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Conditions
Bone and mineral metabolism
Short answer
Osteoporosis (bone loss) is a metabolic disease in which bone density decreases and the bones become more fragile and lose their elasticity, so they break easily. According to international clinical guidelines, women over 65 and men over 70 should be checked for osteoporosis and undergo densitometry at least once (video). Osteoporosis develops silently until a fracture occurs, but it can be diagnosed and prevented even without a fracture.
Densitometry at least once — per international clinical guidelines.
General information
Osteoporosis
- How it develops. Bone is living tissue that constantly renews itself. Osteoporosis starts when less new bone is formed than old bone is lost. It is more common in women during menopause.
- Consequences.
- Fractures occur most often in the hip, wrist and spine. Bone can become so fragile that a fall, or even light strain such as bending or coughing, can cause a fracture.
- The most serious complication is a broken thigh bone: it can cause serious problems with walking in the future.
- When you should see a doctor (video):
- chronic low back pain;
- needing support to stand up from a seat;
- any bone breaking during ordinary movement or in a fall from standing height.
- Preventable risk factors: smoking; too little calcium and vitamin D; too much salt; a sedentary lifestyle; too much vitamin A; alcohol; being very thin.
- Other risk factors:
- estrogen deficiency (after menopause) and a lack of sex hormones;
- some medications: thiazolidinediones (a diabetes medication), barbiturates, anticoagulants, PPIs (stomach medications), aluminum-containing preparations, glucocorticoids, an excessive dose of thyroid hormone;
- endocrine diseases: Cushing's syndrome, diabetes, thyrotoxicosis (toxic goiter), hyperparathyroidism;
- genetic, blood and gastrointestinal diseases.
- Diagnosis. A detailed medical history is taken and a physical examination is performed. Densitometry is used to make the diagnosis, assess the risk of fracture and the need for drug treatment, and monitor the course of treatment. The result is interpreted together with symptoms and blood tests.
General information
Parathyroid glands
- There are normally 4 parathyroid glands. They are located in the neck, behind the thyroid gland. When they enlarge and work too much, they can cause serious problems.
- Parathyroid adenoma.
- What it is: a benign tumor that develops in a parathyroid gland; the most common cause of hyperparathyroidism. Excess parathyroid hormone (PTH) raises calcium in the blood. It usually develops in one gland; genetic factors, radiation and some hereditary syndromes may play a role.
- Systems it affects:
- bones — osteoporosis, bone pain, pathological fractures;
- urinary system — kidney stones, passing a lot of urine;
- digestive system — loss of appetite, constipation, pancreatitis;
- nervous system — depression, fatigue, poor concentration.
- Diagnosis: high PTH and calcium in the blood, calcium in the urine; imaging — ultrasound, parathyroid scintigraphy, CT or MRI, PTH washout.
- Treatment: the main method is surgery (parathyroidectomy). In some cases, medication (calcimimetics) is used.
- Early diagnosis prevents bone and kidney damage.
- Hypoparathyroidism. This is a shortage of parathyroid hormone, and it is accompanied by a calcium deficiency. Calcium is one of the most important microelements for the body: both too little and too much can cause serious complications.
General information
Vitamin D
- Vitamin D is actually like a hormone: the body converts it into an active form, and it affects many systems. In the doctor's words, “Vitamin D is itself a hormone; we do not call it a vitamin anymore.” A deficiency affects hormone balance and plays a part in many problems, including metabolic ones (video).
- The daily requirement for adults is usually around 800–2000 IU. The dose and duration should be set by a doctor according to the vitamin D level in the blood. The preventive dose is different for children and adults.
- Vitamin D toxicity.
- Causes: taking a high dose for a long time without a doctor's advice; dosing errors (for example, high-dose drops or ampoules); taking other preparations that contain vitamin D, and multivitamins, at the same time.
- Signs: nausea, vomiting; thirst, frequent urination; headache, weakness; hypercalcemia (raised calcium in the blood) — kidney stones, kidney damage.
- Diagnosis: the 25(OH)D level in the blood; checking calcium, phosphorus and creatinine.
- Take vitamin D only as prescribed by a doctor and at the prescribed dose. If there are signs of toxicity, be sure to see a doctor.
General information
Magnesium
- Magnesium is needed for more than 300 enzymes to work in the body. It is important for muscle contraction, the transmission of nerve impulses, a steady heart rhythm and bone health. Because of its link with insulin sensitivity, it is especially important in diabetes.
- A deficiency can cause fatigue, muscle spasms, irregular heartbeat, insomnia, irritability and headaches.
- Sources: green leafy vegetables (spinach, cabbage), nuts, seeds, whole grains, legumes, dark chocolate.
- When needed, magnesium preparations are taken on a doctor's advice. Do not take them on your own.
In the doctor's practice
- Osteoporosis. In a patient with a total T-score of −3.6, osteoporosis was diagnosed and treatment was started, taking into account additional clinical symptoms and blood tests. The patient was referred by neurologist Günay Həsənova.
- Parathyroid adenoma. A clinical case involving an adenoma of the left lower parathyroid gland (Gabala, Sağlam Həyat Medical Center).
- Hypoparathyroidism. A patient with primary hypoparathyroidism was freed from intravenous calcium infusions every other day; calcium was fully controlled with oral medication.
- Vitamin D toxicity. Based on the symptoms, vitamin D toxicity was identified in a patient, and action was taken in time.
Q&A
Who should be screened for osteoporosis?
Women over 65 and men over 70. In addition, people who have chronic low back pain, need support to get up from the floor, or have had a fracture in a minor fall should be examined by an endocrinologist (video).
Does vitamin D deficiency affect hormone balance?
Yes. Vitamin D itself works like a hormone, and a deficiency also plays a part in metabolic problems (video).
Can I take high doses of vitamin D on my own?
No. A high dose taken without a doctor's advice and tests can lead to toxicity — hypercalcemia, kidney stones and kidney damage. The dose is set according to the blood level.
The doctor’s videos
The videos are in Azerbaijani.
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