Hypoparathyroidism is a rare endocrine disorder that typically presents with symptoms related to low calcium levels (hypocalcaemia) and high phosphate levels (hyperphosphataemia) in the blood.
The chemical imbalances affect nerves, muscles, bones, skin, and brain function. Symptoms vary depending on how low calcium drops and how fast the change happens. The effects can be wide, worsen over time, and often disable if not treated well.
This section looks at all the symptoms linked to hypoparathyroidism. It covers early warning signs and long-term effects, focusing on how calcium changes impact different body systems.
Neuromuscular Symptoms of Hypoparathyroidism
Low calcium causes nerves and muscles to become too excitable. This leads to muscle spasms and twitching, which can be painful and upsetting.
- Tingling and Numbness (Paraesthesia)
Patients often feel tingling or numbness in fingers, toes, or around the mouth. These feelings may come and go or last longer, depending on calcium levels. - Muscle Cramps and Spasms (Tetany)
Tetany means painful, involuntary muscle contractions. Spasms usually affect hands, feet, and face.
Two classic signs doctors look for are:
- Chvostek’s sign: Twitching of facial muscles when tapping the facial nerve near the ear
- Trousseau’s sign: Hand and forearm spasm when inflating a blood pressure cuff
These symptoms often happen in both sudden and ongoing cases and can get worse with stress, exercise, or illness.
Cognitive and Psychological Symptoms
Low calcium also impacts the brain, causing problems that look like common mental health issues. These symptoms often overlap with other conditions and need blood tests to diagnose properly.
- Brain Fog and Poor Focus
Many patients say they find it hard to concentrate. Their thinking slows down, and memory weakens. This “brain fog” affects work, study, and daily tasks. - Depression and Anxiety
Mood changes are common in adults and children with hypoparathyroidism. These may result from chemical imbalances or the stress of chronic illness. - Irritability and Sleep Problems
Emotional ups and downs and poor sleep often occur, making life harder.
Long-term cases may develop calcium deposits in brain areas, which can cause movement problems or seizures, especially if untreated.
Seizures and Other Neurological Signs
Moderate to severe low calcium can cause seizures. These may be full-body convulsions or smaller, local episodes. They often come without warning.
Seizures are serious and require quick calcium correction and ongoing brain monitoring.
Other neurological signs include:
- Headaches
- Tremors
- Dizziness
- Poor coordination
Most symptoms improve quickly with proper calcium treatment.
Musculoskeletal Symptoms
Calcium and phosphate imbalance affects bones, muscles, and joints.
- Muscle Weakness and Tiredness
Even without spasms, many patients feel weak and tired. This may feel like chronic fatigue or fibromyalgia. - Joint and Bone Pain
Some people have bone aches or stiff joints. This can result from long-term low calcium or low vitamin D. - Slow Growth in Children
Children with hypoparathyroidism may grow slowly. They might be shorter than peers or have delayed teeth and bone problems if untreated.
Skin and Dental Symptoms
Over time, the disease affects skin, hair, nails, and teeth.
- Dry Skin and Hair Loss
Skin may become dry, rough, or flaky. Hair can thin, break, or fall out, especially in women after menopause or those with autoimmune disease. - Nail Problems
Nails may get brittle, ridged, or change color. These signs show stress from calcium deficiency. - Dental Issues
Children may have weak tooth enamel causing pits, decay, or weak roots. Adults can have sensitive teeth or early tooth loss.
These changes affect both appearance and function, especially if they start early.
Cardiovascular Symptoms
Calcium is vital for the heart’s electrical system and muscle function. Hypoparathyroidism can cause:
- Heart Palpitations and Irregular Rhythms
Low calcium can cause abnormal heartbeats. ECGs often show a longer QT interval, which can lead to dangerous heart rhythms. - Heart Failure and Low Blood Pressure
Though rare, long-term low calcium can weaken the heart muscle and cause low blood pressure. - Calcium Deposits in Blood Vessels
Despite low blood calcium, phosphate imbalances may cause calcium to build up in arteries, increasing heart risks.
Regular heart monitoring is important for patients with long-term hypoparathyroidism.
Reproductive and Hormone Effects
Hypoparathyroidism may also affect hormone and reproductive health. Some women report:
- Irregular periods
- Worse premenstrual symptoms with low calcium
- Fertility issues or pregnancy problems in severe cases
Pregnant women need close care to prevent risks like neonatal tetany, preterm birth, and calcium swings during and after pregnancy.
Mild and Hidden Cases
Some patients have mild or no symptoms early on. Doctors may find hypoparathyroidism only through routine blood tests or after surgery.
Even without symptoms, these patients need treatment to avoid long-term damage.
Summary
Symptoms of hypoparathyroidism affect many body systems. They range from muscle spasms and seizures to mood problems, heart issues, and skin changes. These symptoms often mimic other illnesses.
Recognizing symptoms early, especially in those with surgery or genetic risk, helps reduce complications. With careful calcium control and medical care, many symptoms can improve or disappear.
