Hypoparathyroidism can lead to a wide range of symptoms1

When PTH is reduced or lost, mineral homeostasis is impaired, resulting in hypocalcaemia, hyperphosphatemia and

In the PARADOX patient survey (N=374), chronic hypoparathyroidism patients undergoing treatment still reported suffering from an average of 16 different symptoms in the previous year, and they experienced symptoms for an average of 13±9 hours/day.

The PARADOX Shire survey (N=374) was web-based, and patients self-reported answers to an online, non-validated questionnaire that was designed to take approximately 30 minutes to complete. This US survey aimed to quantify the clinical and social burden of illness from the perspective of affected patients.9

Next: Comorbidities ►



  • Fatigue
  • Muscle pain/cramping
  • Pins and needles (Paraesthesia)
  • Muscle spasm (Tetany)
  • Joint or bone pain
  • Pain/heaviness/weakness in hands and feet
  • Disturbance to bowel movements
  • Brittle nails
  • Heat intolerance
  • Headaches
  • Damage to skin/extreme dry skin
  • Cold sensations
  • Hair loss
  • Nausea


  • “Brain fog”/mental lethargy
  • Inability to focus
  • Memory loss/forgetfulness
  • Sleep disturbance
  • Inability to think through a complicated task/multitask


  • Anxiety/fear
  • Feeling sad
  • Emotional sensitivities
  • Feeling misunderstood
  • Hyperirritability/being hypercritical
  • Social withdrawal/feeling isolated

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  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.