In patients with hypoparathyroidism, there are abnormally low levels of parathyroid hormone (PTH) that results in low serum levels of calcium and phosphorus. One major symptom is muscle spasms due to increased excitability of the neuromuscular membrane due to low extracellular calcium levels. Other signs and symptoms include paresthesia of the fingers and toes, fatigue, patchy hair loss, coarse, dry skin, brittle nails, and depression. The other choices, kidney stones, excessive urination, and osteoporosis, are signs and symptoms of hyperparathyroidism.