Treatment

The goal of treatment is to relieve symptoms and to normalize levels of calcium and phosphorus in your body. A treatment regimen usually includes:

• Oral calcium carbonate tablets. Oral calcium supplements can increase calcium levels in your blood. However, at high doses, calcium supplements can cause gastrointestinal side effects, such as constipation, in some people.
• Vitamin D. High doses of vitamin D, generally in the form of calcitriol, can help your body absorb calcium and eliminate phosphorus.
• Magnesium. If your magnesium level is low and you're experiencing symptoms of hypoparathyroidism, your doctor may recommend that you take a magnesium supplement.
• Thiazide diuretics. If your calcium levels remain low even with treatment, thiazide diuretics can help decrease the amount of calcium lost through your urine. However, some people with hypoparathyroidism, including people who inherited the condition, shouldn't take thiazide diuretics.
• Parathyroid hormone (Natpara). The U.S. Food and Drug Administration has approved this once-daily injection for treatment of low blood calcium due to hypoparathyroidism. Because of the potential risk of bone cancer (osteosarcoma), at least in animal studies, this drug is available only through a restricted program to people whose calcium levels can't be controlled with calcium and vitamin D supplements and who understand the risks.

Diet

Your doctor might recommend that you consult a dietitian, who is likely to advise a diet that's:

• Rich in calcium. This includes dairy products, green leafy vegetables, broccoli and foods with added calcium, such as some orange juice and breakfast cereals.
• Low in phosphorus. This means avoiding carbonated soft drinks, which contain phosphorus in the form of phosphoric acid, and limiting meats, hard cheeses and whole grains.

Intravenous infusion

If you need immediate symptom relief, your doctor might recommend hospitalization so that you can receive calcium by intravenous (IV) infusion, as well as oral calcium tablets. After hospital discharge, you'll continue to take calcium and vitamin D orally.

Monitoring

Your doctor will regularly check your blood to monitor levels of calcium and phosphorus. Initially, these tests will probably be weekly to monthly. Eventually, you'll need blood tests just twice a year.

Because hypoparathyroidism is usually a long-lasting disorder, treatment generally is lifelong, as are regular blood tests to determine whether calcium is at normal levels. Your doctor will adjust your dose of supplemental calcium if your blood-calcium levels rise or fall.