When should I consider referring a patient with hypoparathyroidism to an endocrinologist?

Consider referring a patient with hypoparathyroidism to an endocrinologist when:

• There is diagnostic uncertainty or difficulty in managing calcium and parathyroid hormone levels.
• The patient has symptoms that are difficult to control or complications such as severe hypocalcaemia or hypercalcaemia.
• Specialist advice is needed for complex cases, including those requiring advanced monitoring or treatment adjustments.
• There is a need for multidisciplinary management, for example in pregnancy or when considering surgery or novel therapies.

Although the provided guidelines focus primarily on hyperparathyroidism and hypercalcaemia, the principles of specialist referral for parathyroid disorders generally apply to hypoparathyroidism as well, especially when management is complex or uncertain. Endocrinologists have expertise in managing calcium disorders and can provide guidance on monitoring, treatment, and complications.