Treatment Options for Hypoparathyroidism
If you have been diagnosed with hypoparathyroidism, you likely have many questions about treatment options available to you. Here is some information that may help you.
Hypoparathyroidism is a rare condition in which the body does not make enough parathyroid hormone (PTH). PTH is vital to regulating and maintaining a balance of two minerals in the body — calcium and phosphorus. Low PTH levels lead to abnormally low levels of calcium and phosphorus.
The aim of treatment is to normalize the levels of calcium and phosphorus in the body, relieving symptoms that can include numbness around the mouth or in the hands and feet, uncontrollable and painful spasms in the face, hands, arms, and feet, seizures, low blood pressure, anxiety or depression, brittle hair, and dental problems.
There are several conventional treatments your doctor may prescribe:
- Oral calcium carbonate supplements can raise calcium blood levels. Care must be taken, though, since high doses of calcium can cause gastrointestinal problems.
- High doses of vitamin D, usually in the form of calcitriol, can help your body absorb calcium and eliminate phosphorus.
- Thiazide diuretics can help reduce the amount of calcium lost through the urine. However, some people, including those who have a genetic form of hypoparathyroidism, should not take this medicine.
- Your doctor may prescribe magnesium supplements if you are experiencing symptoms due to low levels of this mineral.
PTH replacement therapy
Lifelong conventional therapy notwithstanding, studies suggest that, over time, raising calcium levels without increasing PTH may cause kidney insufficiency.
Natpara is a synthetic form of PTH approved by the U.S. Food and Drug Association (FDA) for use in combination with supplements for patients who do not respond to supplements only. The therapy helps patients maintain acceptable calcium levels while reducing their supplement doses.
Ascendis Pharma is developing a treatment called TransCon PTH, containing a synthetic form of PTH. Top-line data from a Phase 2 trial called PaTH Forward (NCT04009291) found the therapy restored calcium and phosphate balance and eliminated the need for current standard care in adults.
While the disorder is uncommon in children, it can still occur. Treatment and management can be challenging, particularly in babies, since too much vitamin D and calcium may lead to nephrocalcinosis (calcium deposits in kidneys) and nephrolithiasis (kidney stones).
For children who do not respond to conventional therapy — calcium and vitamin D supplements — PTH replacement therapy may be an option. At least one study has demonstrated that such treatment is safe and effective in maintaining stable calcium homeostasis in children.
Last updated: Oct. 16, 2020
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