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What to know about parathyroid hormone and osteoporosisMedically reviewed by Megan Soliman, MD — By Caitlin Geng on June 28, 2022The four parathyroid glands sit behind the thyroid and control how much calcium is present in the bones and blood. When these glands are not functioning as they should, calcium levels can become unbalanced.
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This imbalance can cause bones to become weak and porous, resulting in osteoporosis. Various factors can result in the parathyroid glands producing insufficient or excessive levels of hormones.
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Both of these outcomes can lead to a calcium imbalance. This article outlines what osteoporosis is and what the parathyroid glands do.
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It also explores the relationship between osteoporosis and hyperparathyroidism. Finally, it discusses how doctors may treat the conditions. What is osteoporosis
Share on PinterestPeter Dazeley/Getty ImagesOsteoporosis is a condition in which bones become weak over time and may break easily.
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A person may not realize that they have osteoporosis until one of their bones breaks, as there are not any noticeable outward symptoms. Osteoporosis most commonly affects bones in the hip, wrist, and spine.
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The body breaks down old bone tissue and replaces it with new tissue, which helps keep the bones strong. When a person reaches the age of about 30 years, their bone mass stops increasing. From this point, the aim of bone health is to maintain as much bone mass as possible.
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By the time a person reaches their 40s and 50s, their bones may consist of more broken down tissue than replaced tissue. In the bones of a person with osteoporosis, the spaces in the structure of bone tissue widen and become porous. This makes the bones less dense, and the outer shell of the bone thins.
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The bones become weaker and more brittle, increasing the risk of fractures. What do the parathyroid glands do
The thyroid gland is a butterfly-shaped gland at the base of the throat near the trachea.
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The parathyroid glands are four pea-sized glands in the neck near the thyroid. The parathyroid glands produce hormones called parathyroid hormones (PTH).
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Through the secretion of PTH, the glands regulate how much calcium:the body absorbs from a person’s dietthe bones storethe kidneys secrete
If parathyroid glands produce either too much or too little PTH, the balance of calcium will not be right. If the glands overproduce PTH, a person will develop hyperparathyroidism, and the calcium level in their blood will rise.
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A benign tumor on a parathyroid gland or the enlargement of a gland can cause it to become overactive. In very rare cases, cancer can cause hyperparathyroidism. If the parathyroid glands do not produce enough PTH, a person will have hypoparathyroidism.
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This causes too little calcium in the body and too much phosphorous. The most common causes of hypoparathyroidism include:low levels of magnesium in the bloodinjury to the parathyroid glandsautoimmune attack on the parathyroid glandsin rare cases, radioactive iodine treatment for hypothyroidism
Osteoporosis and hyperparathyroidism
If a person has hyperparathyroidism and one of the parathyroid glands overproduces PTH, the hormones signal the constant release of calcium stores from the bone into the blood.
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This can cause the bones to lose density and structure and become more porous because calcium is what makes bones hard in structure. This loss of calcium can lead to osteoporosis. In people with hyperparathyroidism, the bone continues to dissolve and weaken, and osteoporosis causes the risk of breakage to increase.
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The increased blood levels of calcium may also cause bone pain, which is a common symptom of hyperparathyroidism. Treatment
The treatment for hyperparathyroidism usually involves surgery or medication.
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Doctors may also treat osteoporosis with medication. Surgery
Surgery is the only sure way to cure hyperparathyroidism.
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There are different types of surgery for hyperparathyroidism. Parathyroidectomy is a minimally invasive surgery.
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A surgeon makes a small incision in the neck and removes the overactive gland. The recovery time is usually short, and a person can typically go home the same day. The surgeon may give a person a regional or general anesthetic during the surgery.
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In bilateral neck exploration, the surgeon will make a larger incision to examine all four parathyroid glands and remove the overactive ones. This surgery usually requires general anesthesia, and a person may need to stay in the hospital overnight.
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Medication
A doctor may prescribe medication, such as cinacalcet, to people who are unable to have surgery. This medication decreases the amount of PTH that the parathyroid glands make and lowers calcium levels in the blood. However, cinacalcet does not improve bone density.
