Ukuqiniswa Kwe-Hyperparathyroidism? Izimpawu, Izimbangela, Nokwelashwa

I-Hyperparathyroidism kwenzeka uma ama-glands akho e-parathyroid akhiqiza i-parathyroid hormone eningi kakhulu, okubangela amazinga e-calcium egazini lakho ukuba aphakame kunokujwayelekile. La ma-glands amancane amane entanyeni yakho avamise ukuncedisa ekulawuleni i-calcium emzimbeni wakho, kodwa uma eba namandla kakhulu, angaphazamisa lo mbandela oqondile.

Nakuba igama lingase lizwakale liyesabekayo, i-hyperparathyroidism empeleni iyaphatheka uma ihlonziwe kahle. Abantu abaningi bahlala nezimpawu ezilula iminyaka ngaphandle kokwazi ukuthi yini ebabangela, kungakho ukuqonda le meko kungaba ukukhululeka okukhulu kulabo abagcina bethole izimpendulo.

Iyini i-hyperparathyroidism?

I-Hyperparathyroidism yimeko lapho ama-glands akho e-parathyroid asebenza kanzima kakhulu, ekhipha amazinga amaningi e-parathyroid hormone egazini lakho. Cabanga ngala ma-glands njengabalawuli be-calcium bomzimba wakho - ngokuvamile bagcina inani elifanele le-calcium elihamba egazini lakho.

Uma la ma-glands eba namandla kakhulu, athatha i-calcium eningi emathanjeni akho futhi atshele izinkulungwane zakho ukuba zithathe i-calcium eningi kunokudingekayo. Lokhu kudala umphumela we-domino kulo lonke umzimba wakho, njengoba i-calcium ibalulekile ekusebenzeni kwemisipha, ukuxhumana kwama-nerve, namandla amathambo.

Le meko ithonya cishe umuntu omunye ku-1,000, kanti abesifazane abangaphezu kweminyaka engama-50 bavame ukuxilongwa. Noma kunjalo, ingase ibonakale kunoma iyiphi iminyaka futhi ithonye amadoda, nakuba kungavamile.

Ziyini izinhlobo ze-hyperparathyroidism?

I-hyperparathyroidism eyinhloko yilona uhlobo oluvamile, oluvela uma elinye noma ngaphezulu kwama-glands akho e-parathyroid lithola inkinga ngokwalo. Lokhu kuhlanganisa cishe ama-85% ezimo futhi ngokuvamile kwenzeka ngoba i-tumor encane, enhle ebizwa nge-adenoma yakhiwa ku-gland eyodwa.

I-hyperparathyroidism yesibili ithuthukiswa njengomphumela weminye imiklamo ebangela amazinga e-calcium aphansi emzimbeni wakho. Ama-glands akho e-parathyroid asebenza kanzima ukuze akhokhe, ngokuvamile ngenxa yesifo sezinkulungwane, ukushoda kwe-vitamin D, noma izinkinga zokuthatha i-calcium ezibilisini zakho.

I-hyperparathyroidism yesithathu iyinhlanhla kakhulu futhi ngokuvamile ivela kubantu abanesifo sezinkulungwane isikhathi eside. Kulokhu, ama-glands e-parathyroid asebenze isikhathi eside kangaka kangangokuba awakwazi ukubuyela emsebenzini ojwayelekile ngisho noma inkinga ephambili iphelelwe.

Ziyini izimpawu ze-hyperparathyroidism?

Abantu abaningi abane-hyperparathyroidism elula baye baba nezimpawu ezincane ezivela kancane kancane ezinyangeni noma eminyakeni eminingi. Ungase uqaphele lezi zinguquko zingenela impilo yakho yansuku zonke ngaphandle kokuzixhumanisa ekuqaleni nemeko yezokwelapha.

Izimpawu ezivamile ongazihlangabezana nazo zihlanganisa:

• Ukukhathala okuqhubekayo okungaphuli ngokuphumula
• Ukuzizwa ubuthakathaka noma ukuba namandla amancane kunokujwayelekile
• Ubunzima bokuhlanganisa noma izinkinga zokukhumbula
• Ukushintsha kwemizwelo, kufaka phakathi ukucindezeleka noma intukuthelo
• Ubuthakathaka bemisipha, ikakhulukazi ezinyaweni zakho
• Ubuhlungu bezingxenye zomzimba noma amathambo
• Ukuomile okwandisiwe nokuthamba
• Ukuphefumula noma ukulahlekelwa ukudla
• I-Constipation
• Amatshe ezinkulungwane

Abanye abantu bathuthukisa izimpawu ezinkulu ezidinga ukunakekelwa okusheshayo. Lokhu kuhlanganisa ukudideka okukhulu, ukushaya kwenhliziyo okungajwayelekile, noma ubuhlungu obukhulu besisu, okungabonisa amazinga e-calcium aphezulu kakhulu adinga ukunakekelwa kwezokwelapha ngokushesha.

