Revised ESE clinical guideline published for the management of hypoparathyroidism in adults

The European Society of Endocrinology (ESE) has published an open access Revised Clinical Practice Guideline for the Treatment of Chronic Hypoparathyroidism in Adults in the European Journal of Endocrinology, Volume 193, Issue 5, November 2025.

The Revised Guideline has been developed by an expert multidisciplinary panel chaired by Professor Jens Bollerslev, Faculty of Medicine, University of Oslo, Norway. It is intended as practical guidance for health care providers involved in the diagnosis, management and monitoring of chronic hypoparathyroidism in adults. 

The Revised Guideline has been endorsed by the European Society of Endocrine Surgeons and the Endocrine Society of Australia. 

These guidelines have been developed as the management of hypoparathyroidism has changed since the first ESE clinical guideline was published in 2015, as has the knowledge on patient burden of the disease, and the understanding of morbidities. 

The Revised Guideline is a true collaboration between clinical endocrinologists, methodologists, patient representatives and the various disciplines involved in hypoparathyroidism such as nephrology and endocrine surgery." 

 Professor Jens Bollerslev, Faculty of Medicine, University of Oslo, Norway

A key difference in the Revised Guideline is the redefinition of chronic hypoparathyroidism.

Jens Bollerslev added: "In the original Guideline, the definition of chronic hypoparathyroidism was persisting post-surgery for six months or longer. After a systematic review of the literature, including 14 studies with almost 9,000 patients after neck surgery, the panel saw that the incidence of recovery of parathyroid function increased by almost 7.5% between six months and 12 months. So, in the Revised Guideline, we define chronic hypoparathyroidism 12 months or longer post-surgery." 

The Guideline also provides a very clear treatment algorithm for moving from conventional treatment to cases where parathyroid hormone (PTH) replacement therapy might be introduced, and how to do it. 

Patients with hypoparathyroidism and their support networks are invited to attend the free online ESE Hypoparathyroidism Patient Forum on Saturday 15 November 2025 from 10:00-13:00 CET, where Professor Bollerslev will present the Revised Guideline. 

ESE's Clinical Committee leads on guideline development, with input from experts in other ESE committees as appropriate. All guidelines are subject to a rigorous review process before being published, with input from ESE's Members and relevant parties such as patient support groups.

ESE's Clinical Guideline programme is expanding to provide physicians and patients with guidance in key areas. We will also soon publish Joint Guidance for Healthcare Transition from Paediatric to Adult Endocrine Care jointly with the European Society for Paediatric Endocrinology (ESPE) and in 2026, a Joint Guideline with the Endocrine Society (US) on arginine vasopressin deficiency (AVP-D).