Metabolic Bone Diseases

Calcium and Phosphorus Disorders

Calcium and phosphorus are two minerals essential to our bodies. Together, they help to strengthen the bones and teeth. If either one is out of balance, the body can be affected adversely. The most common calcium and phosphorus disorders include:

• Hypercalcemia, an overabundance of calcium in the blood. Treatment may include the administration of medication to improve the calcium level, steroids and diuretics.
• Hypocalcemia, which occurs when too little calcium is present in the blood. Calcium or vitamin D supplementation may be necessary. If the problem is severe, an injection of calcium gluconate is recommended.
• Hypophosphatemia refers to a low level of phosphorus in the blood. Treatment may involve following a diet with high phosphate levels or taking supplements or medications to moderate levels.

Hyperparathyroidism

Hyperparathyroidism is known as a condition of "moans, groans, stones and bones." Many people do not realize their symptoms were related to the condition until undergoing treatment and feeling much better as a result, while others really may not experience any symptoms. Common symptoms of hyperparathyroidism can include:

• Increased thirst and urination
• Kidney stones
• Abdominal pain
• Nausea
• Vomiting
• Osteoporosis

Hypoparathyroidism

Hypoparathyroidism is a condition caused by an underproduction of parathyroid hormone (PTH) by the parathyroid glands. These glands, located in the neck, are responsible for managing the levels of calcium, vitamin D and phosphorus in the body. If the parathyroid glands do not secrete a sufficient quantity of PTH, the amount of calcium and phosphorus in the body become unbalanced. It can cause symptoms including cataracts, dry hair, abdominal discomfort, scaly skin, muscle cramps and seizures.

To diagnose hypoparathyroidism, your doctor will perform blood and urine tests to measure the levels of various minerals and PTH. Treatment for hypoparathyroidism consists of taking daily supplements of calcium carbonate and vitamin D. Regular follow-up appointments are essential to ensure the correct levels are steadily maintained.

Osteomalacia

Osteomalacia, also known as rickets, is a softening of the bones that may occur as a result of a vitamin D deficiency. This condition often leads to a dull aching pain, muscle weakness and an increased risk of fractures, especially within the ribs, spine and legs. If this condition is suspected, your doctor may perform diagnostic testing such as X-rays or a bone mineral density test to evaluate the health of the bones and determine the underlying cause of symptoms.

Osteopenia

Osteopenia is a condition characterized by low bone mineral density, but not as low as that for osteoporosis. A bone mineral density test estimates the strength of your bones by measuring the density of minerals like calcium. If too many minerals are lost, bones become more porous, light and considerably weaker.

Osteopenia can be a result of the natural aging process, eating disorders, vitamin absorption problems or medications. There are no symptoms associated with osteopenia, but those with the condition have a higher risk of bone fractures. It is diagnosed through bone mineral density testing. Treatment for osteopenia often consists of making lifestyle changes to maintain existing bone mass, such as increasing calcium intake through diet or supplements, and exercising to strengthen the bones.

Osteoporosis

Osteoporosis is a disease characterized by increasing bone loss which can lead to fractures, height loss and a hump-backed appearance. One in two women, and one in five men, over the age of 65 will suffer at least one bone fracture due to osteoporosis.

A diagnosis of osteoporosis is made after a complete medical history, physical examination and laboratory tests, including X-rays and bone densitometry. Other possible causes of bone loss must be ruled out as well. Lost bone cannot be replaced, but the treatment team will work with you to prevent further weakening. The treatment plan may include exercise, diet changes, hormone therapy with estrogen (ERT) or anti-estrogens (SERMs), or bone-preserving medications such as Calcitonin or Alendronate.

Paget's disease

Paget's disease is a chronic bone disorder that affects bone metabolism and causes bones to become fragile and unable to regenerate correctly. New bone is produced at a faster rate and is often softer and weaker than normal, increasing a patient's risk for pain and fractures.

Vitamin D Deficiency

A vitamin D deficiency means that your intake of this vitamin is inadequate to meet your body’s needs.  We naturally produce vitamin D when exposed to sunlight.  But if sun exposure is low and you do not consume foods rich in vitamin D, your levels will become deficient.  Vitamin D is important because it works together with calcium to strengthen the bones.  A vitamin D deficiency can cause such symptoms as bone pain and muscle weakness, but for many people the symptoms are subtle.  This condition has been shown to increase the risk of cardiovascular ailments, cognitive problems and cancer.

Vitamin D deficiency is diagnosed through a blood test.  Treatment requires increasing the body’s level of vitamin D by making dietary changes and taking supplements.