As you may know, after some surgeries, especially those that remove the thyroid gland in the neck or the parathyroid glands nearby, the body can experience a few different kinds of discomfort. Some people may feel unimaginably tired, have body aches, or feel a little confused. So if you or someone you know is experiencing something like this, it could be due to a condition we're going to talk about today called 'Hungry Bone Syndrome'. The name sounds a little strange, doesn't it? You might be thinking, "What does it mean to have hungry bones?" Let's take a look at what it is, in simple terms.
What is 'Hungry Bone Syndrome'?
Simply put, Hungry Bone Syndrome is a condition where your blood calcium levels suddenly drop too low. Doctors call this ``Hypocalcemia''. This condition is often seen after surgery on the parathyroid glands. Did you know that the parathyroid glands are very important in controlling calcium in our body?
People with this 'hungry bone syndrome' may not only have low calcium levels, but sometimes also low levels of magnesium (`(Hypomagnesemia)`) and phosphorus (`(Hypophosphatemia)`) in their blood. These are also important minerals that our bodies need.
But there's nothing to worry about. 'Hungry Bone Syndrome' is a condition that can be treated and cured . The most important thing is to recognize it in time and start treatment.
How common is this condition?
Researchers don't really have an exact idea of how common this 'hungry bone syndrome' is, as it can vary from person to person.
However, some studies have shown that between 4 and 13 out of 100 people who have had parathyroidectomy for a condition called primary hyperparathyroidism develop this condition. Also, some reports say that after surgery for secondary and tertiary hyperparathyroidism, the chance of this condition developing can be as high as 20 to 70 out of 100. So, it seems that this can be a bit more common in some cases.
What are the symptoms of 'Hungry Bone Syndrome'?
The symptoms of 'Hungry Bone Syndrome' are very similar to those caused by low blood calcium (Hypocalcemia). These can be as minor as a small lump in some people, to as severe as confusion or seizures in others. Here are some of the symptoms:
- Rolling or pulling of the flesh: A feeling as if the flesh in the legs or arms is just rolling.
- Muscle weakness: Feeling lifeless and too tired to do anything.
- Bone pain: Feeling as if the bones in the body are hurting.
- Severe fatigue: Fatigue that does not go away even after sleeping.
- Confusion: Difficulty concentrating, not knowing what to do.
- Memory problems: Forgetting things.
- Irritability or irritability: Getting angry over small things, feeling uneasy.
- Depression: Feeling of sadness and hopelessness.
- Numbness in the lips, tongue, fingertips, and/or feet: These areas feel numb, or like ants are running around.
- Difficulty breathing due to spasm of the throat muscles (`(Laryngospasm)`): This is a little dangerous, it makes it difficult to breathe.
- Muscle stiffness and twitching (`(Tetany)`): A condition in which the muscles of the body become stiff and twitch.
- Seizures: This is also a serious symptom.
Along with these symptoms, as mentioned earlier, low levels of magnesium and phosphorus in the blood (`(Hypomagnesemia)` and `(Hypophosphatemia)`) may also occur. The symptoms of these conditions are very similar to those of low calcium. They can also cause muscle problems, seizures, and irregular heartbeats (`(Arrhythmia)`).
Hungry bone syndrome usually occurs within 18 hours of parathyroid or thyroid surgery .
Why does this 'Hungry Bone Syndrome' occur?
There are several main causes of 'Hungry Bone Syndrome':
- After parathyroid surgery (Parathyroidectomy) for primary or secondary hyperparathyroidism.
- Thyrotoxicosis is a condition that occurs after a total thyroidectomy.
- When prostate cancer spreads to the bones (metastasized).
To understand exactly why this happens, it's important to understand a little about how calcium levels are regulated in our bodies.
Imagine, behind your thyroid gland in your neck, there are four small glands called parathyroid glands. These glands produce a hormone called parathyroid hormone (PTH) . The main function of this PTH hormone is to control the level of calcium in the blood (not in the bones, but in the blood). PTH also helps control the levels of phosphorus (also a mineral) and vitamin D (also a hormone) in the blood and bones.
So, when your body senses that your blood calcium level is low, the parathyroid glands release the hormone PTH. This PTH goes and releases a small amount of calcium from the bones and adds it to the blood. Then the blood calcium level is back to normal.
Now, imagine that someone has overactive parathyroid glands, and they have surgery to remove them. What happens is that the previously very high PTH hormone levels suddenly drop. Sometimes, when a thyroid operation is performed, if nearby parathyroid glands are accidentally damaged, PTH levels can also drop.
When PTH levels suddenly drop, the amount of calcium in old bones that is resorbed into the blood (`(Resorption)`) decreases, and the amount of new bone formation (`(Bone Formation)`) increases. This causes the bones to become "starved" of calcium. That is why this is called 'hungry bone syndrome'.
This is what happens when prostate cancer spreads to the bones. There, the activity of bone-building cells (`(Osteoblastic activity)`) increases, so the bones need more calcium.
Who is at higher risk of developing 'Hungry Bone Syndrome'?
Some people are more likely to develop this condition. Let's look at who they are:
- Very high levels of parathyroid hormone (PTH) in the blood.
- Increased levels of alkaline phosphatase in the blood.
- Calcium levels in the blood are usually low.
