Osteoporosis is common in parathyroid disease patients. To understand why, let’s answer questions about the link between hyperparathyroidism (HPT) and osteoporosis.
How Are Bones Made?
The link between HPT and osteoporosis can be traced to how bones are made and continually change. Bones begin as cartilage, with hardening of the skeleton after birth (ossification). They are involved in a skeletal hardening process that continues throughout life.
Every day, bones remodel themselves. They are constantly broken down and replaced by 2 types of cells in the bones called osteoblasts and osteoclasts.Osteoblasts refer to cells that form new bone. They work in groups to produce osteoid, bone constructed from calcium, collagen and fibrous protein. Comparatively, osteoclasts are cells responsible for the breakdown of bone. They are activated by parathyroid hormone (PTH).
Normally, short-term PTH elevations occur several times during the day. These elevations promote the breakdown of bones. They are followed by bone construction by osteoblasts, which make the bones stronger. As a person puts pressure on the bone, the bone responds by remodeling itself more to make itself stronger.
Bone breakdown and replacement processes happens cyclically on a daily basis. But, a malfunctioning parathyroid gland can adversely affect this process. It can also cause hyperparathyroidism and osteoporosis.
Does Hyperparathyroidism Cause Osteoporosis?
A defective parathyroid gland can lead to HPT, and ultimately, osteoporosis.
In a person with normal functioning parathyroids there are short spurts of PTH release that occur naturally several times a day that contribute to bone remodeling; additionally, when the level of calcium is too low in the blood stream the normal parathyroid released PTH to tell the bones to release some calcium into the blood stream. Once the calcium level rises back up to normal the parathyroids stop producing PTH.
When a parathyroid gland malfunctions, it can secrete a high amounts of PTH on a continual basis, and the daily cyclical PTH release is lost. In this instance, the blood PTH level is elevated, which activates osteoclasts that break down bones continuously. This process causes the person with hyperparathyroidism to feel bone pain, and the bones lose calcium and become weaker. This can lead to osteopenia, a condition that causes the bones to become brittle. As bone loss advances further the person develops osteoporosis
Will Hyperparathyroidism and Osteoporosis Occur Simultaneously?
Everyone suffering from hyperparathyroidism will have bone loss. The longer the process goes on the more bone loss they experience. On average it takes 8 years of having hyperparathyroidism before osteoporosis develops. If left untreated 2/3 will go on to develop osteoporosis.
Why Is Testing for Hyperparathyroidism and Bone Density Key?
In addition to PTH and/or calcium level testing, a bone mineral density test can be performed to assess the amount of calcium in a patient’s bone. The bone mineral density test can help a doctor determine if their patient is dealing with HPT, osteoporosis, or both. Following the test, additional assessments can be used to provide an accurate diagnosis so that the doctor can find a safe, effective treatment for their patient.
Should You Pursue Hyperparathyroidism and Osteoporosis Treatment Options?
A great majority of HPT patients will eventually develop osteoporosis, unless a defective parathyroid tumor is removed. As such, it is important to pursue treatment options as soon as parathyroid disease and osteoporosis are identified and diagnosed. The good news is that everyone who is successfully treated for HPT will have improvement in their bone density, even the ones who had minor bone loss.
Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery in Beverly Hills can perform a minimally invasive parathyroidectomy (MIP) to treat HPT and osteoporosis. An MIP is performed via a small incision into a patient’s neck. The procedure usually takes about 20 minutes to complete. And, it has a high cure rate and causes less scarring than traditional parathyroid gland surgeries.
To learn more about minimally invasive parathyroid surgery for HPT and osteoporosis or to request a consultation with Dr. Larian, please contact us online or call us today at 310-461-0300.