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LETTER TO THE EDITOR
Year : 2012  |  Volume : 9  |  Issue : 3  |  Page : 106

Impact of thyroid hormone on bone disorders


1 Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Barwala (Panchkula), Haryana, India
2 Department of Prosthodontics, ITS Dental College, Ghaziabad, Uttar Pradesh, India
3 Department of Oral Pathology and Microbiology, ITS Dental College, Ghaziabad, Uttar Pradesh, India

Date of Web Publication11-Aug-2012

Correspondence Address:
Harkanwal P Singh
Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental college, Barwala (Panchkula), Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.99662

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How to cite this article:
Singh HP, Kumar P, Kumar A, Aggarwal P. Impact of thyroid hormone on bone disorders. Thyroid Res Pract 2012;9:106

How to cite this URL:
Singh HP, Kumar P, Kumar A, Aggarwal P. Impact of thyroid hormone on bone disorders. Thyroid Res Pract [serial online] 2012 [cited 2019 Jun 26];9:106. Available from: http://www.thetrp.net/text.asp?2012/9/3/106/99662

Sir,

Remodeling is crucial for bone health, which is characterized by simultaneous formation and resorption. After a certain age, bone resorption exceeds formation, resulting in bone loss. This imbalance is aggravated by many disease states. [1] Altered thyroid hormone levels is one such condition, which has been associated with bone loss and increased fracture risk.

Diseases of the thyroid gland are a common occurrence in India. Thyrotoxicosis, a commonly recognized clinical condition characterized by excessive thyroid hormone, accelerates bone remodeling, and even though it is one of the known risk factors for osteoporosis, [2],[3] the metabolic effects of thyroxin on bone is a little-discussed subject and the exact mechanism of the deleterious effect of thyroid hormone on bone is poorly understood. Thyroid hormones are anabolic for optimal skeletal growth and modeling during development but are catabolic to mature skeleton. [4] They play an imperative role in bone mineral homeostasis and bone density. Both hyperthyroidism and to some extent hypothyroidism are linked to reduced bone mineral density and, hence, increased risk for fracture. [5]

Thyroid hormones affect bone cells both in vitro and in vivo by stimulating osteoblast and osteoclast cells with more bone resorption and increased skeletal remodeling. [6] Nevertheless, some authors demonstrated that bone loss in thyrotoxicosis may be a direct stimulating effect of excess thyroid hormone acting locally on bone. It has been proposed that thyroid stimulating hormone (TSH) may be a direct negative regulator of bone turnover acting via the TSH receptor on both osteoblasts and osteoclasts. Hence, TSH deficiency could be partly responsible for the skeletal loss seen in thyrotoxicosis. In addition, amplified serum interleukin-6 concentration in hyperthyroid patients favors osteoclast formation and may be an effector of the action of parathyroid hormones on bone. [7],[8],[9] With changing worldwide geographic incidence of hip fractures, it is important to keep in mind the impact of thyroid disorders as a secondary cause of osteoporosis. [10] Reduced bone mineral density in thyrotoxicosis is reversible with treatment, irrespective of method of treatment. [9],[10] After control of thyrotoxicosis, partial recovery takes place. Similar phenomenon is seen during replacement therapy of patents with overt and subclinical hypothyroidism. [9],[11]

 
  References Top

1.Wexler JA, Sharretts J. Thyroid and bone. Endocrinol Metab Clin North Am 2007;36:673-705.  Back to cited text no. 1
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2.Mosekilde L, Eriksen EF, Charles P. Effects of thyroid hormones on bone and mineral metabolism. Endocrinol Metab Clin North Am 1990;19:35-63.  Back to cited text no. 2
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3.Udayakumar N, Chandrasekaran M, Rasheed MH, Suresh RV, Sivaprakash S. Evaluation of bone mineral density in Thyrotoxicosis. Singapore Med J 2006;47:947-50.  Back to cited text no. 3
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4.Bassett JH, Nordström K, Boyde A, Howell PG, Kelly S, Vennstrom B, et al. Thyroid status during skeletal development determines adult bone structure and mineralization. Mol Endocrinol 2007;21:1893-904.  Back to cited text no. 4
    
5.Dhanwal DK, Dennison EM, Harvey NC, Cooper C. epidemiology of hip fracture: worldwide geographic distribution. Indian J Orthop 2011;45:15-22.  Back to cited text no. 5
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6.Bassett JHD, Williams GR: The molecular actions of thyroid hormones in bone. Trends Endocrinol Metab 2003;14:356-64.  Back to cited text no. 6
    
7.El Hadidy el HM, Ghonaim M, El GawadSSh, El Atta MA.Impact of severity, duration, and etiology of hyperthyroidism on bone turnover markers and bone mineral density in men. BMC Endocr Disord 2011;11:15.  Back to cited text no. 7
    
8.Akalin A, Colak O, Alatas O, Efe B. Bone remodeling markers and serum cytokines in patients with hyperthyroidism. Clin Endocrinol (Oxf) 2002;57:125-9.  Back to cited text no. 8
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9.Van de ven AC, Erdtsieck RJ. Changes of bone mineral density, quantitative ultrasound parameters and markers of bone turnover during treatment of hyperthyroidism. Neth J Med 2008;66:428-32.  Back to cited text no. 9
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10.Dhanwal DK, Cooper C, Dennison EM. Geographic variation in osteoporotic hip fracure incidence: the growing importance of asian influences in coming decades. J Osteoporos 2010;2010:757102.  Back to cited text no. 10
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11.Reddy PA, Harinarayan CV, Sachan A, Suresh V, Rajagopal G. Bone disease in thyrotoxicosis. Indian J Med Res 2012;135:177-86.  Back to cited text no. 11
    




 

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