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Differences Between Hypoparathyroidism And Hypothyroidism

Hypothyroidism is when the thyroid gland does not make enough thyroid hormone. Hypoparathyroidism is comparatively rare, where the parathyroid glands behind the thyroid do not produce enough parathyroid hormone.

Both hypothyroidism and hypoparathyroidism are disorders of the endocrine system, which produces and secretes hormones.

However, these conditions involve different glands and hormones and have different symptoms and treatments.

This article outlines the similarities and differences between hypothyroidism and hypoparathyroidism and explains how doctors diagnose and treat these conditions.

As the Endocrine Society explains, the thyroid and parathyroid glands are all part of the endocrine system — the network of glands that produce and secrete hormones. These hormones regulate a range of metabolic processes throughout the body.

Just as hypothyroidism involves the underactivity of the thyroid gland, hypoparathyroidism involves the underactivity of the parathyroid glands.

In both conditions, the glands do not produce enough hormones to meet the body's needs.

The thyroid gland and parathyroid glands produce different hormones, which serve different functions. As such, hypothyroidism and hypoparathyroidism can cause different symptoms and complications.

The thyroid gland is a butterfly-shaped gland in the lower front of the neck, which secretes the thyroid hormones triiodothyronine (T3) and thyroxine (T4).

These hormones play a vital role in regulating the following:

body weight

energy levels

internal temperature

metabolism

skin, hair, and nail growth

The parathyroid glands are a set of four glands that sit just behind the thyroid. These glands secrete parathyroid hormone (PTH), which plays a vital role in regulating blood calcium levels.

The table below highlights the key similarities and differences between hypothyroidism and hypoparathyroidism.

The following section outlines symptoms of hypothyroidism and hypoparathyroidism.

Hypothyroidism symptoms

As the American Thyroid Association explains, people with hypothyroidism do not have enough circulating thyroid hormone for their body's cells to function effectively. This causes body processes to slow down.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), common symptoms of hypothyroidism include:

Hypoparathyroidism symptoms

Symptoms of hypoparathyroidism occur as a result of low calcium levels in the blood. They can range from mild to severe and may include the following:

Other potential symptoms include:

When diagnosing thyroid and parathyroid conditions, doctors will take a full medical and family history, during which they may ask questions about the following:

whether the person has ever had thyroid surgery or radiation to the neck to treat cancer

whether the person is taking any medications that can cause these conditions, such as:

whether anyone else in the family has thyroid or parathyroid disease

Doctors will then run tests to check for hypothyroidism or hypoparathyroidism.

Blood tests for hypothyroidism

The following blood tests allow doctors to check thyroid function:

TSH (thyroid-stimulating hormone) test: This test measures how much TSH the body is producing. The pituitary gland produces TSH in response to how much T4 the thyroid gland is making. In hypothyroidism, the pituitary produces TSH to stimulate the thyroid gland to make more thyroid hormone as there is a lack of T4 being produced.

T4 tests: These measure how much T4 can get into the body's cells. Around 98% to 99% of T4 in the blood is attached or "bound" to a protein called thyroxine-binding globulin (TBG), while the other 1% to 2% of T4 is unattached or "free." Only the free T4 can get into the body's cells.

Blood and urine tests for hypoparathyroidism

Hypoparathyroidism can affect levels of certain minerals in the blood, causing them to fall outside of their usual range. As such, doctors will run blood tests to assess levels of the following:

calcium, which may be low

phosphorus, which may be high

magnesium, which may be low or high

A urine test can also show whether a person is excreting too much calcium, which can be another a sign of hypoparathyroidism.

Below are the different treatment approaches for hypothyroidism and hypoparathyroidism.

Hypothyroidism treatment

Therapy for hypothyroidism aims to replace the hormones that the thyroid gland is no longer able to make.

This involves taking a synthetic hormone called levothyroxine, which is identical to the one the thyroid makes naturally.

Doctors will begin administering blood tests around 6 to 8 weeks after a person starts taking levothyroxine, to help tailor the dose. A person will require a follow-up blood test every 6 months to ensure they continue to receive the correct dosage.

Hypoparathyroidism treatment

The treatment for hypoparathyroidism aims to increase calcium levels and alleviate symptoms.

This typically involves taking calcium supplements along with activated vitamin D to promote calcium absorption. Individuals with severe symptoms may require intravenous (IV) calcium therapy.

Hypoparathyroidism can sometimes occur as a result of too little or too much magnesium in the blood. In such cases, people may need medications to manage their magnesium levels.

Other potential treatment options include:

Recombinant human parathyroid hormone (1-84) or "rhPTH (1-84)": A medication that doctors may reserve for individuals with chronic hypoparathyroidism that does not respond to calcium and vitamin D supplementation.

Thiazine diuretics: Medications that help to reduce excessive calcium excretion in the urine.

Dietary changes: Doctors may encourage individuals to eat more calcium-rich foods while avoiding foods high in phosphorous.

Below are some answers to common questions about hypothyroidism and hypoparathyroidism.

What are the 4 clinical manifestations of hypoparathyroidism?

