Parathyroid hormone replacement in hypoparathyroidism

Author(s): Sharon H Chou & Tamara Vokes

Hypoparathyroidism results from insufficient parathyroid hormone (PTH) to maintain normal serum levels of calcium and phosphate. Unlike most endocrine deficiency disorders, the current standard of treatment is not replacement with PTH but supplementation with calcium and vitamin D. Normal physiology cannot be fully restored with calcium and vitamin D, and long-term complications of this treatment include impaired renal function, nephrolithiasis and ectopic soft tissue calcification. In the last decade clinical studies have emerged using PTH for the treatment of hypoparathyroidism either in place of or in addition to standard treatment with calcium and vitamin D. The effects of PTH replacement on biochemical indices, bone metabolism and quality of life have been promising.