Ngokuthakazelisayo, abanye abantu abane-hyperparathyroidism bazizwa bephilile ngokuphelele futhi bathola le meko kuphela ngokuhlolwa kwegazi okujwayelekile. Lokhu akusho ukuthi le meko ayithinti umzimba wakho - kusho nje ukuthi izimpawu zakho azikabonakali.

Yini ebangela i-hyperparathyroidism?

I-hyperparathyroidism eyinhloko ngokuvamile ithuthukiswa uma i-tumor encane, enhle ikhula kwenye yama-glands akho e-parathyroid. Le adenoma ihlanganisa cishe ama-80-85% ezimo futhi ngokuvamile ithonya i-gland eyodwa kuphela, nakuba ngezinye izikhathi ama-glands amaningi angase ahileleke.

Ngokungavamile, i-hyperparathyroidism eyinhloko ingase ibe yimphumela:

• Ukuhlanganiswa kwama-glands amaningi e-parathyroid (hyperplasia)
• Izimo zezofu zezofu ezifana ne-multiple endocrine neoplasia (MEN) syndromes
• Ngokungavamile kakhulu, umdlavuza we-parathyroid
• Ukuvezwa kwangaphambili kwemisebe endaweni yentanyeni
• Imithi ethile, ikakhulukazi i-lithium esetshenziswa ekwelapheni isifo se-bipolar

I-hyperparathyroidism yesibili ithuthukiswa uma umzimba wakho ubhekene nezinselele eziqhubekayo ngokulawulwa kwe-calcium. Izimbangela ezivamile zihlanganisa isifo sezinkulungwane esiqhubekayo, ukushoda okukhulu kwe-vitamin D, noma izimo ezivikela izibilisini zakho ekubeni zithathe i-calcium ngendlela efanele.

Ezimeni eziningi, isizathu esiqondile sokuthi kungani umuntu ethuthukisa i-hyperparathyroidism sihlala singaziwa. Ubudala bubonakala buqala indima, njengoba le meko iba yinto evamile njengoba sihlala sikhulile, ikakhulukazi kwabesifazane ngemuva kokuphela kwesikhathi.

Nini okufanele ubone udokotela nge-hyperparathyroidism?

Kufanele ucabange ukuya kudokotela uma uhlangabezana nezimpawu eziningi eziqhubeka amasonto amaningi, ikakhulukazi ukukhathala, ubuthakathaka, ukushintsha kwemizwelo, noma ubuhlungu bamathambo obungenasizathu esicacile. Lezi zimpawu zingathinta kakhulu ikhwalithi yempilo yakho futhi zingabonisa amazinga e-calcium aphezulu.

Hlela i-aphoyintimenti ngokushesha uma uthuthukisa amatshe ezinkulungwane, ikakhulukazi uma lokhu kuyisigameko sakho sokuqala noma uma ube namathembe amaningi. Amatshe ezinkulungwane angaba yisibonakaliso sokuqala se-hyperparathyroidism, futhi ukubamba le meko kusenesikhathi kungavimbela izinkinga zesikhathi esizayo.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nezimpawu ezinkulu ezifana nokudideka okukhulu, ubuhlungu besisu obukhulu, ukushaya kwenhliziyo okungajwayelekile, noma izimpawu zokomile. Lokhu kungabonisa i-hyperparathyroid crisis, edinga ukwelashwa okusheshayo.

Uma unezingozi ezifana nomlando womndeni wezifo ze-endocrine noma ubelokhu uthatha i-lithium isikhathi eside, xoxa ngokuqapha i-calcium njalo nodokotela wakho. Ukubona kusenesikhathi kungavimbela izinkinga futhi kuthuthukise imiphumela yokwelashwa.

Ziyini izingozi ze-hyperparathyroidism?

