Understanding hypoparathyroidism as a disease of broad functional deficiency

Hypoparathyroidism (HypoPT) is a rare disease defined by undetectable, low, or inappropriately normal parathyroid hormone (PTH) concentrations in the presence of hypocalcemia. Calcium and active vitamin D are often used for the treatment of HypoPT but do not address the underlying lack of physiological PTH activity. In this review, we discuss how the chronic inadequacy of PTH leads to broad functional consequences. This functional deficiency results in a wide spectrum of symptoms, impaired functioning and quality of life, and significant economic and healthcare costs. We consider how kidney complications could develop in patients with HypoPT and highlight recent developments in understanding the heterogeneity of bone health in HypoPT, including certain patient populations.