- Having vitamin D deficiency.
- Performing thyroid and parathyroid surgeries at the same time.
- Increased blood urea nitrogen (BUN) levels.
- Obesity, that is, extreme fatness.
- Surgical removal of a larger than normal parathyroid gland.
- Spread of cancer cells to the bones (Metastatic tumors of the bones).
- Presence of bone-related diseases such as brown tumors and osteitis fibrosa cystica.
People with these risk factors are more likely to develop 'hungry bone syndrome'.
How do doctors find this?
A doctor will often first determine whether you have 'hungry bone syndrome' by doing a calcium blood test. Generally, if your blood calcium level is below 8.4 mg/dL for more than four days, it is considered a risk factor for 'hungry bone syndrome'.
Not only that, but your doctor may also perform a few other tests to see if this condition has affected other aspects of your health:
- Other blood tests: Your blood may be tested for magnesium, phosphorus, parathyroid hormone (PTH), and/or vitamin D levels.
- EKG (Electrocardiogram): This test measures the rhythm of your heart by attaching electrodes to your chest. This is important because low blood calcium (hypocalcemia) and 'hungry bone syndrome' can cause irregular heartbeats.
- Bone imaging tests: These tests can check for problems with your bones, such as fractures, deformities, or tumors.
What are the treatments for 'Hungry Bone Syndrome'?
Don't worry, there are good treatments for this. The main goal of treatment is to bring the calcium level in your blood back to a healthy level. In most cases, you will receive this treatment while you are in the hospital. Treatment can include:
- Giving calcium through a vein (`(IV Calcium - Calcium Gluconate)`): This helps to quickly restore calcium levels.
- Oral Calcium Supplements (Calcium Citrate or Calcium Carbonate): These are given to maintain calcium levels.
- Oral Vitamin D Supplements: Vitamin D is essential for the body to absorb calcium.
- Magnesium replacement: If magnesium levels are low, that too needs to be corrected.
The doctors will examine your condition and determine the most suitable treatment for you.
How long will it take to recover from this condition? What is the future?
The good news is that this condition, 'Hungry Bone Syndrome', is almost completely curable . That means the prognosis is very good.
However, even with treatment, the time it takes for this condition to fully resolve can vary. Some people get better in a few days, while others may take several months. In very rare cases, it can last for up to a year.
Most importantly, if left untreated, severe hypocalcemia can lead to life-threatening complications such as seizures. Therefore, it is important to seek treatment as soon as possible if symptoms occur.
Can 'Hungry Bone Syndrome' be prevented?
Since 'hungry bone syndrome' can occur after parathyroid surgery (`(Parathyroidectomy)`) or thyroid surgery (`(Thyroidectomy)`), doctors try to take steps to prevent it even before the operation. Let's see what they are:
- Presurgery evaluation: Before surgery , your doctor will check your bone mineral density, blood calcium levels, phosphate levels, PTH levels, and vitamin D levels. These tests can help your doctor determine if you are at risk for developing 'hungry bone syndrome'.
- Preventive measures: If you are at high risk of developing hungry bone syndrome, your doctor may recommend that you take supplements or medications to keep your vitamin D and calcium levels up before surgery. This may help reduce the likelihood and/or severity of hungry bone syndrome.
- Post-surgery monitoring: After surgery, the hospital team will regularly check your blood levels of calcium, phosphate, magnesium, and PTH. This is so that if you develop 'hungry bone syndrome', it can be identified early and treatment can be started immediately.
However, despite all these measures, sometimes 'hungry bone syndrome' can develop. Researchers are still not sure why this happens.
What time should I see a doctor?
If you have had parathyroid or thyroid surgery and later develop the symptoms of low blood calcium (`(Hypocalcemia)`) that we discussed earlier, such as muscle cramps, a feeling of weakness, changes in consciousness (such as confusion), and numbness of the lips and fingers, you should definitely see a doctor as soon as possible.** 'Hungry bone syndrome' and `(Hypocalcemia)` can occur after parathyroid and/or thyroid surgery, may subside after a few days, and then reappear. Therefore, it is very important to pay attention to even the slightest symptom.
'Hungry bone syndrome' is a condition that can occur after surgery to remove the parathyroid or thyroid glands. The good news is that it can be treated and cured. However, it may take some time to fully recover. Since a severe drop in blood calcium levels can be dangerous to your health, it's best to see a doctor as soon as you experience symptoms.
Take home message
So, in simple terms, 'Hungry Bone Syndrome' is a condition that can occur after surgery on the parathyroid or thyroid gland. What it essentially does is that the amount of calcium in the body's blood suddenly decreases. This is because the level of parathyroid hormone (`(PTH)`) decreases after the surgery, causing the bones to "demand" calcium.
Don't be afraid to hear this, because 'Hungry Bone Syndrome' is a condition that can be treated and cured very well.
The most important thing is that if you have any of these symptoms (such as muscle twitching, fatigue, numbness), do not waste time and see a doctor as soon as possible. This way, you can identify the condition early, start the necessary treatment quickly, and cure it before it becomes a bigger problem. Remember, taking care of your health is in your own hands.
` Hungry Bone Syndrome, Hungry Bone Syndrome, Calcium, Hypocalcemia, Parathyroid, Thyroid Surgery, PTH
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න