Modeling the effect of levothyroxine therapy on bone mass density in postmenopausal women: a different approach leads to new inference

Mohammadi, Babak; Haghpanah, Vahid; Tavangar, Seyed Mohammad; Larijani, Bagher

doi:10.1186/1742-4682-4-23

Cited by 13 publications

(9 citation statements)

References 30 publications

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“…Medications included in the study as potential confounders were those that are considered to have a protective effect on bone mineral density such as beta blockers,10 thiazides,11–14 calcium channel blockers,15 ACE inhibitors,16, 17 angiotensin II receptor antagonists and statins 18–20. Medications which can potentially reduce bone mineral density and hence increase the risk of osteoporotic type fractures were also included and these include anti‐epileptic medications,21–23 antiparkinsonian drugs, antipsychotic medications,24 antidepressants,24–27 anxiolytics,16, 24 glucocorticoids,26, 28–38 thyroxine26, 39–41 and NSAIDS 42, 43. The adjustment for multiple drug use was used as a measure of comorbidity.…”

Section: Methodsmentioning

confidence: 99%

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

McGowan

Bennett

Barry

2010

Pharmacoepidemiology and Drug

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Section: Methodsmentioning

confidence: 99%

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

McGowan

Bennett

Barry

2010

Pharmacoepidemiology and Drug

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“…While the majority of reports concluded that suppressive LT4 therapy has no deteriorating effect on BMD,[ 4 5 6 7 8 ] some studies reported opposite conclusions in which LT4 suppressive therapy showed a slightly negative effect on bone metabolism. [ 9 10 11 12 13 ] Several of these studies evaluated the influence of menopausal status and LT4 dose as well. [ 9 10 11 ]…”

Section: Introductionmentioning

confidence: 99%

Change of Bone Mineral Density and Biochemical Markers of Bone Turnover in Patients on Suppressive Levothyroxine Therapy for Differentiated Thyroid Carcinoma

Kim

Hong

et al. 2015

J Bone Metab

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Untreated hyperthyroidism and high-dose thyroid hormone are associated with osteoporosis, and increased bone mineral density (BMD) has been demonstrated in postmenopausal females with hypoparathyroidism. Studies on the effect of suppressive levothyroxine (LT4) therapy on BMD and bone metabolism after total thyroidectomy in patients with differentiated thyroid carcinoma have presented conflicting results, and few studies in relation to the status of hypoparathyroidism have been studied. One hundred postmenopausal women and 24 premenopausal women on LT4 suppression therapy were included in this study. BMD of lumbar spine and femur and bone turnover markers were measured at the baseline and during the follow-up period up to 18 months using dual energy X-ray absorptiometry. Biochemical marker of bone resorption was measured by urine deoxypyridinoline and bone formation by serum osteocalcin. The age ranged from 36 to 64 years old. Thyroid stimulating hormone (TSH) was suppressed during the study. The results showed that BMD of femur and lumbar spine were not significantly changed in both pre- and postmenopausal women except femur neck in postmenopausal women without hypoparathyroidism. Patients with hypoparathyroidism had higher BMD gain than those without hypoparathyroidism in total hip (1.25 vs. -1.18%, P=0.015). Biochemical markers of bone turnover, serum osteocalcin, and urine deoxypyridinoline did not show significant change. In conclusion, patients with well differentiated thyroid carcinoma are not at a great risk of bone loss after LT4 suppressive therapy. The state of hypoparathyroidism is associated with increased BMD, particularly in postmenopausal women.

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“…Suppressive therapy can cause loss of bone mass 27. Therefore, the fact that thyroxine is prescribed uncritically is reason for concern.…”

Section: Discussionmentioning

confidence: 99%

Forgotten drugs: long-term prescriptions of thyroid hormones – a cross-sectional study

Viniol¹,

Bösner²,

Baum³

et al. 2013

IJGM

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BackgroundThyroid hormones are among the most prescribed drugs in Germany. Although iodine supply has been improving in the last decade, annual prescriptions for thyroid hormones are rising. The aim of this study was to provide prevalence of thyroid hormone prescribing and to explore reasons for thyroid hormone prescription in primary care settings.Study designA cross-sectional study.MethodsData collection took place in six general practitioner (GP) practices in Hesse, Germany. We used the records of six GP practices to estimate prevalence of thyroid hormone prescribing. All patients who received a prescription of the active ingredient levotyroxine during the preceding 3 months were mailed a study invitation. A proportion of the identified patients were interviewed. In addition, demographical data and all medical findings related to thyroid disease were recorded.ResultsOn average, 9.2% (SD 4.6) of all patients from participating practices were taking thyroid hormones. The majority were female (82.5%). In 47.7% of the study participants, the GP’s diagnosis, according to their records, was nonexistent. In 13.6% of cases, the documentation of the diagnostic information was incomplete. While 25% of interviewed patients with high educational background initiated further diagnostic investigation, only 4.4% of the patients with lower education did so.ConclusionIn the majority of patients treated with thyroid hormones, doctors had not documented the precise indication for prescription.

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Modeling the effect of levothyroxine therapy on bone mass density in postmenopausal women: a different approach leads to new inference

Cited by 13 publications

References 30 publications

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

Change of Bone Mineral Density and Biochemical Markers of Bone Turnover in Patients on Suppressive Levothyroxine Therapy for Differentiated Thyroid Carcinoma

Forgotten drugs: long-term prescriptions of thyroid hormones – a cross-sectional study

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Modeling the effect of levothyroxine therapy on bone mass density in postmenopausal women: a different approach leads to new inference

Cited by 13 publications

References 30 publications

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

Prescribing of anti‐osteoporotic therapies following the use of proton pump inhibitors in general practice

Change of Bone Mineral Density and Biochemical Markers of Bone Turnover in Patients on Suppressive Levothyroxine Therapy for Differentiated Thyroid Carcinoma

Forgotten drugs: long-term prescriptions of thyroid hormones &ndash; a cross-sectional study

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Forgotten drugs: long-term prescriptions of thyroid hormones – a cross-sectional study