The fact that the thyroid gland is of great importance for life is known to almost everyone. After all, the pathology of this organ of the endocrine system is very common. Sometimes surgery to remove the thyroid gland is the only treatment. For a long time, such surgical intervention was unnecessarily radical, leading to severe complications. The fact is that the organ was removed along with other important anatomical structures, namely, with the parathyroid glands. Relatively recently, scientists have begun to attach more importance to these endocrine organs and understand what important functions they have. Diseases of the parathyroid gland lead to serious disorders of calcium and phosphorus metabolism. This affects the functioning of the bone, muscle, and nervous system.
Characteristics of parathyroid diseases: symptoms, causes
The parathyroid (parathyroid) glands are responsible for important functions for the body. They secrete a special hormone, without which the regulation of phosphorus-calcium metabolism is impossible. The average person has 4 parathyroid glands. In some, their number reaches 8-10 pieces. Unlike other endocrine glands, these anatomical structures do not have a lobular structure. Outside, they are covered by a capsule, and inside they consist of glandular parenchyma. These organs secrete parathyroid hormone. This biological substance is necessary for influencing the nervous and musculoskeletal systems. Parathyroid hormone is considered an antagonist of calcitonin. Its function is to produce osteoclasts. These cells help move calcium out of the bones and into the bloodstream.
The causes of parathyroid diseases include endo- and exogenous factors. Among them are chronic renal and endocrine pathologies, malabsorption in the gastrointestinal tract, neoplasms, harmful chemical and physical effects. How does parathyroid dysfunction occur? Symptoms of the disease in men and women have some differences. However, the main manifestations of pathologies in both sexes are damage to the skeletal system, disorders of the heart, and muscle tissue. In some cases, neurological changes are noted.
Etiology and risk factors
The main cause of parathyroid disease is the excess production of the hormone or, conversely, itsfailure. In the first case, an excessive amount of calcium accumulates in the bloodstream, which leads to disturbances in the body. This condition is called hyperparathyroidism. The following causes of this pathology are distinguished:
- Genetic disorders.
- Parathyroid cancer.
- Benign formations: adenoma or cyst.
- Lack of vitamin D and calcium in the body.
- Mabsorption of nutrients in the intestines.
With insufficient production of the hormone, hypoparathyroidism develops. This disease develops against the background of chronic renal failure or high phosphorus content. Also, an autoimmune disorder in the body can lead to a deficiency of parathyroid hormone. Less commonly, the cause of the pathology is surgical intervention, namely, thyroidectomy.
There are a number of risk factors that can lead to parathyroid disease. These include:
- Infectious processes leading to tissue necrosis.
- Rickets.
- Endocrine disorders, in particular - thyroid disease.
- Pathologies of the kidneys and gastrointestinal tract.
In addition, the disease can provoke malnutrition. This is especially true for young children who need a daily dose of vitamin D and calcium.
Mechanism of development of parathyroid pathologies
The pathogenesis of hyperparathyroidism depends on the etiology of the disease. An increase in hormone production can beassociated with benign and malignant tumors. In both cases, the parathyroid tissue grows and there are more endocrine cells. All of them produce a hormone, as a result of which its concentration in the body increases dramatically. Secondary hyperparathyroidism occurs due to calcium deficiency. Since the endocrine organs function according to the rules of feedback, the deficiency of this chemical element leads to a compensatory increase in the work of the parathyroid glands.
Primary hypoparathyroidism is most often associated with autoimmune cell damage. The reason for the production of antibodies may be a lack of thyroid hormones, diseases of the adrenal glands, ovaries, liver. Also, autoimmune aggression can cause fungal lesions of the skin or mucous membranes. Secondary parathyroid hormone deficiency develops due to impaired calcium absorption in the intestines and renal tubules. This leads to hyperphosphatemia and metabolic disorders.
The parathyroid gland. What symptoms can the disease have?
Since the parathyroid gland is one of the regulators of calcium-phosphorus metabolism, the symptoms of pathologies are associated with disorders of the bone, muscle and nervous system. Consider the manifestations of hyperparathyroidism. Regardless of the etiology of the disease, excessive hormone secretion is accompanied by the following symptoms:
- Bone softening - osteomalacia.
- Pain in the back and lower back.
- Hair and teeth loss.
- Appearance of sand or kidney stones.
- Increased thirst and frequenturination.
- Nausea and vomiting.
- Emotional instability.
Often, these symptoms are observed in women with parathyroid disease. Among the male population, an increase in hormone production is 3 times less common.
How does parathyroid insufficiency manifest itself? The symptoms of the disease at the initial stages, despite the opposite mechanism of development, are largely similar. People suffering from hypoparathyroidism also experience hair loss, chronic fatigue, and rapid destruction of tooth tissue. Later, tachycardia, convulsive syndrome (in the calf muscles, feet) and parasthesia join. Patients complain of sensations such as crawling, numbness of the skin, a feeling of chills. Hypoparathyroidism is often accompanied by conjunctivitis and keratitis.
