Thyrotoxicosis and osteomalacia: from symptom to pathogenesis

Area of Science:

• Endocrinology
• Bone Metabolism
• Mineral Homeostasis

Background:

• Thyroid hormones directly influence bone mineral homeostasis, increasing resorption and renal calcium loss.
• Osteomalacia, characterized by inadequate bone mineralization, is associated with thyrotoxicosis.
• Thyrotoxicosis can lead to osteopenia and may coexist with osteomalacia.

Purpose of the Study:

• To assess the impact of thyrotoxicosis on osteomalacia occurrence and development.
• To improve the diagnosis and treatment strategies for thyrotoxicosis-induced osteomalacia.

Main Methods:

• Literature search of PubMed using keywords: "osteomalacia" and "thyrotoxicosis"; "osteopenia" or "osteomalacia" or "osteoporosis" and "thyrotoxicosis".
• Analysis of 15 and 129 retrieved papers, respectively, to understand the relationship and pathogenesis.

Main Results:

• Thyrotoxicosis-related osteomalacia pathogenesis is linked to vitamin D catabolism, deficiency, and calcium metabolism disorders.
• Common causes of osteomalacia include nutritional deficiencies, impaired vitamin D absorption, kidney diseases, and hypophosphatemia.
• Thyrotoxicosis can induce osteopenia, highlighting the potential for co-existing osteomalacia.

Conclusions:

• Monitoring alkaline phosphatase, liver function, and clinical symptoms is vital in thyrotoxicosis patients.
• Radiological examinations (e.g., chest and pelvic X-rays) may be necessary for detecting osteomalacia.
• Timely diagnosis and treatment of osteomalacia in thyrotoxicosis patients are essential to prevent fractures and deformities.