Hypoparathyroidism is a rare endocrine disorder characterized by insufficient secretion of parathyroid hormone (PTH) or resistance to its action. Parathyroid hormone plays a critical role in maintaining calcium and phosphate balance by regulating bone metabolism, kidney calcium reabsorption, and vitamin D activation. Deficiency of PTH results in low blood calcium levels (hypocalcemia) and elevated phosphate levels, leading to neuromuscular and systemic complications.

The most common cause of hypoparathyroidism is accidental damage or removal of the parathyroid glands during neck or thyroid surgery. Other causes include autoimmune destruction, genetic disorders affecting parathyroid development, severe magnesium deficiency, and rare infiltrative diseases. In some cases, the cause remains idiopathic. Unlike hyperparathyroidism, hypoparathyroidism often presents with acute and symptomatic hypocalcemia.

Clinical manifestations vary in severity and are largely related to low calcium levels. Early symptoms include numbness and tingling around the mouth, hands, and feet, muscle cramps, and fatigue. More severe hypocalcemia can lead to muscle spasms, tetany, seizures, cardiac rhythm disturbances, and neuropsychiatric symptoms such as anxiety and depression. Chronic disease may result in cataracts, dental abnormalities, and impaired quality of life.

Diagnosis is based on laboratory findings showing low serum calcium, elevated phosphate, and inappropriately low or normal PTH levels. Additional evaluation includes magnesium levels, vitamin D status, and kidney function assessment. Electrocardiography may be performed to evaluate cardiac effects of hypocalcemia.

Management focuses on restoring and maintaining stable calcium levels while avoiding complications related to overtreatment. Conventional therapy includes oral calcium supplementation and active forms of vitamin D to enhance intestinal calcium absorption. Treatment requires careful dose titration and regular monitoring, as excessive supplementation may lead to hypercalciuria and kidney complications.

Long-term management emphasizes maintaining calcium levels in a low-normal range to reduce symptoms while minimizing renal risk. Patient education is essential, as adherence and symptom recognition play a major role in disease control. In selected patients with difficult-to-control disease, advanced therapies may be considered under specialist care.

With appropriate treatment and monitoring, most individuals with hypoparathyroidism can achieve symptom control and maintain functional lives. Early recognition and structured endocrine follow-up are key to preventing long-term complications and improving patient outcomes.