Bone mineral density in hyperthyroidism

Karga, Helen; Papapetrou, Peter D.; Korakovouni, A.; Papandroulaki, Fotini; Polymeris, Antony; Pampouras, George

doi:10.1111/j.1365-2265.2004.02110.x

Cited by 66 publications

(34 citation statements)

References 16 publications

(51 reference statements)

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“…Several studies have shown that hyperthyroidism results in bone resorption (1,2), whereas successful treatment of the disorder improves bone mineral density (BMD) (2,3). Moreover, subclinical hyperthyroidism, i.e., suppression of thyroid-stimulating hormone (TSH) without an elevation in thyroid hormones, has also been associated with bone loss (2).…”

Section: Introductionmentioning

confidence: 99%

Low TSH levels are not associated with osteoporosis in childhood

Papadimitriou

Papadimitriou²,

Papadopoulou³

et al. 2007

eur j endocrinol

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Introduction: A recent study on TSH receptor (TSHR) null mice suggested that skeletal loss occurring in hyperthyroidism is caused by the low TSH rather than high thyroid hormone levels. The aim of this study was to examine whether low TSH results in osteoporosis in the human. Subjects and methods: We determined bone mineral density (BMD) and markers of bone metabolism in two male siblings aged 9.8 and 6.8 years with isolated TSH deficiency, due to a mutation of the TSH b-subunit gene. BMD was measured in the lumbar spine (L1-L4) by dual-energy X-ray absorptiometry. Laboratory investigation included the determination of serum calcium, phosphate, 25-hydroxyvitamin D, parathyroid hormone concentrations, and urine calcium (Ca)/creatinine (Cr) ratio. Osteoblast activity was measured by serum bone alkaline phosphatase and osteocalcin levels, and osteoclast activity by urine cross-linked amino-terminal, carboxy-terminal telopeptides of type I collagen and deoxypyridinoline concentrations. Results: BMD of both patients was within the normal range for age and sex; z-scores were K0.55 and K0.23 for patients 1 and 2 respectively. Serum calcium, phosphate, urine Ca/Cr ratio, and specific markers of bone metabolism were also within normal range. Conclusion: In childhood, chronic extremely low TSH levels, in the face of normal thyroid hormone levels, are not related to bone loss.

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Section: Introductionmentioning

confidence: 99%

Low TSH levels are not associated with osteoporosis in childhood

Papadimitriou

Papadimitriou²,

Papadopoulou³

et al. 2007

eur j endocrinol

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“…Hyperthyroidism in adulthood, on the other hand, is associated with increased bone turnover and a reduction in BMD at various skeletal sites due to increased cortical porosity and accelerated bone loss (7)(8)(9)(10)(11). Interestingly, population studies have shown that both hypo-and hyper-thyroidism in adults may be associated with an increased fracture risk (12).…”

Section: Introductionmentioning

confidence: 99%

Thyroid hormone status within the physiological range affects bone mass and density in healthy men at the age of peak bone mass

Roef

Lapauw

Goemaere

et al. 2011

European Journal of Endocrinology

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Context: The hormonal factors involved in the regulation of peak bone mass (PBM) in men have not been fully investigated. Apart from gonadal steroids and somatotropic hormones, thyroid hormones are known to affect bone maturation and homeostasis and are additional candidate determinants of adult bone mass. Objective: We aimed to investigate between-subject physiological variation in free and total thyroid hormone concentrations, TSH, and thyroid binding globulin (TBG) in relation to parameters of bone mass, geometry, and mineral density in healthy men at the age of PBM. Design and setting: We recruited 677 healthy male siblings aged 25-45 years in a cross-sectional, population-based study. Areal and volumetric bone parameters were determined using dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). Total and free thyroid hormones, TBG, and TSH were determined using immunoassays. Results: Free and total thyroid hormone concentrations were inversely associated with bone mineral density (BMD) and bone mineral content (BMC) at the hip and total body (free triiodothyronine (FT 3 ), total T 3 (TT 3 ), and total T 4 (TT 4 )) and at the spine (FT 3 ). TBG was negatively associated with BMC and areal BMD at all sites. At the radius, cortical bone area was inversely associated with TT 3 , TT 4 , and TBG, and trabecular bone density was inversely associated with free thyroxine, TT 4 , and TBG. We observed inverse associations between cortical bone area at the mid-tibia and FT 3 , TT 3 , TT 4 , and TBG. No associations between TSH and DXA or pQCT measurements were found. Conclusion: In healthy men at the age of PBM, between-subject variation in thyroid hormone concentrations affects bone density, with higher levels of FT 3 , TT 3 , TT 4 , and TBG being associated with less favorable bone density and content.

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“…Thyroid hormones exert a major effect on bone metabolism by accelerating bone turnover and bone loss [5,6]. L-T4 therapy may also be accompanied by iatrogenic latent or even overt hyperthyroidism.…”

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confidence: 99%