vi medicine informatics




Patients with untreated Graves disease are also at risk for osteoporosis and thus increased fractures. An increased thyroxine level stimulates bone resorption by increasing osteoclast activity, resulting in increased porosity of cortical bone and reduced volume of trabecular bone. The increased bone resorption leads to increased serum calcium. Increased calcium levels inhibit parathyroid hormone secretion and conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D. Alkaline phosphatase levels are expected to be elevated because of increased bone turnover.

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