies, autoimmune diseases, radioactive iodine therapy, or severely low magnesium levels.

Hypoparathyroidism is a rare disease. Rare diseases are defined by the NIH as affecting fewer than 200,000 people in the United States. A 2013 study estimated that there were 77,000 hypopara patients in the U.S. [1] It is likely that there are more than that but still less than 200,000. Like many rare diseases, hypopara suffers from a lack of medical attention, resources, and awareness.

The only treatment for hypopara to date has been calcium and vitamin D and the prescription drug Rocaltrol (an activated form of vitamin D). Parathyroid hormone replacement has been an effective treatment but does not negate the ongoing need for calcium and vitamin D supplementation. Products like Cal-EZ can provide needed calcium and vitamin D to help maintain more normal calcium levels.

More about hypoparathyroidism

The primary challenge of hypoparathyroidism is hypocalcemia (too little calcium in the blood). In normal circumstances, when calcium or magnesium levels are low in the blood, the Calcium Sensing Receptor (CaSR) signals the parathyroid glands to release parathyroid hormone (PTH). PTH then causes the bones and kidneys to put calcium back into the bloodstream to fix the calcium deficiency. In hypoparathyroidism there is insufficient parathyroid function so when calcium or magnesium levels in the blood are low, there is no PTH released to correct it.

The symptoms that hypoparathyroidism patients experience are primarily related to hypocalcemia and hypomagnesemia and include [2]:

• Paresthesias - tingling in the finger, toes, or around the mouth
• Tetany - uncontrollable muscle spasms
• Brain fog - difficulty concentrating or remembering / feeling detached
• Emotional dysfunction - anxiety and or depression
• Muscle stiffness or cramping
• Bone pain
• Seizures
• Prolongation of the QT interval - observable on electrocardiogram
• Congestive heart failure
• Hypotension
• Laryngospasm - uncontrollable spasm of the voice box
• Chvostek's Sign - twitching of the nerve between the ear and cheekbone
• Trousseau's Sign - tetany in the foreman brought on by applying a pressurized cuff on the arm for 2 minutes
• Diaphoresis - excessive sweating
• Gastric Achlorhydria - reduction of acid production in the stomach
• Dry course skin and/or hair - eczema, dermatitis

Longer term symptoms:

• Cataracts - film forming in the eye obstructing vision
• Calcification of soft tissues - such as the kidneys
• Calcification of the basal ganglia - this creates Parkinson's-Disease-like symptoms

Because of these challenging symptoms, which are rarely managed completely by supplement use, hypopara patients will sometimes be unable to work a conventional job and can have difficulty exercising or performing strenuous physical activities or high stress activities.

In addition to the unceasing effort to maintain sufficient calcium levels, less predictable episodes of symptomatic hypocalcemia can be brought on by a number of different triggers:

• Hypomagnesemia (low magnesium in the blood)
• Severe hypermagnesemia (a severe case of too much magnesium in the blood)
• Hyperphosphatemia (too much phosphorus in the blood)
• Sweating - sweat contains calcium so as you perspire you lose calcium
• Acute stress or anxiety - many patients report rapid drops in calcium when stressed or anxious
• Excessive physical activity - this is relative to what an individual might be used to
• Sudden change in diet - consider how your diet changes when you go on vacation.
• Changes in medications - this includes prescription medications but also includes switching
  brands of calcium

Hypopara patients must supplement with calcium products. Vitamin D is also vital in this equation because vitamin D helps calcium to be absorbed during digestion. Products like Cal-EZ can provide the right amounts of calcium and vitamin D to help patients maintain that balance. As for the times when triggers bring on symptomatic hypocalcemia, because Cal-EZ is a powder, it has been proven to absorb more quickly than citrate tablets. That equates to faster relief from symptoms and more control over fluctuations.

History

The parathyroids were discovered in 1852 by Richard Owen of the Royal College of Surgeons. Curiously he discovered them while dissecting a rhinoceros. The parathyroid glands were not discovered in humans until 1880 by Swedish medical student Ivar Viktor Sandstrom. Interestingly, Sandstrom named them the "parathyroid glands" but conceivably they could have been named "the Glands of Owen" (which might have avoided a lot of confusion).

RESOURCES

• http://www.mayoclinic.org/ - online resource of the Mayo Clinic
• http://ods.od.nih.gov/ - the National Institutes of Health, Office of Dietary Supplements
• http://www.nlm.nih.gov/medlineplus/ - a service of the U.S. National Library of Medicine
• http://www.hypopara.org/ - the Hypoparathyroidism Association, Inc. The non-profit support group for hypoparathyroidism
• http://hypoparathyroidism.com/ - stories and information sponsored by NPS Pharmaceuticals

FACEBOOK

• https://www.facebook.com/groups/hypoparalodge/
• https://www.facebook.com/groups/HypoparaAssociation/

REFERENCES

1. Powers, Joy, Ruscio and Lagast, "Prevalence and Incidence of Hypoparathyroidism in the United States Using a Large Claims Database," JBMR, vol. 28, no. 12, pp. 2570-2576, 2013.
2. Cleveland Clinic, "Cleveland Clinic Center for Continuing Education," The Cleveland Clinic Foundation, 2000-2014. [Online]. Available: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/hypocalcemia/. [Accessed 2014].