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REVIEW ARTICLE
Year : 2011  |  Volume : 8  |  Issue : 2  |  Page : 23-30

Skeletal system in thyroid disorders


Department of Endocrinology, AIMS, New Delhi, India

Correspondence Address:
Viveka P Jyotsna
Department of Endocrinology, AIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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Thyroid physiology is linked to skeletal health. T3 and TSH independently affect bone growth and development, mineralization, and remodeling. Previously treated hyperthyroidism is likely a long-term risk factor for fractures. Thyroidectomy and methimazole may decrease the risk of fractures in these patients compared with treatment with radioactive iodine. Hypothyroidism may also be a risk factor for fractures, although the mechanism is not understood .Fracture risk does not seem to be related to levothyroxine replacement in hypothyroid patients. Treatment of hyperthyroidism improves BMD but not necessarily to normal levels. The effects of subclinical hyperthyroidism on the bone are controversial. TSH-suppressing doses of levothyroxine may cause reduced bone density, especially in postmenopausal women. Replacement therapy with levothyroxine has not been shown to cause osteoporosis, although it may temporarily reduce bone density after the initiation of treatment. Supplementation of calcium and vitamin D in hyperthyroid patients should be considered.


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