Parathyroid and Osteoporosis: What’s the Connection?

Osteoporosis is a disease where bones lose their density and strength. It’s one of the most common causes of fractures, affecting many people worldwide.

Osteoporosis is a disease where old bone tissue is lost more quickly than new bone tissue can be produced, resulting in too few healthy bone cells. Over time, the bones lose their density and strength and the weakened bones become brittle and can break more easily. Those with osteoporosis must take particular care to avoid over-stressing their bones in any way, as this could result in bone fractures which could lead to serious complications.

What Are the Parathyroid Glands?

The parathyroid glands are located near the thyroid gland: behind the windpipe, and above the lower part of the esophagus. These glands produce parathormone, or PTH, which works with vitamin D to control how much calcium is in your blood. PTH works in a variety of ways. It tells the bones to release calcium into the bloodstream, while also initiating the absorption of calcium from the foods you eat. It also ensures that the kidneys conserve calcium when necessary.

If there isn’t enough calcium in your blood, the parathyroid glands release PTH to raise your blood calcium levels. When your blood calcium levels are high, the parathyroid glands stop releasing PTH. This causes your blood calcium levels to drop. As long as your blood calcium levels remain low, the parathyroid glands continue to produce PTH. Eventually, your blood calcium levels rise again, and the cycle repeats itself.

Lack of Vitamin D Can Affect the Parathyroid and Osteoporosis

Calcium is one of the most important minerals in your body. It plays many roles, including helping build strong bones and teeth, clotting blood, sending signals through nerves and regulating muscle movement. Most people know that calcium is essential to good bone health. But did you know that your body doesn’t produce it? You must get it from foods like milk, yogurt, cheese and dark green vegetables, such as broccoli and kale. Or you can take a supplement.

Regulating calcium levels is one of the most important functions of the parathyroid glands. When these glands are not functioning properly, calcium levels get out of balance, which increases the risk of osteoporosis.  If you’re deficient in vitamin D, the parathyroid glands produce less calcitriol, a hormone that regulates calcium absorption. This can result in low calcium levels. Conversely, too much calcium can cause kidney stones. Thus, it’s important to make sure that your body is getting the proper amount of vitamin D to ensure the healthy functioning of the parathyroid glands.

Hyperparathyroidism

Primary hyperparathyroidism (PHPT), also called idiopathic hypercalcemia, is a disease where the parathyroid glands become enlarged and begin to produce too much parathyroid hormone. This causes calcium levels in the blood to increase. PHPT occurs most often in women older than 50, although it can happen at any age. In secondary hyperparathyroidism, low calcium levels in the blood caused by another disease, such as kidney disease, cause the parathyroid glands to overproduce PTH as they struggle to maintain adequate calcium levels in the blood.

Symptoms of hyperparathyroidism include fatigue, muscle cramps, constipation, nausea, vomiting, weight loss, depression, decreased appetite and pain in the bones and joints. Most people with PHPT don’t know they have this disease because symptoms aren’t always present.

If hyperparathyroidism is left to persist, bone loss and a higher incidence of kidney stones can occur. In some cases, people develop tumors called adenomas on their parathyroid glands. These tumors can cause severe symptoms such as nausea, vomiting, fatigue, muscle weakness, depression, anxiety, memory problems, seizures, heart palpitations and even death.

Doctors usually catch primary hyperparathyroidism early — before serious complications develop — through the use of routine lab tests. Treatment of hyperparathyroidism often includes surgery to remove the enlarged parathyroid glands, followed by medication to keep calcium levels normal.

Diagnosing and Treating Hyperparathyroidism Disease

To diagnose hyperparathyroidism, your doctor will test your levels of calcium and phosphorus. They might also check your vitamin D levels. If you exhibit high calcium levels, your doctor will then probably do further testing to see if you also have high levels of PTH.

Once hyperparathyroidism is determined, further testing is often performed to rule out certain causes and check the severity of the condition. Some of the tests performed might include a bone mineral density test, a urine test and imaging of your kidneys.

Although surgery is the most common treatment for hyperparathyroidism, other approaches include “watchful waiting” and medication. Before surgery, you will probably need to undergo imaging tests to find exactly where your parathyroid glands are located. Once found, your surgeon will remove any enlarged glands or those that have tumors. Afterward, they will implant small pieces of tissue under your skin that will help stimulate the production of the missing parathyroid hormone.

If you’re worried about falling prey to osteoporosis, talk to your doctor about ways to ensure adequate calcium intake. It is also important to test vitamin D levels regularly. And remember, when it comes to parathyroid and osteoporosis, you’ll want to keep track of the calcium level in your urine. A high number could mean you’re not absorbing enough calcium from your foods or that there is a problem with your parathyroid glands.