There’s no cure for hypoparathyroidism, but treatment options like calcium supplements, diuretics, and parathyroid hormone therapy can help regulate your calcium and phosphate levels.

Hypoparathyroidism is a rare health condition where your parathyroid glands don’t produce enough parathyroid hormone (PTH) to meet your body’s needs. It’s caused by loss of or damage to the parathyroid gland.

PTH is responsible for regulating calcium and phosphate levels in your bloodstream. When your body doesn’t make enough PTH, your calcium level can become too low (hypocalcemia), and your phosphate level can become too high (hyperphosphatemia). This can lead to symptoms such as:

  • muscle cramps and aches
  • weakness
  • headaches
  • vocal changes
  • cognitive impairment

Currently, there’s no cure for hypoparathyroidism. However, treatment can help regulate your calcium and phosphate levels and manage symptoms.

Calcium supplements are often the go-to treatment for hypoparathyroidism.

Calcium supplements are used to increase low calcium levels. Depending on your individual needs, your doctor may prescribe oral calcium carbonate or calcium citrate.

According to a crossover clinical trial from 2022, calcium carbonate is the most common calcium supplement used for hyperparathyroidism.

Calcium citrate may be less likely to cause side effects like constipation, gas, and bloating. It may also be less likely to lead to kidney stones, a potential adverse effect of calcium supplements caused by increased calcium excretion in the urine.

If hypocalcemia is severe or your symptoms are significantly impairing, you might receive intravenous (IV) calcium therapy for immediate relief.

Vitamin D helps your intestines absorb calcium, but PTH is necessary to activate vitamin D in your body. For this reason, doctors often prescribe activated vitamin D (calcitriol) in a supplement form. This form of vitamin D has already been chemically activated during production, so it doesn’t require PTH to work properly.

For some people living with hypoparathyroidism, low levels of magnesium (hypomagnesemia) may also become a concern. Your body requires an adequate amount of magnesium to produce PTH, and hypomagnesemia is a potential cause and contributing factor in the development of hypoparathyroidism.

Low levels of vitamin D in hypoparathyroidism can also lead to hypomagnesemia. Vitamin D helps with both calcium and magnesium absorption, so it’s common for people with low calcium levels in hypoparathyroidism to also experience low magnesium levels.

To help regulate your magnesium levels, your doctor will likely prescribe an oral supplement.

Diuretics are medications that increase your urine output by promoting water and electrolyte excretion. In hypoparathyroidism, your doctor might prescribe thiazide diuretics due to their specific effects on calcium levels in the bloodstream.

Thiazide diuretics inhibit sodium reabsorption in the kidneys, which indirectly triggers calcium reabsorption. This helps prevent calcium loss through your urine by keeping calcium in the bloodstream.

If you’re not benefiting enough from calcium and activated vitamin D supplementation, your doctor might add a thiazide diuretic to your treatment plan.

Supplements aren’t the only way to manage your calcium, magnesium, and phosphate levels. Diet can play an important role in hypoparathyroidism treatment, too.

Based on your individual needs, your doctor may recommend increasing your calcium intake by eating more dairy products and green, leafy vegetables; and limiting foods high in phosphorus, such as carbonated drinks, eggs, and meats.

Are phosphorus and phosphate the same?

Phosphorus and phosphate aren’t exactly the same, but they are related. Phosphorus is an element that’s naturally present in the environment — including in food. After you eat a food containing phosphorus, your body converts it into phosphate to be used for a variety of functions like building bones and signaling within cells.

PTH therapy may be prescribed for people with hypoparathyroidism who don’t experience improvements from treatment with supplements and dietary changes.

PTH therapy uses human-made (synthetic) PTH to replace the missing PTH in your body. Administered via an injection just under the skin, PTH therapy may help reduce the calcium and activated vitamin D supplementation you need.

While PTH therapy has been available since 2015, in 2024, a new drug, palopegteriparatide (Yorvipath), was approved by the Food and Drug Administration (FDA) for the treatment of hypoparathyroidism in adults. This new option is thought to be more stable than previous forms of PTH used in replacement therapy, which helps maintain PTH levels within the target range for longer.

Hypoparathyroidism is a rare health condition caused by low levels of PTH. While there’s currently no cure, treatment is available to help manage your calcium and phosphate levels.

Supplementation with calcium and activated vitamin D are the first-line treatments for hypoparathyroidism. Some people may also benefit from magnesium supplementation, diuretics, or PTH therapy.

If you have hypoparathyroidism, it’s important to work with your doctor to determine the best treatment approach for you.