What Are the Factors That Can Cause Hypoparathyroidism?

Hypoparathyroidism is a rare condition in which the body produces abnormally low levels of an important hormone called parathyroid hormone, or PTH. This hormone controls calcium levels in the body by acting on bones to control the breakdown of bone material to release calcium, and on the stomach and intestines to regulate calcium absorption from the diet.

Low amounts of this hormone lead to symptoms ranging from mild tingling in the fingers and toes to severe muscle cramps, among others.

PTH is produced in the parathyroid glands — four small nodules in the neck, behind the thyroid glands.

There are several factors that can lead to hypoparathyroidism.

Neck surgery

The most common cause of hypoparathyroidism is surgery to the head or neck. This type of surgery can accidentally damage blood flow or nervous connections to the thyroid and parathyroid glands. This may disrupt the secretion of PTH and lead to hypoparathyroidism.

Family history

Although rare, some children are born without parathyroid glands. This is called congenital hypoparathyroidism and may be part of familial hypoparathyroidism. If you have a family history of hypoparathyroidism, you may have mutations in the genes that provide instructions for making PTH.

Some other types of endocrine diseases such as Addison’s disease, in which the body cannot produce enough of two other hormones called aldosterone and cortisol can also cause hypoparathyroidism.

Cancer and radiation therapy

Some types of head and throat cancers can affect the parathyroid glands, preventing them from secreting hormones normally.

High-dose radiation therapy can also damage the glands and lead to hypoparathyroidism.

Autoimmune reaction

Your immune system can sometimes mistakenly attack the parathyroid glands, causing damage that can be permanent. It is not known what causes autoimmune diseases in which the immune system attacks healthy tissue as if it is an infection.

Low blood levels of magnesium

Magnesium levels are important for the function of the parathyroid glands. Low levels of magnesium signal the parathyroid gland to secrete PTH, which signals the kidneys to retain magnesium, raising magnesium levels in the body.

However, very low levels of magnesium can cause a block on PTH secretion through unknown mechanisms. When magnesium levels drop due to malnourishment or alcoholism, for example, the glands cannot function normally. Taking a magnesium supplement can treat this type of hypoparathyroidism.

Through a different mechanism, extremely high levels of magnesium can also suppress PTH secretion from the parathyroid glands. These glands have protein sensors that “sense” when calcium is low to control secretion. When magnesium levels are very high, it is able to bind to these same sensors and activate them to a degree. This reduces the amount of PTH the glands secrete in response.

Last updated: March 31, 2020

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