Untreated severe hyperthyroidism
Hyperthyroidism
Over production of hormones by the thyroid gland located at the front of neck.
Do low TSH levels predispose to osteoporosis in hyperthyroidism?
The evidence that low TSH levels predispose to osteoporosis in hyperthyroidism is discussed in view of the emerging role of pituitary hormones in bone biology. Publication types Research Support, N.I.H., Extramural
Does thyroid-stimulating hormone (TSH) cause bone loss?
TSH and bone loss We have recently challenged the view that the bone loss associated with hyperthyroidism is solely due to elevated thyroid hormone levels. We find that thyroid-stimulating hormone (TSH), derived from the anterior pituitary gland, inhibits bone resorption by the osteoclast. Mice haploinsufficient in t …
What is the link between thyroid disease and osteoporosis?
What is the link between thyroid disease and osteoporosis? Thyroid hormone affects the rate of bone replacement. Too much thyroid hormone (i.e. thyroxine) in your body speeds the rate at which bone is lost. If this happens too fast the osteoblasts may not be able to replace the bone loss quickly enough.
What happens if your TSH level is too low?
There is also some evidence that people with low TSH levels may lose bone at a faster rate than those with normal TSH levels even when the blood thyroxine measurement is within the normal range, but this is still being studied. If you have hyperthyroidism, the first step is to treat the overactivity.
How does low TSH affect osteoporosis?
In humans, TSH inhibits markers of bone resorption with a single administration, and low TSH levels correlate with increased fracture risk. The evidence that low TSH levels predispose to osteoporosis in hyperthyroidism is discussed in view of the emerging role of pituitary hormones in bone biology.
Is there a connection between hypothyroidism and osteoporosis?
High levels of thyroid hormones, or hyperthyroidism, cause rapid bone loss, and new bone might not be as strong as the bone lost. This process of increased bone loss over time causes osteoporosis. Hypothyroidism, which slows your body's metabolism, also slows down your bone's metabolism.
How does thyroid hormone affect bone density?
Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone turnover osteoporosis.
How does levothyroxine affect osteoporosis?
Furthermore, our novel finding provides evidence for an association between the fracture risk and levothyroxine dosage, according to the osteoporosis status. In conclusion, prescribed levothyroxine doses of >150 µg/d were associated with a higher risk of fracture in elderly female patients with severe osteoporosis.
Does low TSH affect bone density?
In older women without significant thyroid dysfunction [29], low TSH levels are independently associated with decreased bone density in the femoral neck. A meta-analysis of 1371 studies and 70,298 participants also showed that subclinical thyroid dysfunction is an important risk factor for fractures [30].
Can low TSH cause bone loss?
There is also some evidence that people with low TSH levels may lose bone at a faster rate than those with normal TSH levels even when the blood thyroxine measurement is within the normal range, but this is still being studied.
How does hypothyroidism affect calcium levels?
Abstract. Hypothyroidism is known to affect calcium homeostasis by decreasing bone turnover and serum calcium level, and by increasing parathyroid hormone and 1,25-dihydroxyvitamin D concentrations.
Does thyroid medication deplete calcium?
If the hyperthyroidism is treated early, bone loss can be minimized. In the same manner, excessive amounts of thyroid hormone replacement medication can also result in bone loss. In addition to osteoporosis, hyperthyroidism can cause blood calcium levels to rise (hypercalcemia) by as much as 25%.
What is the role of thyroid hormone in long bone growth?
Thyroid hormones act at all levels to regulate the process of ossification thereby controlling the rate of bone maturation and linear growth.
Does your thyroid affect your calcium?
When the calcium level is high in the bloodstream, the thyroid gland releases calcitonin. Calcitonin slows down the activity of the osteoclasts found in bone. This decreases blood calcium levels.
Does taking levothyroxine cause bone loss?
Interestingly, the patients that received 2 years of levothyroxine replacement therapy had lower bone density. Thus, simultaneous treatment of hypothyroidism and bone loss seems to be necessary.
Does taking Synthroid cause osteoporosis?
A study of Korean women over 65 looked at the relationship between a higher dose of levothyroxine and the risk of bone fractures. They found that women who were already at an increased risk for osteoporosis experienced more bone fractures if they took higher doses of levothyroxine (Ko, 2014).
