Patients with
hypoparathyroidism can exhibit a variety symptoms

Hypoparathyroidism (HPT) can lead to a broad spectrum of
clinical manifestations—ranging from mild to life-threatening—
such as laryngospasm, seizures, or heart failure. Clinical
presentation is largely determined by the severity and rate of
development of mineral imbalance, as well as disease duration.1

Picture model of heart | Symptoms of HPT vary and can affect different parts of the body.

Signs and symptoms

Most patients present with mild, nonspecific signs and symptoms associated with changes in mineral homeostasis.2

Image of muscles | HPT can affect the neuromuscular system.


  • Fatigue
  • Generalized muscle weakness
  • Muscle cramping (sometimes painful),
    manifested as carpal and/or pedal spasm
  • Neuromuscular irritability resulting in tetany
  • Bronchospasm and wheezing
Image of brain | HPT can manifest with neurologic symptoms.


  • Paresthesia and numbness, especially
    around the mouth and in the fingers and toes
  • Seizures, spells
  • Basal ganglia and brain calcifications
Image of brain | HPT can manifest with neuropsychiatric symptoms.


  • Poor memory and concentration
  • Depression
  • Anxiety
  • Personality disturbances
Image of heart | HPT can affect the cardiovascular system.


  • Congestive heart failure, including cardiomegaly,
    pulmonary congestion, and volume overload
  • Chest pain
  • Arrhythmias
  • Heart block
  • Prolonged QTc interval

Symptoms may occur independently of mineral levels. Patients may be:

despite having hypocalcemia and/or hyperphosphatemia3

Arrow pointing left and right | HPT can be symptomatic and asymptomatic.

despite being in the target serum calcium range4,5

  • Asymptomatic
    despite having hypocalcemia and/or hyperphosphatemia3
  • Symptomatic
    despite being in the target serum calcium range4,5

Due to variability in symptom presentation, frequent monitoring is critical when evaluating patients with hypoparathyroidism.2,3,6

Chronic HPT is associated with comorbidities that can affect several organ systems—including renal, neuropsychiatric, skeletal, cardiovascular, and ophthalmologic systems.3


Patients with inadequately controlled hypoparathyroidism can suffer a high burden of illness.7



1. Shoback D. Hypoparathyroidism [clinical practice]. N Engl J Med. 2008;359(4):391-403. 2. Brandi ML, Bilezikian JP, Shoback D, et al. Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab. 2016;101(6):2273-2283. 3. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab. 2016;101(6):2300-2312. 4. Bilezikian JP, Brandi ML, Cusano NE, et al. Management of hypoparathyroidism: present and future. J Clin Endocrinol Metab. 2016;101(6):2313-2324. 5. Mitchell DM, Regan S, Cooley MR, et al. Long-term follow-up of patients with hypoparathyroidism. J Clin Endocrinol Metab. 2012;97(12):4507-4514. 6. Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology clinical guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1-G20. 7. Siggelkow H, Clarke BL, Germak J, et al. Burden of illness in not adequately controlled chronic hypoparathyroidism: findings from 13-country patient and caregiver survey. Clin Endocrinol (Oxf). 2020;92(2):159-168.