Aunt Zhang, 43, has been suffering from hyperthyroidism for more than 20 years, and her poor sleep quality at night and easy awakening are her symptoms all along. But since last week, she not only did not sleep well, but sometimes woke up by inexplicable pain in her body, thinking that her hyperthyroidism was aggravated, so she hurried to Nanjing Tongren Hospital for treatment accompanied by her family. After the thyroid function and bone metabolism biochemical examination of Aunt Zhang, it was found that her hyperthyroidism was poorly controlled, and the markers of bone transformation were elevated, and the results of further examination by dual-energy X-ray absorptinometer showed that the bone mineral density T value was -31. It has reached the level of severe osteoporosis, and a slight collision may lead to fractures.
Source: Visual China.
The elderly are prone to osteoporosis, and women are also prone to osteoporosis after menopause, but can hyperthyroidism also cause osteoporosis?This made Aunt Zhang feel very puzzled. Guo Wanhua, director of the Department of Nuclear Medicine of Nanjing Tongren Hospital, explained to her that osteoporosis is not an exclusive disease of a specific age group, endocrine diseases such as hyperthyroidism and hypothyroidism, and immune diseases such as lupus erythematosus and rheumatoid arthritis can lead to the occurrence of osteoporosis.
So, how does hyperthyroidism cause osteoporosis?"Normal bone metabolism relies on the homeostasis between osteoclast bone resorption and osteoblast bone formation, which is influenced by a variety of hormones. Guo Wanhua said that hyperthyroidism is a hypermetabolic disease, the body is always in a state of hypermetabolism, and hypermetabolism will enhance the catabolism of substances, calcium and phosphorus metabolism disorders, resulting in negative calcium balance in the body, further aggravating osteoporosis. Its symptoms are mainly manifested as bone pain, pathological fractures, and bone deformities. In addition, vitamin D can promote calcium absorption, but hyperthyroidism can cause insufficient absorption and synthesis of vitamin D, which in turn reduces calcium absorption.
Migratory pain is one of the typical features of secondary osteoporosis, which is not exactly located, sometimes the foot hurts, sometimes the joints hurt, sometimes the pain hurts at night, but when it comes to doing things during the day, the pain is relieved. Guo Wanhua reminded that in addition, there may also be fatigue, spinal deformation and other conditions, especially for middle-aged and elderly people, if they find that their height has become shorter by 3-5 cm, or even more, they must seek medical attention in time to consider the possibility of osteoporosis.
For the second osteoporosis of hyperthyroidism, it is necessary to first control the condition of hyperthyroidism, and then cooperate with the corresponding anti-bone resorption and bone forming drugs on the premise of reducing thyroid hormone secretion. Guo Wanhua said that if osteoporosis has been detected, the effect of calcium and vitamin D alone is often difficult to achieve expectations.
It is recommended to pay attention to storing bone mass through reasonable diet, appropriate exercise, supplemental sun exposure and other ways when you are young, and middle-aged and elderly people should regularly carry out bone density testing in combination with their own conditions, especially pay attention to their own chronic diseases, visit patients regularly, and detect diseases that affect bone metabolism as early as possible. ”
Yangtze Evening News Purple Cow News reporter Xu Qianqian.
Proofreading Tao Shangong.