Morbidity in patients on <scp>l</scp>‐thyroxine: a comparison of those with a normal TSH to those with a suppressed TSH

Leese, Graham; Jung, R. T.; Guthrie, C. C.; Waugh, Norman; Browning, M. C. K.

doi:10.1111/j.1365-2265.1992.tb01480.x

Cited by 119 publications

(55 citation statements)

References 17 publications

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“…An older study (18) found no significant overall increase in the rate of fracture among 306 women with treated hyperthyroidism compared with age-matched controls. A more recent study (20) found that thyroid hormone users with low TSH levels (Ͻ0.05 mIU/L) did not have an increased rate of hospitalization for fracture compared with persons who had normal TSH levels. Of note, in that study, the risk for hospitalization because of fracture was approximately twofold greater in persons older than 65 years of age with low TSH levels.…”

Section: Discussionmentioning

confidence: 96%

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

et al. 2001

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Section: Discussionmentioning

confidence: 96%

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

et al. 2001

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“…In a study based upon interviews of 300 white postmenopausal women, no increased fracture risk was found in women taking L-T4 (101). In a study of 1180 patients treated with L-T4, the overall fracture rate in women over 65 years after 5 years was 2.5% in those with low TSH, and 0.9% in those with normal TSH values; the difference was not statistically significant (102).…”

Section: Bone Structure and Metabolismmentioning

confidence: 91%

Subclinical hyperthyroidism: clinical features and treatment options

et al. 2005

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Subclinical hyperthyroidism appears to be a common disorder. It may be caused by exogenous or endogenous factors: excessive TSH suppressive therapy with L-thyroxine (L-T4) for benign thyroid nodular disease, differentiated thyroid cancer, or hormone over-replacement in patients with hypothyroidism are the most frequent causes. Consistent evidence indicates that 'subclinical' hyperthyroidism reduces the quality of life, affecting both the psycho and somatic components of well-being, and produces relevant signs and symptoms of excessive thyroid hormone action, often mimicking adrenergic overactivity. Subclinical hyperthyroidism exerts many significant effects on the cardiovascular system; it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias, and with an increased left ventricular mass, often accompanied by an impaired diastolic function and sometimes by a reduced systolic performance on effort and decreased exercise tolerance. It is well known that these abnormalities usually precede the onset of a more severe cardiovascular disease, thus potentially contributing to the increased cardiovascular morbidity and mortality observed in these patients. In addition, it is becoming increasingly apparent that subclinical hyperthyroidism may accelerate the development of osteoporosis and hence increased bone vulnerability to trauma, particularly in postmenopausal women with a pre-existing predisposition. Subclinical hyperthyroidism and its related clinical manifestations are reversible and may be prevented by timely treatment.European Journal of Endocrinology 152 1-9

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“…A study of 1100 patients on T4 replacement in Scotland found no significant differences in fracture rates in patients on T4 when compared with the general population (Leese et al 1992). The prospective study of over 9516 postmenopausal women described above (Cummings et al 1995) reported an increased RR for incident fracture of the femur in those taking thyroid hormone (RR 1·6, 95% CI 1·1-2·3), but this was no longer significant when adjusted for a previous history of hyperthyroidism (which was present in 36% of those prescribed T4).…”

Section: The Effects Of Thyroid Hormones On the Skeletonmentioning

confidence: 99%

“…One Scottish study reported hospital admission rates due to ischaemic heart disease amongst subjects taking long-term T4 therapy. They compared findings in those with suppressed serum TSH (<0·05 mU/l) (representing about half of the cohort) with those in whom TSH was detectable but not elevated (Leese et al 1992). Patients within the study population who were aged under 65 years on T4 therapy had an increased risk of hospital admission due to ischaemic heart disease compared with the general population (females 2·7 vs 0·7%; males 6·4 vs 1·7%, P<0·01).…”

Section: Thyroid Hormone and The Heartmentioning

confidence: 99%

Thyroid hormone in health and disease

Boelaert

Franklyn²

2005

Journal of Endocrinology

221

127

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Thyroid disease is common, affecting around 2% of women and 0·2% of men in the UK. Our understanding of the effects of thyroid hormones under physiological circumstances, as well as in pathological conditions, has increased dramatically during the last two centuries and it has become clear that overt thyroid dysfunction is associated with significant morbidity and mortality. Both hypoand hyperthyroidism and their treatments have been linked with increased risk from cardiovascular disease and the adverse effects of thyrotoxicosis in terms of osteoporosis risk are well established. Although the evidence suggests that successful treatment of overt thyroid dysfunction significantly improves overall survival, the issue of treating mild or subclinical hyper-and hypothyroidism remains controversial. Furthermore, the now wellestablished effects of thyroid hormones on neurodevelopment have sparked a whole new debate regarding the need to screen pregnant women for thyroid function abnormalities. This review describes the current evidence of the effects of thyroid hormone on the cardiovascular, skeletal and neurological systems, as well as the influence of thyroid diseases and their treatments on the development of malignancy. Furthermore we will describe some recent developments in our understanding of the relationship between thyroid status and health.

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Morbidity in patients on l‐thyroxine: a comparison of those with a normal TSH to those with a suppressed TSH

Abstract: Patients under the age of 65 years on L-thyroxine had an increased risk of ischaemic heart disease. There was no excess of fractures in patients on L-thyroxine even if the TSH is suppressed.

Cited by 119 publications

References 17 publications

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

Subclinical hyperthyroidism: clinical features and treatment options

Thyroid hormone in health and disease

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