Therapeutic goals proposed by the European Society of Endocrinology include the following:1

Parameter Goals of management Target range
Serum calcium concentration (albumin-adjusted total calcium) Maintain in lower part of or slightly below the reference range (2.12–2.65mmol/L),2 with patients free of the symptoms/signs of hypocalcaemia 2.1−2.3 mmol/L
24-hour urinary calcium excretion Maintain within reference range men: <7.5 mmol/24 hours;
women: <6.25 mmol/24 hours
Serum phosphate concentration Maintain within reference range 0.8−1.4 mmol/L2
Serum calcium−phosphate product Maintain at <4.4 mmol2/L2
Serum magnesium concentration Maintain within reference range 0.75−1.05 mmol/L2
Vitamin D Achieve adequate status
Overall well-being and QoL Personalise treatment when implementing different therapeutic efforts to achieve the therapeutic goals
Information/education Enable patients to know about possible symptoms of hypocalcaemia or hypercalcaemia and/or complications of their disease

Next: Monitoring ►

  1. 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):G1-20.
  2. Levine MA. Normal mineral homeostasis. Interplay of parathyroid hormone and vitamin D. Endocr Dev. 2003;6:14-33.
  3. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of Hypoparathyroidism: Etiologies and Clinical Features. J Clin Endocrinol Metab. 2016;101(6):2300-12.
  4. Underbjerg L, Sikjaer T, Mosekilde L, et al. Cardiovascular and renal complications to postsurgical hypoparathyroidism: a Danish nationwide controlled historic follow-up study. J Bone Miner Res. 2013;28(11):2277-85.
  5. Underbjerg L, Sikjaer T, Mosekilde L, et al. The Epidemiology of Nonsurgical Hypoparathyroidism in Denmark: A Nationwide Case Finding Study. J Bone Miner Res. 2015;30(9):1738-44.
  6. Astor MC, Lovas K, Debowska A, et al. Epidemiology and Health-Related Quality of Life in Hypoparathyroidism in Norway. J Clin Endocrinol Metab. 2016;101(8):3045-53.
  7. Clarke BL, Brown EM, Collins MT, et al. Epidemiology and Diagnosis of Hypoparathyroidism. J Clin Endocrinol Metab. 2016;101(6):2284-99.
  8. Powers J, Joy K, Ruscio A, et al. Prevalence and incidence of hypoparathyroidism in the United States using a large claims database. J Bone Miner Res. 2013;28(12):2570-6.
  9. Hadker N, Egan J, Sanders J, et al. Understanding the burden of illness associated with hypoparathyroidism reported among patients in the paradox study. Endocr Pract. 2014;20(7):671-9.
  10. Mitchell DM, Regan S, Cooley MR, et al. Long-term follow-up of patients with hypoparathyroidism. J Clin Endocrinol Metab. 2012;97(12):4507-14.
  11. Shoback D. Clinical practice. Hypoparathyroidism. N Engl J Med. 2008;359(4):391-403.
  12. Chatterjee S. Permanent hypoparathyroidism following radioiodine treatment for hyperthyroidism. J Assoc Physicians India. 2004;52:421-2.
  13. Horwitz CA, Myers WP, Foote FW, Jr. Secondary malignant tumors of the parathyroid glands. Report of two cases with associated hypoparathyroidism. Am J Med. 1972;52(6):797-808.
  14. Bilezikian JP, Khan A, Potts JT, Jr., et al. Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317-37.