There are no symptoms of Hypoparathyroidism ( low Parathyroid hormone levels) but there are symptoms of Hypocalcaemia ( low calcium levels) and related conditions.

Individuals may feel different symptoms in different ways and will often have their own ( quite narrow)  individual range within the normal reference range where they feel symptom free.

LOW CALCIUM

Symptoms are those of tetany and develop along a spectrum ranging from mild to more severe.

Asymptomatic

Many people have no symptoms at all once their calcium and vitamin D levels are properly adjusted. as levels do fluctuate , blood tests are still important so that occasional blips may be adjusted. People with Idiopathic forms of hypoparathyroidism, once on medication, seem to tolerate lower levels of calcium than post surgical types who may experience more fluctuations.

Mild symptoms

Many people experience only mild symptoms which may require no action or just an occasional minor adjustment. These usually take the form of paraesthesias - tingling in the hands, fingers, and around the mouth, and twitching muscles.

Severe symptoms are more unusual. They may occur post operatively or when medication has been inadequate over a period of time or in Brittle hypoparathyroidism where levels remain constantly unstable. Symptoms may develop over time if ignored or unrecognised, or they may come on rapidly suddenly requiring urgent action to avoid a crisis.

Warning signs may be a drop in temperature, sensitivity to sound, shakiness, irritability, anxiety, diarrhea and gradually worsening muscle spasms.

Early symptoms of tetany may include:

• Tingling or numbness in the hands and/or feet
• Tingling or numbness in the face especially around the mouth
• Irritability
• Brain fog
• Tiredness
• Headache
• Diarrhea
• Twitching or trembly muscles
• Sudden temperature drop

If not treated , more severe symptoms may develop and can include:

• Increasing brain fog, feeling 'out of it
• Worsening tetany, feeling very shaky and trembly inside (not visible)
• Hard to function or move around
• Carpopedal spasm (painful muscle spasms or cramps of the hands and feet)
• Painful muscle spasms all over the body
• HIgh anxiety
• Confusion
• Severe muscle cramps
• Seizures (this is rare)

Other symptoms may develop over time

• Cardiac effects

• Memory loss
• Depression
  
• Dry skin and itching, dry hair
• Cataracts and eye problems
• Dental problems
• Kidney stones
• Kidney failure
  

HIGH CALCIUM

Vitamin D and calcium treatment requires regular blood testing as calcium levels  can fluctuate in response to many factors and medication occasionally needs to  be adjusted. This can also involve a certain amount of guesswork as well. So people with Hypoparathyroidism can sometimes develop high calcium levels  and you should be aware of the symptoms to look out for.

Early warning signs can include:

• Extreme tiredness (fatigue) and lethargy
• Feeling weak
• Not wanting to eat much (anorexia)
• Constipation
• Loss of concentration and interest in doing things
• Mild confusion

If the hypercalcaemia is not treated then the symptoms become much worse and can include

• Feeling and being sick
• Drowsiness
• Passing large amounts of urine
• Feeling very thirsty
• Dehydration
• Confusion
• Agitation
• Muscle spasms, tremors.
• Bone pain and weakness
• Irregular heart beat
• Difficulty thinking and speaking clearly

If you have any of these symptoms you should contact your doctor immediately to arrange a blood test. Left untreated this can be a life threatening condition.