Chart — Endocrine
Parathyroid Disorders Comparison Chart
Read it off one rule: PTH and calcium move together, phosphate moves opposite. HyperPARA = high PTH = high calcium; hypoPARA = low PTH = low calcium.
Educational use only. Surgical and replacement decisions are provider-directed and individualized. This chart is an educational comparison aid. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Hyperparathyroidism vs Hypoparathyroidism
| Feature | Hyperparathyroidism | Hypoparathyroidism |
|---|---|---|
| PTH | HIGH | LOW |
| Serum calcium | HIGH (PTH tracks Ca) | LOW |
| Serum phosphate | LOW (inverse) | HIGH (inverse) |
| Common causes | Parathyroid adenoma (primary); CKD (secondary) | Accidental gland removal/damage in thyroid/neck surgery; autoimmune |
| Signs/symptoms | Bones, stones, groans, moans (hypercalcemia) | Tetany, Chvostek/Trousseau, cramps, laryngospasm, seizures (hypocalcemia) |
| Treatment | Hydration/mobility ± parathyroidectomy | Calcium + active vitamin D (calcitriol), often lifelong |
| Nursing priority | IV fluids, mobility, stone/fracture precautions; post-op watch for hypocalcemia | IV calcium gluconate (acute), airway/seizure precautions, monitor QT |
Exam Traps
- ✦PTH and calcium move together; phosphate moves opposite.
- ✦HyperPARA → hyperCALCEMIA (bones/stones/groans/moans); hypoPARA → hypoCALCEMIA (tetany).
- ✦Hypoparathyroidism is most often iatrogenic — damaged glands during thyroid/neck surgery.
- ✦After parathyroidectomy, the risk flips to hypocalcemia — calcium is the priority lab.
- ✦Hypoparathyroidism treatment = calcium + active vitamin D (calcitriol), often lifelong.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with American Diabetes Association (ADA) Standards of Care · American Association of Clinical Endocrinology (AACE). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →