photo of clinical researcher
In This Article

If you’re having symptoms like muscle cramps, twitching, and tingling, it could behypoparathyroidism (hypoPT). It happens when your body doesn’t make enough parathyroid hormone (PTH) or has undetected amounts of PTH. As a result, you have low levels of calcium in your blood, too much phosphorus in your blood, and extra calcium in your urine. This can cause a wide range of problems.

You’ll need an accurate diagnosis because hypoparathyroidism symptoms can be similar to those in a lot of other diseases and conditions. It’s important to know if you have hypoPT so you can treat it properly.

Your doctor will use some simple tests to see if you have hypoparathyroidism. They may want to rule out other possible factors, so your doctor may use a variety of tests.


How Do Doctors Diagnose Hypoparathyroidism?

The telltale signs of hypoPT are having a lack of PTH, a hormone made by your parathyroid glands, along with low levels of calcium (hypocalcemia). Your doctor will want to determine if your body is producing low levels of PTH or none at all. 

A physical exam and medical history review will also be part of the diagnosis process. They can do other tests to figure out the progress of the condition. They can also see how hypoparathyroidism is affecting other areas of your health. 

What Tests Can Diagnose Hypoparathyroidism?

Your doctor may use the following tests to see if you have hypoPT:

Blood test. A health care professional will check your blood to determine your levels of:

  • Calcium
  • PTH
  • Phosphorus
  • Magnesium
  • Albumin

The doctor may also want to use bloodwork to look at your:

  • Thyroid, liver, and kidney function
  • Bone health
  • Vitamin D level

Urine calcium test. A urine test will let the doctor know how much calcium the kidneys are releasing. Ask what kind of urine test it is, as your doctor will likely want to collect all of your urine over the course of a day (also called a 24-hour urine calcium test).

To do a 24-hour urine calcium test, you will pee in the toilet after you wake up. Then you’ll collect all of your urine in a separate container for the rest of the day. On the next day, collect your first batch of urine in a sample container as well. Then you’ll submit it to the lab so they can analyze it.

Bone mineral density test. This test is an X-ray that can see the strength of your bones and help determine your risk of fractures. It’s usually done in the spine, hip, or forearm. You’ll lay down on a platform, and a mechanical arm will pass over your body. The test is painless, and it can take anywhere from 10 to 30 minutes.

Electrocardiogram. This test can tell if you have an abnormal heart rhythm. The doctor places electrodes or sensors on your chest, arms, and legs, which are hooked up to a machine. The machine views the electrical activity going on in your heart. It’s painless and takes about 10 minutes.

Computed tomography (CT) scan. Your doctor may order this test to see if you have calcium built up in your brain. You may have a contrast dye injected into your vein to help the doctor get a better view. Then you lie down on a table, which is fed through a machine that performs the painless scan. The test can take anywhere from 10 to 30 minutes.

Physical exam. A simple physical exam can give your doctor more insight to see if you have hypoparathyroidism. One thing they may do during it is tap in front of your ear while your mouth is open. This checks for Chvostek’s sign, which is when muscles in your face twitch. It’s common if you have hypoPT. 


They may check your joint range of motion. The doctor may also want to check for carpopedal spasms, which are painful muscle contractions in your feet and hands (that are also common if you have hypoparathyroidism). Your doctor can pump up a blood pressure cuff around the lower part of your arm to see if this happens.

What Else Goes Into a Hypoparathyroidism Diagnosis?

Your doctor may ask about your personal health history as well as past neck surgery or other endocrine disease. They also may want to know if any of your family members have or have had hypoparathyroidism or other endocrine deficiency disease.

Show Sources

Photo Credit: Rapeepong Puttakumwong / Getty Images


Cleveland Clinic: “Blood Tests,” “CT (Computed Tomography) Scan,” “Electrocardiogram,” “Hypoparathyroidism.”

Eunice Kennedy Shriver National Institute of Child Health and Human Development: “How Do Healthcare Providers Diagnose Hypoparathyroidism?”

ParathyroidUK: “Diagnosis of Hypopara.”

UCLA Health: “What is a Urine Calcium Test?”

Mayo Clinic: “Bone Density Test,” “Hypoparathyroidism.”

The Journal of Clinical Endocrinology and Metabolism: “Management of Hypoparathyroidism: Summary Statement and Guidelines.”