Features of diseases in men
Symptoms of pathologies of the parathyroid glands in men do not differ much from the signs of the disease in women. The initial manifestations of the disease are the same in both sexes. However, women suffer from the disease more severely than men. This applies to both hypo- and hyperparathyroidism. The clinical picture in men is dominated by myalgia and symptoms of urolithiasis. Emotional lability among the representatives of the strong half is expressed to a lesser extent. Men are also less prone to osteoporosis and bone softening.
Symptoms of the disease inwomen
Among the female population, secondary hyperparathyroidism is most common. In most cases, it develops in young and middle age - from 20 to 50 years. Hyperparathyroidism is associated with thyroid insufficiency, which occurs against the background of autoimmune inflammation or iodine deficiency. In addition, a pathological condition may develop due to ovarian dysfunction, menopausal syndrome, or the use of contraceptives. The instability of the hormonal background leads to diseases of the parathyroid gland. Symptoms in women begin insidiously. In the initial stages, the disease is accompanied only by increased fatigue. Then joins the nervousness and increased muscle excitability. Patients complain of headache, periodic muscle spasms, decreased memory and performance.
A pronounced increase in the content of parathyroid hormone leads to the destruction of bone tissue. In women, this symptom is more pronounced than in men. This is due not only to hyperparathyroidism, but also to the insufficiency of sex hormones that occurs during menopause and postmenopause. The manifestations of the disease include osteomalacia, that is, softening of the bone tissue. As a result of this disorder, patients become prone to fractures. In addition, women are more likely to complain of back pain and muscle weakness. Another manifestation is urolithiasis, diagnosed with hyperparathyroidism.
Features of the course of pathology in children
In addition to possible genetic disorders and autoimmune pathologies, lack of calcium and vitamin D is the main cause of the diseaseparathyroid gland in children. Deficiency of these elements leads to a violation of the exchange between calcium and phosphorus. Unlike adults, the disease in children is more severe and dangerous. Indeed, at an early age, bone tissue is not fully formed.
Symptoms of hyperparathyroidism resemble the clinical picture of rickets. Signs of pathology include tearfulness, sleep disturbance, muscle hypotension and gastrointestinal disorders, the appearance of kidney stones. Children with hyperparathyroidism gain weight more slowly. With severe violations of mineral metabolism, a delay in physical development is possible. The lack of calcium in the bone tissue leads to impaired gait and valgus deformity of the knee joints. If treatment is not started on time, hyperparathyroidism in a child will lead to disability.
Possible complications of pathologies
The main complication of hyperparathyroidism is an elevated level of calcium in the blood. If the content of this element reaches 15 mg, a serious condition develops for the body. Hypercalcemic crisis leads to acute renal failure and coma. Another dangerous complication is bone fragility. People with hyperparathyroidism are often prone to injury and disability.
The opposite condition is hypocalcemia. Its danger lies in convulsions. If the level of calcium in the blood is slightly reduced, then the patient is only concerned about involuntary contractions of the muscles of the limbs. With severe hypocalcemia, convulsive syndrome can cover the respiratory andvascular musculature, leading to bronchospasm, laryngospasm, renal colitis, and cardiac disorders.
Diagnostic criteria for parathyroid pathologies
How to detect parathyroid disease? Diagnosis consists of a survey, examination of the patient and laboratory tests. The criteria for pathologies include characteristic complaints (fatigue, nausea, convulsions, damage to the teeth), weakness or, conversely, an increase in muscle tone. To confirm the diagnosis, it is required to check the level of parathyroid hormone, as well as calcium and phosphorus in the venous blood. To visualize the bones and identify violations of their structure, X-rays and CT scans are performed.
Methods of treating diseases
To improve the patient's condition, it is required to normalize the level of hormones. Treatment of diseases of the parathyroid glands pursues this goal. Wellness activities include:
- Proper nutrition.
- Substitution therapy.
- Surgical treatment.
- The right way of life.
Treatment should be comprehensive and permanent. Surgery is required if the gland tissue produces excessive amounts of the hormone.
Replacement therapy for hypoparathyroidism
In order for calcium levels in the body to reach normal levels, a balanced diet and replacement therapy is required. The diet should be dominated by dairy products: hard cheeses, cottage cheese, kefir. Also, it is recommended to eat eggs, liver and sea fish. As replacement therapyprescribe drugs "Calcium D3", "Vitamin D", "Aquadetrim", etc. With pronounced muscle contractions, anticonvulsant treatment is performed.
To improve the absorption of preparations containing calcium and vitamin D, you need to take walks in the fresh air and stay in the sun. In the winter season, procedures are prescribed, accompanied by ultraviolet irradiation in the required doses.
Recommendations for the treatment of hyperparathyroidism
Surgical diseases of the parathyroid gland primarily include cyst, hyperplasia, adenoma and cancer. To normalize the level of the hormone, an operation should be performed. Surgical treatment consists in partial removal of the parathyroid glands. After surgery, patients are advised to be exposed to solar and other radiation as little as possible.