Izinto eziningi zingandisa amathuba akho okuba ne-hyperparathyroidism, nakuba ukuba nalezi zingozi akusho ukuthi uzoba nale meko. Ukuziqonda kungakusiza wena nodokotela wakho ukuba niqaphele izimpawu zokuqala.

Izingozi ezibaluleke kakhulu zihlanganisa:

• Ukuba owesifazane oneminyaka engaphezu kwama-50, ikakhulukazi ngemuva kokuphela kwesikhathi
• Ukuba nomlando womndeni we-hyperparathyroidism noma izifo ezinhlobene ze-endocrine
• Ukuvezwa kwangaphambili kwemisebe ekhanda lakho noma endaweni yentanyeni
• Ukuthatha imithi ye-lithium yokwelapha isifo se-bipolar
• Ukuba nezifo zezofu ezifana ne-MEN-1 noma i-MEN-2
• Isifo sezinkulungwane esiqhubekayo
• Ukushoda okukhulu, okuqhubekayo kwe-vitamin D
• Izifo ezithile zokugaya ukudla ezithinta ukubamba i-calcium

Ubudala nobulili kudlala indima ebalulekile, le meko icishe ibe yizikhathi ezintathu evamile kwabesifazane kunamadoda. Ingozi iyanda kakhulu ngemuva kokuphela kwesikhathi, mhlawumbe ngenxa yezinguquko ze-hormonal ezithinta ukuguqulwa kwe-calcium.

Ukuba nenye noma ngaphezulu kwezingozi akusho ukuthi uzoba ne-hyperparathyroidism. Abantu abaningi abanezingozi abazuthuthukisi le meko, kanti abanye abangenazo izingozi ezicacile bayenza. Ukuhlola okujwayelekile kungasiza ekubambekeni noma yiziphi izinguquko emazingeni akho e-calcium kusenesikhathi.

Ziyini izinkinga ezingase zenzeke nge-hyperparathyroidism?

Uma ingaphathwa, i-hyperparathyroidism ingabangela izinkinga eziningi ezinkulu njengoba umzimba wakho uqhubeka ubhekene namazinga e-calcium aphezulu ngokuhamba kwesikhathi. Izindaba ezinhle ukuthi ukwelashwa okuqondile kungavimbela izinkinga eziningi futhi kuphinde kubeke ezinye zazo.

Izinkinga ezivamile ongazihlangabezana nazo zihlanganisa:

• I-Osteoporosis nokuwanda kwengozi yokugqwala njengoba i-calcium ithathelwa emathanjeni akho
• Amatshe ezinkulungwane, angase abe khona futhi abangele ubuhlungu obukhulu
• Ukonakala kwezinkulungwane ngenxa yamazinga e-calcium aphezulu ngokuqhubekayo
• Ukungahambi kahle kwenhliziyo ngenxa ye-calcium ephezulu
• I-Peptic ulcers ngenxa yokwanda kokukhiqizwa kwe-acid yesisu
• Ukudideka nokucindezeleka okungathinta impilo yakho yansuku zonke
• I-High blood pressure

Ezimeni ezingavamile, amazinga e-calcium aphezulu kakhulu angabangela i-hyperparathyroid crisis. Leli bhubhane lezokwelapha lingabangela ukushaya kwenhliziyo okungozi, ukudideka okukhulu, i-coma, noma ngisho nokuhluleka kwezinkulungwane. Ngokujabulisayo, le nkinga ayivamile futhi ngokuvamile ivela kuphela uma le meko ingabonakali futhi ingaphathwa isikhathi eside.

Izinkinga eziningi zithuthuka kancane kancane eminyakeni eminingi, okusho ukuthi ukuxilongwa kusenesikhathi nokuphathwa kungazivimbela ngokuphelele. Ngisho noma izinkinga sezivela, eziningi zingathuthuka kakhulu ngokwelashwa okuqondile kwe-hyperparathyroidism ephambili.

I-Hyperparathyroidism ixilongwa kanjani?

Ukuhlonza i-hyperparathyroidism ngokuvamile kuqala ngokuhlolwa kwegazi okuqapha amazinga akho e-calcium ne-parathyroid hormone. Udokotela wakho uzodinga le mihlola uma unezimpawu noma uma ukuhlola okujwayelekile kubonisa amazinga e-calcium aphezulu.

