Bone mineral content in hypothyroid male patients with hormone replacement: A 3-year study

Toh, Sang H.; Brown, Paul H.

doi:10.1002/jbmr.5650050507

Cited by 54 publications

(17 citation statements)

References 15 publications

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“…Stall et al (16) found an accelerated rate of bone toss only in women who had low TSH levels, whereas Toh and Brown (17) Our longitudinal study differs from the others since we examined euthyroid subjects receiving suppressive doses of L-thyroxine. In agreement with other studies, we have shown that this drug treatment induces a decrease in bone mass, even though there are some discrepancies in the skeletal site preferentially affected.…”

Section: Discussionmentioning

confidence: 88%

Longitudinal study of bone loss after thyroidectomy and suppressive thyroxine therapy in premenopausal women

Pioli

Pedrazzoni

Palummeri

et al. 1992

Acta Endocrinologica

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Passeri M. Longitudinal study of bone loss after thyroidectomy and suppressive thyroxine therapy in premenopausal women. Acta Endocrinol 1992:126:238-42. The effects of suppressive doses of L-thyroxine on the appendicular and axial bone mineral content were followed for 12\p=n-\36 months after total or subtotal thyroidectomy in 15 premenopausal women. Compared to age-matched controls, these patients had a more marked bone loss of the spinal bone mineral content (2.6 \m=+-\1.9% vs 0.2 \m=+-\ 1.2% per year). The changes in radial cortical bone density were not significantly different from the control group. We conclude that when a suppressive therapy with L-thyroxine is necessary the rate of bone loss should be monitored at regular intervals.Suppressive doses of L-thyroxine. a common form of therapy after thyroidectomy for different thyroid dis¬ eases, prevent further growth of abnormal tissue. Patients taking suppressive doses of L-thyroxine fre¬ quently have elevated serum thyroxine and free thyrox¬ ine concentrations, but serum triiodothyronine levels are within the normal range ( 1 ). These patients do not usually show biological or clinical signs of hyperthyroidism, but controversy exists as to whether such patients might have adverse tissue effects (2, 3). Thyroid hor¬ mones have important effects on bone metabolism and hyperthyroidism alters the bone remodelling activity and increases mainly cortical bone porosity, even if trabecular volume and cortical width may also be reduced (4). Cross-sectional studies have shown a reduction in bone density after prolonged suppression of the pituitary-thyroid axis with L-thyroxine (5-7) and marked bone mineral changes have been observed also under replacement therapy in hypothyroidism (8,9).The bone effects of thyroid hormone therapy could be particularly important in thyroidectomized patients in whom a decrement of calcitonin secretion, a potentially protective factor for bone (10), occurs.The aim of this longitudinal study was to assess the effects of suppressive doses of L-thyroxine on the appen¬ dicular and axial bone mineral content in premenopau¬ sal thyroidectomized women. Materials and methodsThe subjects for the study were chosen from all the premenopausal women consecutively admitted during the course of one year for thyroidectomy and were candidates for suppressive therapy. Criteria for exclusion were the presence of other medical disorders, the use of drugs known to interfere with bone and mineral metab¬ olism or previous treatment with thyroid hormones.Fourteen premenopausal women (age: 43 ±6.8 years) undergoing thyroidectomy for goiter (N = 6) and carcinoma (N = 8) were recruited. All the patients were euthyroid at the time of the study. Each subject gave written informed consent to the study.Ten patients underwent near-total thyroidectomy and four subtotal thyroidectomy. All were normally men¬ struating before and throughout the study. After surgery the women began a suppressive therapy with L-thyrox¬ ine. The initial dose was 150¿ug/day (3 ¿tg-kg^-day-1...

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Section: Discussionmentioning

confidence: 88%

Longitudinal study of bone loss after thyroidectomy and suppressive thyroxine therapy in premenopausal women

Pioli

Pedrazzoni

Palummeri

et al. 1992

Acta Endocrinologica

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“…Several studies have reported that short-term thyroid replacement to the euthyroid state in hypothyroid patients produces loss of both cortical and trabecular bone [4, 12, 18]. However, long-term follow-up studies on these subjects have not been reported.…”

Section: Discussionmentioning

confidence: 98%

“…Toh and Brown [18]conducted a 3-year follow-up study on 35 white male patients, including 8 patients with primary hypothyroidism and 16 with Graves’ disease after iodine-131 treatment. BMC was measured only at the distal third of the radius, and no differences were found compared to control at baseline.…”

Section: Discussionmentioning

confidence: 99%

Effect of Subclinical Hypothyroidism and Obesity on Whole-Body and Regional Bone Mineral Content

Bertoli

Fusco²,

Andréoli³

et al. 2002

Horm Res Paediatr

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Objective: The present investigation was aimed to evaluate the effect of subclinical hypothyroidism and obesity on bone mineral content (BMC) in different body segments. Methods: Thirty-two premenopausal women (age: 37 ± 9.9 years), with a wide range in body mass index (BMI), were studied. Subclinical hypothyroidism was defined by a basal TSH ≧4 µU/l and/or a TRH-stimulated peak ≧30 µU/l. For each subject, weight, height, BMI (weight/height²) and the waist/hip ratio were measured. Total BMC, total bone mineral density (BMD), leg BMC, leg BMD, trunk BMC, trunk BMD, arm BMC and arm BMD were determined using dual-energy X-ray absorptiometry. Thyroid function (basal and TRH-stimulated TSH, free T₃ and free T₄) were determined from fasting blood samples for all subjects. Results: Anova was conducted within all the groups to observe the effect of thyroid status and/or obesity on BMC and BMD. There was no statistical difference for age. Total BMC was affected by obesity (p < 0.05) but not by thyroid status, BMD of the legs was significantly influenced both by thyroid function and obesity (p < 0.01); total BMD was affected by hypothyroid status (p < 0.05). A direct relationship between leg BMD and TSH was demonstrated. Conclusion: Subclinical thyroid hypofunction and obesity seem to affect BMD differently in the body segments. An influence of gravitational force seems necessary in order to make evident the effect of subclinical hypothyroidism on bone. A condition of subclinical hypothyroidism should be considered when evaluating subjects for osteoporosis, since a BMD measured at the femoral neck may induce underestimation of initial osteoporosis.

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“…It is unclear whether replacement therapy with doses of thyroid hormone that maintains TSH within the physiologic range affects bone mass. Treatment of hypothyroid patients with replacement doses of thyroid hormone has been reported to either decrease [143][144][145] or to have no effect [146,147] on bone mineral density. A meta-analysis concluded that replacement therapy is associated with decreased bone mineral density at the spine and hip in premenopausal, but not postmenopausal, women [135].…”

Section: Hypothyroidismmentioning

confidence: 99%

Thyroid Hormone and the Skeleton

Baran

2013

Osteoporosis

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Bone mineral content in hypothyroid male patients with hormone replacement: A 3-year study

Cited by 54 publications

References 15 publications

Longitudinal study of bone loss after thyroidectomy and suppressive thyroxine therapy in premenopausal women

Longitudinal study of bone loss after thyroidectomy and suppressive thyroxine therapy in premenopausal women

Effect of Subclinical Hypothyroidism and Obesity on Whole-Body and Regional Bone Mineral Content

Thyroid Hormone and the Skeleton

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