After reviewing more than 300 studies on the condition, an international group of researchers set 31 new recommendations aimed at improving the current care of chronic hypoparathyroidism — a condition that occurs in patients when they do not produce enough parathyroid hormone, causing their blood calcium levels to fall. Symptoms are wide-ranging and include unusual muscle movements, cataracts, kidney complications and depression. Women with low levels of parathyroid hormone are also more likely to have complications during pregnancy.

Modern medical treatment focuses on improving the well-being of patients and reacting to the long-term outcome. The guideline provides recommendations for treatment and monitoring of the condition, including those for special circumstances such as during pregnancy and breastfeeding.

Chronic hypoparathyroidism is one of the few endocrine diseases where lacking a hormone is not treated by replacing it. This problem is widely discussed in the guideline.

Hypoparathyroidism is a rare disease that affects found 1 out of 4000 adults. It usually occurs after thyroid surgery but can also arise through the body’s immune system mistakenly destroying the parathyroid glands. The guideline recommends that patients who do not have either of these problems should be tested for genetic mutations.

“Hypoparathyroidism is a complicated condition which causes patients to suffer many unspecific symptoms in everyday life and we believe there is room to improve their quality of care,” said lead author of the study Professor Jens Bollerslev. “These guidelines are meant to provide clinicians with practical recommendations on how to manage this rare and poorly-understood disease.”