Imihlola ebalulekile yokuxilonga ihlanganisa:

• Amazinga e-calcium e-serum (ngokuvamile aphezulu e-hyperparathyroidism)
• Amazinga e-parathyroid hormone (PTH) (ngokuvamile aphezulu noma ngokungafanele ajwayelekile)
• Amazinga e-vitamin D ukuze kuvinjwe ukushoda
• Imihlola yokusebenza kwezinkulungwane
• Ukuqapha i-calcium ye-urine yamahora angu-24
• I-scan yobubanzi bamathambo ukuze uhlole ukulahleka kwamathambo

Udokotela wakho angase futhi a-ode izifundo zokubonisa ukuthola ukuthi iyiphi i-parathyroid gland enama-overactive. Lokhu kungase kuhlanganise i-scan ekhethekile efana ne-sestamibi scan noma i-ultrasound yentanyeni yakho, ikakhulukazi uma kukhona ukuhlinzwa okucabangelwayo.

Ngezinye izikhathi ukuxilongwa kudinga ukuhlolwa okuphindaphindwayo, njengoba amazinga e-calcium engahlukahluka. Udokotela wakho angase futhi adinge ukukhipha ezinye izimo ezingabangela izimpawu ezifanayo noma amazinga e-calcium aphezulu, njengomdlavuza othile noma imiphumela yemithi.

Iyini ukwelashwa kwe-hyperparathyroidism?

Ukwelashwa kwe-hyperparathyroidism kuncike kuhlobo nobunzima bomeko yakho, kanye nokuthi uhlangabezana yini nezimpawu noma izinkinga. Udokotela wakho uzohlangana nawe ukuze unqume indlela engcono kakhulu ngokusekelwe esimweni sakho somuntu siqu.

Nge-hyperparathyroidism eyinhloko, ukuhlinzwa kuvame ukuba yilona ukwelashwa okuphumelelayo, ikakhulukazi uma unezimpawu noma izinkinga. Le nqubo, ebizwa nge-parathyroidectomy, ihilela ukususa i-gland noma ama-glands asebenza kakhulu futhi inenkambo ephumelelayo enkulu engaphezu kwama-95%.

Uma ukuhlinzwa kungafanele kuwe, izinketho zokuphathwa kwezokwelapha zihlanganisa:

• Imithi efana ne-cinacalcet esiza ekuwehliseni amazinga e-calcium
• I-Bisphosphonates ukuvikela amathambo akho
• Ukuqapha okujwayelekile ngokuhlolwa kwegazi ne-scan yobubanzi bamathambo
• Ukuqinisekisa uketshezi olufanele ukuze usize izinkulungwane zakho zicubungule i-calcium

Nge-hyperparathyroidism yesibili, ukwelashwa kugxile ekunakekeleni isizathu esiphambili. Lokhu kungase kuhilele ukwelapha isifo sezinkulungwane, ukulungisa ukushoda kwe-vitamin D, noma ukuthuthukisa ukubamba i-calcium ezibilisini zakho.

Uhlelo lwakho lokwelashwa luzolungiswa ngokwezidingo zakho, izimpawu, nempilo yakho yonke. Abantu abaningi bazizwa bephilile kakhulu phakathi kwamasonto ambalwa kuya ezinyangeni zokuqala kokwelashwa okuqondile.

Indlela yokuphatha i-hyperparathyroidism ekhaya?

Nakuba ukwelashwa kwezokwelapha kubalulekile nge-hyperparathyroidism, kunezinto eziningi ongazenza ekhaya ukuze usekele impilo yakho futhi mhlawumbe uthuthukise ezinye izimpawu. Lezi zindlela zisebenza kangcono uma zidibaniswa nokukhathalelwa kwezokwelapha okuqondile.

Ukugcina uqinisile kubalulekile kakhulu, njengoba kusiza izinkulungwane zakho zicubungule i-calcium engaphezulu futhi kunganciphisa ingozi yakho yamatshe ezinkulungwane. Hlose iziglasi ezingaba ngu-8-10 zamanzi nsuku zonke, ngaphandle uma udokotela wakho ekweluleka ngenye indlela.

