Reduced Bone Mineral Content in Totally Thyroidectomized Patients: Possible Effect of Calcitonin Deficiency*

McDermott, Michael T.; Kidd, Gerald S.; Blue, Peter W.; Ghaed, Victor N.; Hofeldt, Fred D.

doi:10.1210/jcem-56-5-936

Cited by 72 publications

(27 citation statements)

References 25 publications

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“…Well-differentiated thyroid cancer would not be expected to affect bone mass. Theoretically, loss of calcitonin as a result of complete ablation of the thyroid gland could contribute to bone loss (27,31). Good longitudinal studies are needed.…”

Section: Resultsmentioning

confidence: 99%

Possible Limited Bone Loss with Suppressive Thyroxine Therapy Is Unlikely to Have Clinical Relevance

Müller

Bayley²,

Harrison³

et al. 1995

Thyroid

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To determine the effect of suppressive doses of thyroxine (T4) on bone mass, we studied 50 women on suppressive doses of T4 for 3-27 years (mean of 11 years). Twenty-five had nontoxic goiter and 25 had well-differentiated thyroid carcinoma. Fifty controls were matched for age, menopausal status, and body mass index. Bone mineral density (BMD) was measured in the lumbar spine (LS), femoral neck (FN), trunk (TK), and extremities (EXT) by dual-energy X-ray absorptiometry (DXA). In addition, the trunk area was measured by neutron activation analysis and recorded as a calcium bone index (CaBI). Twenty-one patients were restudied with DXA measurements at a mean of 1.5 +/- 0.5 (1 SD) years. The total population of 50 patients showed no difference in bone mass from controls. In patients with nontoxic goiter, there was no evidence of any loss in bone mass. Cancer patients showed insignificant reductions of 2-5% in BMD of LS, FN, and TK and a significant 5% reduction in BMD of EXT, compared to controls, and a 12% reduction in CaBI compared to goiter patients. Cancer patients had a slightly higher (p < 0.001) mean daily dose of T4 than goiter patients (0.23 vs 0.15 mg/day) but had a similar degree of TSH suppression. BMD and CaBI values did not correlate with free T4 index) with the daily T4 dose, accumulative dose, or with duration of T4 therapy. There were no significant changes in bone mass in either goiter or cancer patients restudied after a mean of 1.5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Resultsmentioning

confidence: 99%

Possible Limited Bone Loss with Suppressive Thyroxine Therapy Is Unlikely to Have Clinical Relevance

Müller

Bayley²,

Harrison³

et al. 1995

Thyroid

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“…(167,168) or reduced (169,170) bone mineral content in the radius (167)(168)(169)(170) and spine (168,169). Similarly, longitudinal studies of up to 2 yr duration have reported rates of radial bone loss which were accelerated (165) or normal (171) compared to control groups.…”

Section: Ct and The Development Of Osteoporosismentioning

confidence: 99%

The Role of Calcitonin in the Development and Treatment of Osteoporosis*

McDermott

Kidd

1987

Endocrine Reviews

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CT is a peptide hormone produced predominantly by thyroid C cells and probably to a lesser extent by extrathyroidal tissues. Although its physiological function has not yet been established, it is a pharmacological inhibitor of osteoclastic bone resorption. There is currently no convincing evidence that naturally occurring or iatrogenic CT deficiency is involved in the pathogenesis of osteoporosis; however, a selective examination of patients with various rates of bone turnover would help to resolve this issue. As a pharmacological inhibitor of bone resorption, CT has potential usefulness in the therapy of osteoporosis. CT has been shown to stabilize or modestly increase indices of cortical and trabecular bone mass and total body calcium when administered to patients with established osteoporosis for periods of 1-2 yr. The increments in bone mass seen in some studies appear to be transient and are likely due to reductions in bone resorption with bone formation remaining unaffected until remodeling spaces are filled. The duration and magnitude of these increases are probably limited by the eventual decline in bone formation as remodeling equilibrium is reestablished. Therefore, reduction in the rate of bone loss with maintenance of the existing skeletal mass, rather than significant sustained increases in bone mass, should be considered the most realistic therapeutic goal with this agent. Whether or not a reduction in the rate of bone loss persists for longer periods needs further evaluation as does the important issue of subsequent fracture rates. The identification of patients with increased bone resorption rates (high turnover osteoporosis) should help provide a basis for more selective treatment of those patients who would be most likely to respond to this form of therapy. Whether there is additional benefit to using intermittent CT concurrently or sequentially with bone formation stimulating agents (coherence therapy) also needs to be explored. CT may also be of benefit in the prevention of osteoporosis, particularly in postmenopausal women who are unable or unwilling to take estrogen replacement. These potential benefits must be weighed carefully against the current cost of CT and the inconvenience of it having to be given by injection, problems which should be solved by future research.

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“…Some authors have found a reduced (2,3) and others a normal (4,5) bone mineral den¬ sity compared with age-matched controls. In one study the results suggested that the bone mineral density was diminished in postmenopausal thyroi¬ dectomized patients (6).…”

mentioning

confidence: 99%

Bone mass in totally thyroidectomized patients. Role of calcitonin deficiency and exogenous thyroid treatment

Anseán¹,

Mautalén²,

Corrêa

et al. 1991

Acta Endocrinologica

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Calcitonin has an uncertain role in the preservation of bone mass. Since surgical thyroidectomy abolishes the calcitonin secretion in response to calcium, the bone mineral density at the radius shaft and lumbar spine was measured in 60 patients (5 men, 16 premenopausal, 34 postmenopausal euparathyroid and 5 postmenopausal hypoparathyroid women) who had undergone near total thyroidectomy for thyroid cancer 8.4\m=+-\0.7 years before the study. All patients were maintained on suppressive doses of thyroid hormones. Bone mineral density values of the radius shaft (expressed as Z-score) of 34 postmenopausal euparathyroid women was significantly below the normal average (mean \m=+-\sem = \ m= -\ 0 . 5 9 \m=+-\0.2; p=0.01). Bone mineral density of the lumbar spine was also below the normal average although the difference only approached statistical significance (\m=-\0.36\m=+-\0.2; 0.05

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Reduced Bone Mineral Content in Totally Thyroidectomized Patients: Possible Effect of Calcitonin Deficiency*

Cited by 72 publications

References 25 publications

Possible Limited Bone Loss with Suppressive Thyroxine Therapy Is Unlikely to Have Clinical Relevance

Possible Limited Bone Loss with Suppressive Thyroxine Therapy Is Unlikely to Have Clinical Relevance

The Role of Calcitonin in the Development and Treatment of Osteoporosis*

Bone mass in totally thyroidectomized patients. Role of calcitonin deficiency and exogenous thyroid treatment

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