According to a 2021 review, the four clinical manifestations of hypoparathyroidism are:

hypocalcemia (a deficiency of calcium in the blood)

hypercalciuria (excess calcium in the urine)

hyperphosphatemia (excess phosphate in the blood)

low or undetectable PTH levels

Can hypothyroidism cause parathyroid disorders?

According to a 2017 review, hypothyroidism and congenital parathyroid disorders may occur together.

This usually occurs when genes that control the thyroid and parathyroid glands malfunction during embryonic development.

Why is calcium low in hypoparathyroidism?

As a 2022 article explains, healthy parathyroid glands release PTH when blood calcium levels become too low.

The PTH then causes the kidneys to release an active form of vitamin D called calcitriol.

Together, the PTH and calcitriol regulate calcium and phosphate levels. As calcium levels increase, the parathyroid glands receive signals to stop producing PTH.

In hypoparathyroidism, the parathyroid glands do not produce enough PTH, so calcium levels remain low.

Why is hypoparathyroidism bad?

Untreated hypoparathyroidism can cause hypocalcemia and hyperphosphatemia.

Hypocalcemia is a potentially life threatening condition that can cause complications, such as:

anxiety and depression

involuntary muscle spasms or seizures

QTc prolongation, in which the heart muscle takes longer to contract and relax

Hyperphosphatemia can cause vascular calcification and atherosclerosis. This is where calcium phosphate deposits accumulate in the blood vessels, causing the vessels to thicken and harden.

Atherosclerosis may lead to a heart condition called left ventricular hypertrophy, in which the heart's left ventricle becomes enlarged. This, in turn, may result in high blood pressure and impaired heart function.

Hypothyroidism and hypoparathyroidism are endocrine conditions involving an underproduction of the hormones the body needs to function properly.

Hypothyroidism occurs when the thyroid gland does not make enough thyroid hormone. In hypoparathyroidism, the parathyroid glands do not make enough parathyroid hormone (PTH), resulting in low blood calcium and high phosphorus.

Blood tests can help diagnose both conditions. The standard treatment for hypothyroidism is levothyroxine — a synthetic hormone that simulates thyroxine (T4).

The usual treatment for hypoparathyroidism is calcium and activated vitamin D supplementation, which aim to restore blood calcium and phosphorous levels.

Without treatment, hypothyroidism and hypoparathyroidism can cause complications, some of which may be severe and even life threatening. As such, anyone who experiences symptoms of either condition should contact a doctor for a diagnosis and appropriate treatment.

Drugs For Treatment Of Hypothyroidism

Symptoms of hypothyroidism are often general, unspecific changes in the body. Lethargy, weight gain, stiffness and cramping of muscles are some of the symptoms of hypothyroidism.

Liotrix

Liotrix is a thyroid hormone, prescribed for hypothyroidism.

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Thyroglobulin

Thyroglobulin is a hormone of the thyroid gland, prescribed for hypothyroidism (deficiency in the production of thyroid hormone).

Thyroid -dessicated

Thyroid -dessicated is a dried and powdered form of thyroid hormone, prescribed for hypothyroidism, TSH suppression (in thyroid cancer, nodules, goiters, and enlargement in chronic thyroiditis).

Treatment Options For High Blood Pressure (Hypertension)

Hypertension increases your risk of heart attack and stroke. A variety of treatments can help you manage your blood pressure, including lifestyle changes and medications.

Treatment for high blood pressure typically involves a combination of medication and lifestyle changes. The goal is to get your blood pressure into its optimal range.

Elevated blood pressure doesn't necessarily raise your risk of heart attack or stroke. But without attention, it can progress to high blood pressure — which definitely does raise your risk.

Read on to learn more about lifestyle changes and medication options for high blood pressure.

A healthy lifestyle is the first line of defense against high blood pressure. Habits that help manage blood pressure include:

A balanced diet: Eating a nutrient-dense, balanced diet can help manage blood pressure and improve health. You may want to try the DASH diet, which stands for Dietary Approaches to Stop Hypertension. It prioritizes fruits, vegetables, whole grains, lean meats, nuts, and legumes.

Physical activity: Staying physically active with regular cardiovascular exercise is good for your heart. Aim for 150 minutes of moderate intensity exercise per week.

Moderate weight: Maintaining a moderate weight can improve your blood pressure.

Avoid alcohol: If you drink, avoid heavy alcohol use. Experts recommend no more than one drink per day for women and two drinks per day for men.

Avoid smoking: You can improve your blood pressure by avoiding secondhand smoke and quitting smoking if applicable.

Manage stress: Stress can raise your blood pressure, so take steps to manage stress where you can. You can try guided breathing, meditation, yoga, or speaking with a therapist.

Reduce salt: Eating too much sodium can raise your blood pressure, so try to consume less salt. Aim to get no more than 2,300 milligrams (mg) per day.

Learn more lifestyle strategies and habits for lowering blood pressure.

Some people find that lifestyle changes alone are not enough to manage high blood pressure. In these cases, many types of blood pressure medications with different modes of action can help.