Does thyroid medication cause osteoporosis?
Too much thyroid medicine increases the activity of the osteoclasts (the bones that break down bone) and put you at an increased risk for breaking a bone.
Does levothyroxine affect bone density?
Interestingly, the patients that received 2 years of levothyroxine replacement therapy had lower bone density. Thus, simultaneous treatment of hypothyroidism and bone loss seems to be necessary.
Does hypothyroidism affect calcium levels?
Abstract. Hypothyroidism is known to affect calcium homeostasis by decreasing bone turnover and serum calcium level, and by increasing parathyroid hormone and 1,25-dihydroxyvitamin D concentrations.
Does thyroid medication affect calcium levels?
If the hyperthyroidism is treated early, bone loss can be minimized. In the same manner, excessive amounts of thyroid hormone replacement medication can also result in bone loss. In addition to osteoporosis, hyperthyroidism can cause blood calcium levels to rise (hypercalcemia) by as much as 25%.
But as of 2019, the truth is that real science still indicates that suppressed TSH is not responsible for any harm to bones
In 2007 Bassett et al stated, “Thyroid hormone excess rather than thyrotropin (TSH) deficiency induces osteoporosis in hyperthyroidism”. Note: this means too much thyroid hormone for the patient is a risk for osteoporosis, but this means they would usually have hyperthyroid symptoms. Low TSH itself is not an issue.
Paul Robinson
Paul Robinson is a British author and thyroid patient advocate. The focus of his books and work is on helping patients recover from hypothyroidism. Paul has accumulated a wealth of knowledge on thyroid and adrenal dysfunction and their treatment. His three books cover all of this.
What happens if T3 is too high?
Excess T3 in bone cell receptors will overstimulate cellular activity. If excess T3 keeps coming in, it will cause tissues to suffer, and fairly quickly, from loss of bone mineral density. Read a summary of the studies that prove this: “ Rationale: Low TSH vs. true hyperthyroidism .”.
Why do doctors fear TSH?
This may be because the effects of extreme hyperthyroidism are more swift and dramatic: thyrotoxicosis, thyroid storm, cardiac arrest, death.
What is the most important hormone level to optimize?
The most important hormone level to optimize is our active hormone Free T3, not the TSH hormone. TSH’s main role (if it is no longer needed to stimulate a healthy thyroid gland to produce hormones) is to mildly boost peripheral T4-T3 conversion when there is a slight T3 deficiency in blood.
Why do bones become brittle?
Bones become brittle when local T4-T3 conversion is deficient. In children, this also hinders bone development and they can become short of stature. HYPER: When there’s way too much T3 or T4 in blood, the TSH will go low in response.
Which hormone has the biggest influence on thyroid?
Not many studies have used the research methods that can reveal T3’s direct influence. But molecular biology already tells us a lot–T3 is the thyroid hormone that has the biggest influence.
Can high TSH make thyroid hormone appear out of nowhere?
HYPO: If the deficit of thyroid hormone in bloodstream is too extreme, high TSH can’t make more thyroid hormone appear out of nowhere. Also, if T4 is abundant in blood but both T3 and TSH are low, then the insufficient TSH cannot stimulate enough T4-T3 hormone conversion to make up for the T3 deficit in bloodstream.
Is TSH a major driver?
However, TSH is not the major driver. “The data” on mice with thyroid hormone receptor variations indicate that “the effects of disrupted or increased T3 action in bone predominate over skeletal responses to TSH” (Bassett and Williams, p. 532).
What happens if your TSH is too low?
If the thyroxine level in your body stays too high for a long period or the thyroid-stimulating hormone (TSH) level in your body stays too low for a long period then there is a higher risk of developing osteoporosis.
How does thyroid affect bone loss?
Thyroid hormone affects the rate of bone replacement. Too much thyroid hormone (i.e. thyroxine) in your body speeds the rate at which bone is lost. If this happens too fast the osteoblasts may not be able to replace the bone loss quickly enough.
How long after thyroid treatment can you get a bone density scan?