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Osteoporosis treatment
To diagnose osteoporosis, a doctor may perform a bone density scan and develop a treatment plan based on the person’s age and sex, as well as their history of bone breakages and risk of future bone breakages. Treatment will aim to strengthen the bones and prevent fractures.
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Medication options may include:Selective estrogen receptor modulators (SERMs): These work in a similar way to the hormone estrogen and help maintain bone density, especially in the spine.Bisphosphonates: These help maintain bone density by slowing the rate at which the body breaks down bone.Parathyroid hormone: Doctors may inject parathyroid hormone treatments to stimulate cells to produce new bone. Hormone replacement therapy (HRT): Doctors might prescribe HRT to replace hormones lost during menopause, which can be a factor in the onset of osteoporosis.
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If a person does not require medication, a doctor may suggest monitoring the situation and keeping track of bone density. Summary
If a person has hyperparathyroidism, PTH will signal to the bones to release calcium in a constant stream. The loss of calcium from the bones can cause the bones to lose density and become weak and porous.
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This condition is called osteoporosis. The most effective treatment for hyperparathyroidism is surgery, which will help slow the loss of bone density. A surgeon may remove one parathyroid gland or open a larger incision to view and remove multiple affected parathyroid glands.
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A doctor may prescribe medication if a person cannot have surgery. This treatment can help lower the levels of calcium in the blood, but it will not address osteoporosis.
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To treat osteoporosis, a doctor may suggest monitoring the person’s bone density, or they may prescribe medication to slow the loss of bone. Last medically reviewed on June 28, 2022EndocrinologyOsteoporosisBones / Orthopedics 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references.
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We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Abate, E.
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G., et al. (2017).
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Review of hypoparathyroidism.https://www.frontiersin.org/articles/10.3389/fendo.2016.00172/fullBarnsley, J., et al. (2021).
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Pathophysiology and treatment of osteoporosis: Challenges for clinical practice in older people.https://link.springer.com/article/10.1007/s40520-021-01817-yClarke, B. L. (2014).
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Bone disease in hypoparathyroidism.https://pubmed.ncbi.nlm.nih.gov/25166046/Hyperparathyroidism. (2021).https://www.nhs.uk/conditions/hyperparathyroidism/Khan, M., et al. (2021).
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Physiology, parathyroid hormone.https://www.ncbi.nlm.nih.gov/books/NBK499940/Osteoporosis. (2017).https://www.nia.nih.gov/health/osteoporosisParathyroid disorders. (2016).https://medlineplus.gov/parathyroiddisorders.htmlParathyroid gland.
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(n.d.).https://www.cancer.gov/publications/dictionaries/cancer-terms/def/parathyroid-glandPrimary hyperparathyroidism. (2019).https://www.niddk.nih.gov/health-information/endocrine-diseases/primary-hyperparathyroidismTreatment: Osteoporosis. (2019).https://www.nhs.uk/conditions/osteoporosis/treatment/Zhang, C., et al.
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(2021). Combination therapy of PTH and antiresorptive drugs on osteoporosis: A review of treatment alternatives.https://www.frontiersin.org/articles/10.3389/fphar.2020.607017/fullFEEDBACK:Medically reviewed by Megan Soliman, MD — By Caitlin Geng on June 28, 2022
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New clues arise
Related CoverageWhat to know about hyperparathyroidismMedically reviewed by Kelly Wood, MD
Hyperparathyroidism is a condition wherein the parathyroid glands produce too much parathyroid hormone. Learn more about it here.READ MOREWhat to know about osteoporosisMedically reviewed by Brenda B. Spriggs, M.D., MPH, FACP
Osteoporosis occurs when bone density decreases.
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This affects the structure and strength of bones and makes fractures more likely. Osteoporosis is…READ MOREThyroid gland function, location, and common conditionsMedically reviewed by Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
The thyroid gland produces hormones that affect metabolism, mood, breathing, heart rate, and more.
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Learn more about thyroid gland function.READ MORECalcium supplements for adults under 35 improve bone mineral density, study shows
Researchers from China have summarized existing evidence on the effects of calcium supplementation in younger age groups, finding that supplementation…READ MORE
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