For some people, a combination of two or more drugs may be needed to manage their blood pressure. Your doctor can recommend the right medication protocol for you.

High blood pressure medications can be divided into the categories listed below, based on how they work. The drugs in each section are just a sampling of what's available.

Diuretics

Diuretics, sometimes called water pills, help the kidneys get rid of excess water and salt. This reduces the volume of blood that needs to pass through the blood vessels, resulting in lower blood pressure.

There are four major types of diuretics defined by how they work. They include:

thiazide diuretics (chlorthalidone, Microzide, Diuril)

potassium-sparing diuretics (amiloride, Aldactone, Dyrenium)

loop diuretics (bumetanide, furosemide)

combination diuretics, which include more than one variety used together

Diuretics in the thiazide group generally have fewer side effects than the others, particularly when taken at low doses. If you have early stage high blood pressure, lower doses are recommended.

Beta-blockers

Beta-blockers help the heart beat with less speed and force. The heart pumps less blood through the blood vessels with each beat, so blood pressure decreases. Some examples of beta-blockers include:

Alpha-beta-blockers

Alpha-beta-blockers have a combined effect. They're a subclass of beta-blockers that block the binding of catecholamine hormones to both alpha and beta receptors.

They can decrease the constriction of blood vessels like alpha-1 blockers, slowing the rate and force of the heartbeat like beta-blockers. Examples include:

carvedilol (Coreg)

labetalol hydrochloride (Normodyne)

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.

Some ACE inhibitors include:

benazepril hydrochloride (Lotensin)

captopril (Capoten)

enalapril maleate (Vasotec)

fosinopril sodium (Monopril)

lisinopril (Prinivil, Zestril)

Angiotensin II receptor blockers (ARBs)

ARBs block the action of angiotensin II directly on the blood vessels. It attaches at the receptor site on the blood vessels and keeps them from narrowing. This causes blood pressure to fall.

Some examples include:

candesartan (Atacand)

eprosartan mesylate (Teveten)

irbesartan (Avapro)

losartan potassium (Cozaar)

telmisartan (Micardis)

valsartan (Diovan)

Calcium channel blockers

Calcium channel blockers limit calcium from entering the smooth muscle cells of the heart and blood vessels. This makes the heart beat less forcefully with each beat and helps blood vessels relax, lowering blood pressure.

Examples of these medications include:

amlodipine besylate (Norvasc, Lotrel)

felodipine (Plendil)

diltiazem (Cardizem)

isradipine (DynaCirc, DynaCirc CR)

verapamil hydrochloride (Calan SR, Covera-HS, Isoptin SR, Verelan)

Alpha-1 blockers

Your body produces types of hormones called catecholamines when it experiences stress. Catecholamines, such as norepinephrine and epinephrine, cause the heart to beat faster and with more force. They also constrict blood vessels, raising blood pressure.

The muscles around some blood vessels have alpha-1 or alpha-adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.

Alpha-1 blockers bind to alpha-1 receptors, blocking catecholamines from attaching. This keeps them from narrowing blood vessels so blood is able to flow through the blood vessels more freely, and blood pressure falls.

Examples of these drugs include:

doxazosin mesylate (Cardura)

prazosin hydrochloride (Minipress)

terazosin hydrochloride (Hytrin)

Alpha-2 receptor agonists (central agonists)

When an alpha-2 receptor is activated, the production of norepinephrine is blocked. This decreases the amount of norepinephrine produced. Less norepinephrine means less constriction of blood vessels and lower blood pressure.

Since alpha-2 receptor agonists can work in the brain and central nervous system, they're also known as central agonists. This makes these medications useful for treating a large range of health conditions beyond high blood pressure.

Examples include:

Vasodilators

Vasodilators relax the muscles in the walls of blood vessels, especially small arteries, called arterioles. This widens the blood vessels and allows blood to flow through them more easily. Blood pressure falls as a result.

Examples include:

Treatment for high blood pressure includes ongoing care as well as individual treatments tailored for specific situations and younger age groups.

Ongoing medical care

To make the most of your treatment, it's vital to get regular medical checkups and blood pressure tests. Regular checkups allow your doctor to monitor how well your treatment is going and make any necessary adjustments to your treatment plan.

If your blood pressure starts inching back up, your doctor can respond promptly. Doctors' visits also give you an opportunity to ask questions and bring up any concerns.

Treatment for specific situations

Additional treatment options may be needed in certain situations, like resistant hypertension or secondary hypertension.

Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medications. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.

Even such hard-to-treat cases can often be managed successfully. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.

Secondary hypertension is high blood pressure that's directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.

Treatment options for children and teens

The first line of treatment for children and teens with high blood pressure is a healthy lifestyle. This includes:

Children may take the same blood pressure medications as adults when necessary. For children with secondary hypertension, blood pressure often returns to normal once the underlying condition is treated.

High blood pressure treatment usually involves a combination of lifestyle changes and medication. Sometimes, lifestyle changes are enough to return your blood pressure to normal levels. These changes may include diet, exercise, and weight loss.

If your high blood pressure continues, be sure to consult a doctor who can prescribe the appropriate medication.

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