Hypoparathyroidism treatment
Last updated June 3, 2025, by Marisa Wexler, MS
Fact-checked by Jose Lopes, PhD
The main goal of hypoparathyroidism treatment is to normalize the body’s calcium levels, which can help to prevent disease complications and maximize quality of life.
The rare condition is marked by low levels of parathyroid hormone (PTH), a signaling molecule that helps control calcium and other nutrients. Treatment strategies typically include calcium and vitamin D supplements, PTH replacement therapy, and lifestyle or dietary adjustments tailored to each person’s needs.
Conventional treatment approaches
Calcium is often low in people with hypoparathyroidism​, and most symptoms of the disease arise due to its deficiency. For that reason, the cornerstone of treatment for hypoparathyroidism​ involves supplementation with calcium and calcitriol, an active form of vitamin D that helps the intestines absorb calcium more efficiently.
The supplements seek to maintain blood calcium levels at about 8 to 9 milligrams per deciliter (mg/dL), a range that’s close to normal for healthy adults. This helps relieve hypoparathyroidism​ symptoms and reduces the risk of long-term complications.
The two main forms of calcium used for the treatment of hypoparathyroidism are:
- calcium carbonate, which contains 40% elemental calcium and should be taken with food
- calcium citrate, which contains 21% elemental calcium and does not require food to be absorbed.
Specific dosages and dosing regimens of calcium and vitamin D for hypoparathyroidism will usually depend on the patient’s starting calcium levels and the prescribed supplement. Supplements are typically taken two to four times daily. However, those containing calcium carbonate, which have more elemental calcium, may be needed in lower amounts overall.
Regular monitoring helps healthcare providers fine-tune treatment over time and ensure calcium blood levels remain within the target range. Because hypoparathyroidism affects each person differently and treatment responses also vary, dosing is tailored to a person’s needs, even when the same types of supplements are used.
PTH replacement therapy
PTH replacement therapy for hypoparathyroidism​ works by delivering a lab-made version of PTH to patients. This type of hypoparathyroidism medication can help normalize PTH levels, thus helping to restore levels of calcium and other nutrients.
PTH replacement therapy is generally considered for adults whose disease is not adequately controlled with conventional therapy or who have trouble taking supplements as directed.
Currently, Yorvipath (palopegteriparatide), marketed by Ascendis Pharma, is the only PTH replacement therapy approved in the U.S. It’s given once daily as an injection under the skin, or subcutaneously, and is designed to reduce or eliminate the need for calcium and vitamin D supplements in adults with hypoparathyroidism.
An earlier PTH replacement therapy, Natpara, was also approved for the treatment of hypoparathyroidism, but was discontinued in 2024 due to supply issues.
Treatment considerations
It’s generally recommended that treatment be initiated as soon as possible following a hypoparathyroidism​ diagnosis. Most patients will be started on calcium and vitamin D supplements, but other treatments like PTH replacement therapy may be considered if symptoms are not adequately managed with supplements or to reduce the need for standard supplements.
Individual treatment regimens are tailored to each person’s situation, taking into account factors such as age, overall health status, and whether they are pregnant or breastfeeding. During treatment, calcium levels are regularly monitored to ensure they stay within a safe and effective range, and dose adjustments may be made as needed.
There are several different hypoparathyroidism types, including acquired, autoimmune, congenital, familial isolated, and idiopathic hypoparathyroidism. Although each type has different underlying hypoparathyroidism causes, all are marked by low levels of PTH that result in disrupted calcium levels. As such, supplements and/or PTH replacement therapy may be used to manage different types of hypoparathyroidism.
Hypoparathyroidism diet
In addition to taking supplements, people with hypoparathyroidism are often advised to follow a high-calcium diet so that more of their daily calcium requirements are met through food. This generally won’t be enough to normalize calcium levels, but it can help reduce the need for calcium supplements.
Because PTH also regulates phosphorus levels, people with hypoparathyroidism typically have elevated phosphorus levels. A low-phosphorus diet, which typically involves limiting foods such as meats, dairy, and eggs, as well as soda, is usually recommended to restore phosphorus levels.
However, if phosphorus levels remain high despite dietary modifications, doctors may prescribe drugs called phosphorus binders to help lower them.
Other treatments and supportive care
Some additional medications may be used to help manage calcium levels in hypoparathyroidism. Thiazide diuretics, for example, can reduce calcium loss in urine and increase its levels in circulation by promoting calcium reabsorption in the kidney.
Sometimes, low levels of magnesium can contribute to hypoparathyroidism. If that’s the case, magnesium supplements may be added to a person’s hypoparathyroidism management plan to normalize magnesium levels.
Beyond these treatments, it’s also important for people with hypoparathyroidism to maintain a healthy lifestyle. This includes regular physical activity, attending regular check-ups with their healthcare providers, and seeking support for mental health.
Prognosis and long-term outlook
If left untreated, hypoparathyroidism can lead to serious complications such as seizures and larynx spasms, a potentially life-threatening condition in which the vocal cords suddenly close, blocking airflow. However, with appropriate treatment and monitoring, most people with hypoparathyroidism can expect a good long-term prognosis.
For those with chronic (long-term) hypoparathyroidism, most will need to continue taking calcium and vitamin D supplements daily for the rest of their lives to maintain calcium levels and prevent complications. Still, they are often able to live healthy, functional lives.
Hypoparathyroidism News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