Cabanga ngalezi zindlela zokuphatha ekhaya eziwusizo:

• Hlala usebenza ngokomzimba ngokuzivocavoca okusekelayo impilo yamathambo
• Limita ukudla okunama-calcium amaningi uma udokotela wakho ekweluleka kanjalo
• Gwema i-thiazide diuretics ngaphandle uma ilotshwe, njengoba zingandisa amazinga e-calcium
• Thatha izithasiselo ze-vitamin D kuphela njengoba udokotela wakho ekweluleka
• Lawula ukucindezeleka ngezindlela zokuphumula noma imisebenzi ezwakalayo
• Thola ubuthongo obunempilo ukuze usize ngokukhathala nezimpawu zemizwelo

Gcina uqapha izimpawu zakho encwadini elula, uqaphele noma yiziphi izinguquko noma izibonelo. Lolu lwazi lungaba lubalulekile eqenjini lakho lokunakekelwa kwezokwelapha ekuhleni uhlelo lwakho lokwelashwa.

Khumbula ukuthi ukuphathwa ekhaya kusekela kodwa akukhiphi ukwelashwa kwezokwelapha. Landela njalo izeluleko zokwelapha zokwelapha yakho futhi ugcine zonke i-aphoyintimenti ezicwangcisiwe zokuqapha isimo sakho.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho kungasiza ekuqinisekiseni ukuthi uthola okuningi ngesikhathi sakho nomhlinzeki wakho wezokunakekelwa kwezokwelapha. Qala ngokubhala zonke izimpawu zakho, ngisho noma zibonakala zingaxhunyanisiwe, kufaka phakathi ukuthi zaqala nini nokuthi zikuthinta kanjani impilo yakho yansuku zonke.

Letha uhlu oluphelele lwazo zonke imithi, izithasiselo, nama-vitamin owaqaphela, njengoba ezinye zingathinta amazinga e-calcium noma zisebenzisane nokwelashwa. Faka imithi yokuthengwa ngaphandle komthetho nama-supplements e-herbal, njengoba lezi ngezinye izikhathi zingase zibe yiyona.

Lungiselela lezi zindaba ezibalulekile ngovakatshi wakho:

• Isikhathi sokuqala izimpawu zakho nokuthi zishintshe kanjani
• Umlando wakho womndeni wezokwelapha, ikakhulukazi noma yiziphi izifo ze-endocrine
• Imiphumela yokuhlolwa kwegazi yakamuva uma unayo
• Noma yiziphi izifundo zokubonisa zakamuva noma izinqubo zezokwelapha
• Imibuzo mayelana nezinketho zokwelashwa nokuthi yini okulindelekile
• Ulwazi mayelana nokumbozwa kwakho kwe-insurance ngokwelashwa okungenzeka

Cabanga ukuletha umngani othembekile noma ilungu lomndeni ukuze likusize ukukhumbula ulwazi olubalulekile oluxoxwe ngesikhathi se-aphoyintimenti. Bangase futhi banikeze ukwesekwa futhi basize ekuvikeleni izidingo zakho.

Unganqikazi ukubuza imibuzo mayelana nanoma yini ongayiqondi. Iqembu lakho lokunakekelwa kwezokwelapha lifuna ukukusiza uzizwe ulwazi futhi ukhululekile ngohlelo lwakho lokwelashwa.

Iyini into ebalulekile mayelana ne-hyperparathyroidism?

I-Hyperparathyroidism yimeko ephatekayo kakhulu ethinta ukulawulwa kwe-calcium komzimba wakho, futhi nakuba izimpawu zingase zibe yinto ecasulayo, abantu abaningi bazizwa bephilile kakhulu uma bethola ukwelashwa okuqondile. Okubalulekile ukuqaphela izimpawu ezivame ukuba zingezona ezicacile nokuthola ukuhlolwa kwezokwelapha okuqondile.

Ukuxilongwa kusenesikhathi nokuphathwa kungavimbela izinkinga ezinkulu futhi ngokuvamile kuphinde kubeke imiphumela eminingi emathanjeni akho, ezinkulungwini, nempilo yakho yonke. Kungaba ngokuhlinzwa noma ukuphathwa kwezokwelapha, izinketho zokwelashwa ziphumelela kakhulu kubantu abaningi.

Uma ucindezela ukuthi ungase ube ne-hyperparathyroidism ngokusekelwe ezimpawini eziqhubekayo ezifana nokukhathala, ubuthakathaka, ukushintsha kwemizwelo, noma ubuhlungu bamathambo, unganqikazi ukuxoxa ngalokhu nodokotela wakho. Ukuhlolwa kwegazi okulula kungaqala inqubo yokuxilonga futhi mhlawumbe kunikeze izimpendulo ezithuthukisa kakhulu ikhwalithi yempilo yakho.

