Tetany – causes, symptoms and nutritional recommendations
Tetany is a symptom of disease syndromes that are associated with muscle and nerve hyperactivity, impaired concentration, chronic nervousness and fatigue. The term tężyczka went to the medical language in the nineteenth century and comes from the Latin word tetania. A number of factors contribute to the causes of tetany, among which the low concentration of three elements – calcium, magnesium and potassium – can be distinguished.
Diagnosis of tetany is based on the observation of typical symptoms and laboratory tests. In order to detect latent tetany, tetanic tests are performed, such as the Chvostka symptom, consisting of facial muscle contraction in response to an impact on the facial nerve or Ibrahim-Lusta symptom consisting in sagittal muscle contraction after the hammer strikes the fibula nerve. What is the etiology of tetany and how can diet prevent its symptoms?
Causes of tetany
Hypocalcaemia, or too low level of calcium ions in the blood serum is the most common cause of tetany. Lowering the total calcium concentration to (<2.25 mmol / l) or ionized calcium to (<0.95 mmol / l) may lead to disturbances in the proper functioning of peripheral nerves, causing their hyperactivity. The concentration of calcium in the form of ions plays the most important role in the pathogenesis of tetany. The level of total calcium in patients diagnosed with tetany may be within normal limits. There are many causes of hypocalcemia, min
– insufficient supply of calcium with diet,
– vitamin D deficiency,
– calcium absorption disorders,
– parathormone deficiency,
– period of increased demand (pregnancy, lactation, increase),
– calcium deposition in soft tissues,
– excessive removal of calcium with urine,
Hypomagnesaemia is too low total magnesium in the blood serum (<0.65mmol / l). Low levels of magnesium can be caused
– insufficient supply of magnesium with diet,
– disturbances of absorption in the gastrointestinal tract,
– increased demand (increase, pregnancy, breastfeeding),
– excessive magnesium loss in the urine as a result of taking certain medications,
Hypokalemia occurs when the serum potassium level is lower than 3.5 mmol / l. The decrease in potassium levels may be caused by diuretic therapy, kidney and gastrointestinal disorders as well as chronic diarrhea.
Zasadowica is a condition in which the concentration of calcium ions in the blood serum decreases due to the binding of calcium ions to plasma proteins, which is caused by the reduction of hydrogen ions in the blood serum. The amount of ionized calcium reduced in this way may result in the occurrence of tetany.
Types of tetany
Two types of tetany can be found in the literature, differing in the reasons for the origin and the type of symptoms. There is an open tetany and latent tetany.
Caused by hypocalcaemia. Tantrum attack is manifested
– numbness of the tongue, skin around the lips, upper and lower limbs,
– numbness of feet, hands (often whole limbs),
– contraction of the muscles of the hands and feet,
– squeezing in the chest or even loss of consciousness.
Between tetany attacks, patients often experience constant fatigue, tension, irritability and loss of attention.
Tetanus (normocalcemia) is caused by hypomagnesemia or alkalosis. Tetany is revealed
– bad mood, chronic tiredness, depressed mood,
– irritability, insomnia,
– speech defects,
– disturbances of concentration and memory,
– numbness and tingling of the fingers of the hands, cramps in the muscles of the calves and feet,
– pains and dizziness,
– the trembling of hands and body, the numbness of the face and tongue.
Sometimes the symptoms of latent tetany are confused with neurosis or with anxiety disorders.
The role of the diet
The deficiency of calcium, magnesium, potassium and vitamin D leading to tetany are the result of the use of an incorrect diet and disorders in absorption in the gastrointestinal tract.
Calcium intake in Poland is not always sufficient and therefore potential shortages are possible. The dairy products are rich in calcium (yellow cheese, cottage cheese, natural yoghurt), but calcium-rich products are also eggs, fish, nuts and almonds, seeds, seeds (poppy seeds, chia seeds, sesame seeds, linseed, amaranth) , dried figs, spirulina, green leafy vegetables (arugula, kale, parsley). In addition to the inadequate supply of calcium-rich products, the usual diet is rich in phosphorus, which disturbs the absorption of calcium. Phosphorus is found in large quantities in cereal and dairy products as well as meat and sausages. Unfortunately, the fact that the phosphorus supply is too high along with the diet is caused by adding it to food along with additional substances. Large amounts of it can be found in products such as cold meats, processed cheese, powdered soups and fast food. The appropriate ratio of calcium to phosphorus in the adult diet should be 11, however, as research has shown, this ratio in Poland is even 12.4. In the disruption of calcium absorption and assimilation, anti-nutritive substances such as oxalates may also play a role.
Another component of the diet that can affect the onset of hypocalcaemia is vitamin D. Vitamin D increases the absorption of calcium in the gastrointestinal tract and bone mineralization. It is also responsible for the reabsorption of calcium ions in the kidneys and the release and incorporation of them into the skeletal system. Vitamin D deficiency is a very common phenomenon and may be caused by insufficient supply with diet – low intake of marine fish and fish fats. Vitamin D also contain egg yolks, milk and dairy products (butter, cheese), offal (liver), meat, some mushrooms (mushrooms, shiitake mushrooms), yeast. and disorders of its metabolism. Due to the insufficient supply of vitamin D along with the diet and its insufficient synthesis through the skin in the autumn and winter, it is recommended to supplement it from September to April, preferably in combination with vitamin K2.
Hypomagnesemia decreases the concentration of the active form of vitamin D in the blood. This causes an increase in urinary calcium excretion, which results in hypocalcaemia and therefore symptoms of tetany. The products rich in magnesium are bran and wheat germs, nuts, seeds, coarse groats (buckwheat, millet), brown rice, legume seeds, oatmeal, cocoa, bittersweet chocolate.
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