If you have had prolonged untreated hyperthyroidism and have other risk factors for osteoporosis and bone fractures, a bone mineral density scan two to three years after your thyroid treatment starts will help assess your risk. If a bone density scan shows osteoporosis then this can be treated with medication.
What are the risks of osteoporosis?
Factors that increase the risk of osteoporotic fractures include: 1 Personal history of a broken bone, especially a fragility fracture either occurring spontaneously, or as a result of low trauma such as a minor fall 2 Family history of osteoporosis or low trauma fracture 3 Early menopause 4 Previous steroid therapy 5 Anorexia nervosa 6 Low body weight 7 Poor diet 8 Smoking 9 Excessive alcohol intake 10 Lack of exercise or mobility 11 Prolonged untreated hyperthyroidism 12 Prolonged over-treated hypothyroidism 13 Other illnesses such as rheumatoid arthritis, coeliac disease, and primary hyperparathyroidism
What are the factors that affect bone replacement?
Many factors influence this process of bone replacement, including hormones, the amount of exercise you take and the amount of vitamin D and calcium in your diet. The rate at which the bone replacement occurs is normally in balance. If more bone is lost than is replaced, your bones become less dense and you may develop osteoporosis.
How to keep your bones healthy?
You can help keep your bones healthy by eating a well-balanced diet containing calcium-rich foods, maintaining normal vitamin D levels, avoiding smoking, keeping your alcohol drinking to within recommended limits , and exercising regularly. High impact exercise, such as jogging or power walking, helps strengthen bones.
Is levothyroxine bad for osteoporosis?
Underactive thyroid (hypothyroidism) An underactive thyroid is not, in itself, a risk factor for osteoporosis, but if you are prescribed levothyroxine to increase your thyroid levels to the normal range you should have regular blood tests, at least once a year, to ensure your thyroid hormone levels are not too high.
What are the effects of thyroid hormones on bone?
Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone tur ….
Is TSH asymptomatic or asymptomatic?
Subclinical hyperthyroidism, defined as low thyrotropin (TSH) and free hormones within the reference range, is a subtler disease, often asymptomatic, and the diagnosis is incidentally made during screening exams.
Does thyroid affect bone mass?
Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone turnover osteoporosis.
Is there a relationship between BMD and hypothyroidism?
At the moment, there are no clear data that demonstrate any relationship between BMD in adults and hypothyroidism. Despite these clinical evidences, the cellular and molecular actions of thyroid hormones on bone structures are not complete clear.
Does thyroxin decrease BMD?
Available data similarly suggest that a long-term TSH suppressive dose of thyroxin may decrease BMD and may induce an increased risk of fracture. These effects are particularly observed in postmenopausal women but are less evident in premenopausal women.
Dear Doctors
Clinical Study by Heemstra, et Al
- Here’s an example of one good clinical study of the effect of TSH versus T4 and T3 on bone health biomarkers in treated thyroid patients. Researchers studied 22 patients without thyroid glands 5 years after thyroidectomy from differentiated thyroid cancer (DTC). Baseline:They first measured everyone’s baseline biomarkers. On these patients’ prescribed TSH-suppressive L-T4 t…
How to Read Research Studies on TSH Risk
- If you read a study on TSH and osteoporosis (or any health risk), ask these important questions as you read. 1. Did they measure patients’ Free T3 levels?How can we know for sure if “Low TSH” played a role independent of both T4 and T3 hormones if a population study did not measure Free T3? 2. How long-term was the study and did they measure Free T3 at many points? Do we know …
Implications For Thyroid Therapy
- Doctors and patients can do two things: 1. Measure Free T3 and Free T4, not just TSH,whenever a patient is symptomatic on therapy. Be aware that symptoms are usually connected to T3 because it’s the active hormone. 2. If L-T4 monotherapy is maintaining them in a state of lower TSH, higher T4 and lower T3,realize that their bones and heart are likely at risk from their lower T3 most of al…
in Conclusion
- Too often, doctors fear low TSH and T3-hyperthyroidism (or overdose) far more than high TSH or T3-hypothyroidism (or underdose). This may be because the effects of extreme hyperthyroidism are more swift and dramatic: thyrotoxicosis, thyroid storm, cardiac arrest, death. But we believe that a significant portion of treated thyroid patients suffer fr...