What to ask when starting a medication for hypoparathyroidism

Hypoparathyroidism is a medical condition where the body is unable to produce sufficient amounts of parathyroid hormone (PTH).

PTH regulates the body’s calcium levels, and it also plays a role in balancing levels of phosphorus and vitamin D.

This hormone is produced by the parathyroid glands, four pea-sized endocrine glands located in the front of the neck, just behind the thyroid gland. The most common cause of hypoparathyroidism is damage to the parathyroid glands. This can occur during surgery, such as surgery to remove a tumor or surgery on the thyroid gland. Hypoparathyroidism can also be caused by autoimmune disease, where the body’s immune system attacks healthy tissue.

A person with hypoparathyroidism will have low levels of calcium and elevated levels of phosphate. This can cause tingling, numbness, muscle spasms, pain, hair loss, cognitive problems, skin problems, fatigue, and many other symptoms. Hypoparathyroidism can also cause serious complications, including cataracts, heart arrythmias, and kidney disease.

How is hypoparathyroidism treated?

Treatment for hypoparathyroidism can be highly dependent on the underlying cause. For example, if low parathyroid hormone levels are caused by a magnesium deficiency, the primary treatment will be restoring magnesium levels.

The main treatment for hypoparathyroidism is a regimen of calcium supplements, along with a prescription-only, active form of vitamin D called calcitriol. The goal of this treatment approach is to maintain blood calcium levels as close to normal as possible. These supplements require regular blood and urine tests to check calcium and phosphorous levels as well as and monitoring for kidney function.

Medications that prevent calcium loss through urine (called thiazide diuretics) may also be prescribed.

In some circumstances, a healthcare team may recommend parathyroid hormone injections. These injections work by replacing the PTH that is not being made by the body.

Questions when starting a medication

People with hypoparathyroidism often need to take multiple medications and need to take medications multiple times per day. Following a medications schedule as exactly as possible is critical to getting the best result from treatment. If you are having difficulty taking a medication for any reason, tell your healthcare provider.

Know the following for each medication you are taking:

• What is the name of the medication and the dosage?
• How does this medication need to be stored?
• How does the medication treat hypoparathyroidism?
• How is the medication administered?
• Calcium supplements, calcitriol, and thiazide diuretics are taken as pills.
• Parathyroid hormone injections may be self-administered, and a healthcare provider will train you on how to use an injector.

How often do you need to take the medication?

• What time of day should the medication be taken?
• Does it need to be taken with or without food? Are there other specific instructions?
• What should I do if I miss a dose?
• What should I do if I accidentally take an extra dose?

What side effects can this medication cause?

• Is there a risk of serious side effects?
• What should I do if I am experiencing a side effect?
• What symptoms require immediate medical attention?

How will I be monitored for complications and side effects?

• How often will I need to come in for blood work?
• What tests will be used to monitor kidney function?
• What other tests or consultations are recommended?

Can this medication interact with other medications?

• Your healthcare provider should have an up-to-date list of all medications you take, including prescription medications, over-the-counter medications, and supplements (including herbal products).

What will this medication cost, and who can I talk to if I have concerns about the cost?

What lifestyle modifications can I make to get the most benefit from this medication?

Is there anything that I need to avoid while taking this medication?

For information about your diagnosis, your treatment, and your overall health, a healthcare provider will always be your best source of information. A pharmacist is also an excellent resource when you have questions about a medication.