Hypoparathyroidism

All patients should be instructed in the symptoms of hypocalcaemia, and given emergency contact numbers for their physicians. Paraesthesias and cramping, especially of the fingers and toes, are usually the first symptoms. Should symptoms develop, patients should either call their surgeon, endocrinologist, advice nurse, or other provider for immediate guidance, or go to a nearby accident and emergency department or urgent care clinic for assessment. Patients should be advised that maintaining sufficient intestinal calcium absorption may be difficult with diarrhoea or vomiting, and these concomitant issues may precipitate a hypocalcaemic attack or even crisis. Patients with chronic hypoparathyroidism should know that they are calcium-supplement dependent and that failure to take sufficient calcium (and calcitriol) can bring on immediate symptoms and complications, including death. Medic-alert bracelets are advisable.

If the aetiology of the hypoparathyroidism is genetic or autoimmune, family members should be instructed on signs and symptoms of hypocalcaemia as they may be at risk for developing the condition as well.