Effects of Levothyroxine on Bone Mineral Density, Muscle Force, and Bone Turnover Markers: A Cohort Study

Abstract

There was little evidence of adverse LT(4) effects on bone; however, premenopausal women with DTC might be at risk for reduced vBMD in their ultradistal radii.

Bone mineral density in treated at a young age for differentiated thyroid cancer after Chernobyl female patients on TSH-suppressive therapy receiving or not Calcium-D3 supplementation

“…A systematic review of 21 studies of the effect of L-T4 therapy on BMD found that post-menopausal women with subclinical hyperthyroidism are at higher risk for developing osteoporosis, while men and premenopausal women are not [10]. Concordantly, overall adverse effect of L-T4 was not found in a recent study, yet peri-menopausal women with DTC might be at risk for reduced BMD at ultradistal radii also confirmed by the higher level of bone resorption marker (C-terminal telopeptide of type 1 collagen) as compared with controls [12]. A prospective study also demonstrated that TSH suppression after surgery for papillary thyroid carcinoma had adverse effects on BMD in women aged above 50 years but not in younger patients [14].…”

“…Overt hyperthyroidism is associated with an increased risk of osteoporosis, while whether subclinical hyperthyroidism affects the skeleton is under debate [7,8]. Effects of the latter on bone mineral density (BMD) have been addressed in a number of studies with somewhat controversial results [9][10][11][12][13][14][15]. The current understanding is that subclinical hyperthyroidism is a risk factor for osteoporosis in postmenopausal women but not in premenopausal women or male patients [10].…”

Determinants of successful ablation and complete remission after total thyroidectomy and 131I therapy of paediatric differentiated thyroid cancer

“…DTC patients who do not achieve CR are generally treated with TSH suppressive therapy, which in the long term is associated with, among others, undesired cardiovascular side effects [16][17][18][19] and a possible reduction of bone mass [20,21]. However, once CR is reached, TSH levels in the lower half of the normal range can be restored [22,23].…”

Radioiodine Treatment and Thyroid Hormone Suppression Therapy for Differentiated Thyroid Carcinoma: Adverse Effects Support the Trend toward Less Aggressive Treatment for Low-Risk Patients

“…Postmenopausal women with DTC may suffer from bone loss [53,61,62,63], while THST does not - or to a much lesser extent - affect BMD in premenopausal women and men [64,65]. Of female DTC patients randomized to THST (but not those randomized to a TSH in the normal range), patients of 50 years and older had a significantly decreased BMD within 1 year, which was not applicable to those under 50 years of age [61].…”