Khumbula ukuthi ukuba ne-hyperparathyroidism akukukhombi, futhi ngokwelashwa okuqondile, abantu abaningi babuyela emisebenzini yabo evamile futhi bazizwa bephilile kakhulu kunangaphambi kokuxilongwa.

Imibuzo evamile ebuzwayo mayelana ne-hyperparathyroidism

Ingaphela yodwa i-hyperparathyroidism?

I-hyperparathyroidism eyinhloko ngokuvamile ayipheli ngaphandle kokwelashwa, njengoba ngokuvamile ibangelwa yi-tumor enhle noma i-gland enkulu eqhubeka ikhiqiza i-hormone engaphezulu. Noma kunjalo, i-hyperparathyroidism yesibili ingathuthuka uma isizathu esiphambili, njengokushoda kwe-vitamin D noma isifo sezinkulungwane, siphathwa ngempumelelo. Abantu abaningi abane-hyperparathyroidism eyinhloko bazodinga ukuhlinzwa noma ukuphathwa okuqhubekayo kwezokwelapha ukuze bagcine amazinga abo e-calcium ajwayelekile.

Ingozi yini ukuhlinzwa kwe-hyperparathyroidism?

I-Parathyroidectomy ngokuvamile ibhekwa njengenqubo ephephile enenkambo ephumelelayo enkulu engaphezu kwama-95%. Ukuhlinzwa ngokuvamile kwenziwa njengenqubo yokuphuma noma ngokuhlala esibhedlela esifushane. Nakuba zonke izihlinzwa zithwala ingozi ethile, izinkinga ezinkulu azivamile futhi abantu abaningi bayaphulile ngokushesha. Udokotela wakho uzoqonda izingozi nezinzuzo ezithile ngokusekelwe esimweni sakho sempilo somuntu siqu.

Ngingadinga yini izithasiselo ze-calcium ngemuva kokuhlinzwa kwe-parathyroid?

Abantu abaningi badinga izithasiselo ze-calcium zesikhashana ngemuva kokuhlinzwa kwe-parathyroid njengoba ama-glands abo asaleyo alungisa emsebenzini ojwayelekile. Lokhu ngokuvamile kuyisikhashana, ihlala amasonto ambalwa kuya ezinyangeni ezimbalwa. Udokotela wakho uzoqapha amazinga akho e-calcium eduze ngemuva kokuhlinzwa futhi alungise izithasiselo zakho njengoba kudingeka. Abanye abantu bangadinga izithasiselo ze-calcium ne-vitamin D isikhathi eside, kodwa lokhu kuyahlukahluka kumuntu ngamunye.

Ingasiza yini ukushintsha ukudla ekulawuleni i-hyperparathyroidism?

Nakuba ukudla kudwa kungakwazi ukwelapha i-hyperparathyroidism, ukuguqulwa kokudla okuthile kungasiza ekulawuleni izimpawu nokusekela ukwelashwa kwakho. Udokotela wakho angase akweluleke ukulinganisela ukudla kwe-calcium nokuhlala uqinisile. Noma kunjalo, ungenzi izinguquko ezinkulu zokudla ngaphandle kwesiqondiso sezokwelapha, njengoba izidingo zakho ze-calcium zingase zibe ezahlukene kunokulindelekile. Ukudla okulinganiselayo okune-calcium eyanele kodwa engekho eningi, kanye namazinga afanele e-vitamin D, ngokuvamile kunconywa.

Kuthatha isikhathi esingakanani ukuzizwa ukhulu ngemuva kokwelashwa kwe-hyperparathyroidism?

Abantu abaningi baqaphela ukuthuthuka emazingeni amandla nasemizwelweni phakathi kwamasonto ambalwa kokwelashwa okuphumelelayo, nakuba ukululama kwamathambo kuthatha isikhathi eside. Ngemuva kokuhlinzwa, abantu abaningi bazizwa bephilile kakhulu phakathi kwenyanga eli-1-3 njengoba amazinga abo e-calcium eqondile. Ezinye izimpawu, njengokuthuthuka kobubanzi bamathambo, kungase kuthathe izinyanga eziyi-6-12 noma isikhathi eside ukuze kubonise ukululama okuphelele. Wonke umuntu uyahlala ngesivinini sakhe, ngakho-ke ukubambelela enkambweni yokululama kubalulekile.