Re: TSH suppression/no osteoporosis

[Guest guest]

a good study to show the doc.

cindi

Clin Endocrinol (Oxf). 1993 Nov;39(5):529-33. Related Articles, Links

Suppressed TSH levels secondary to thyroxine replacement therapy are not

associated with osteoporosis.

Grant DJ, McMurdo ME, Mole PA, Paterson CR, Davies RR.

University of Dundee, Department of Ageing and Health, Medical School, UK.

OBJECTIVE: Recent studies have suggested that patients receiving thyroxine

are at increased risk of osteoporosis. We set out to measure bone mineral

densities in two groups of post-menopausal women receiving thyroxine replacement

therapy (those with serum TSH levels persistently suppressed or non-suppressed)

and to compare the results in both groups with those of the local control

population. DESIGN: Cross-sectional study. PATIENTS: Seventy-eight

post-menopausal

women who had been treated with thyroxine for primary autoimmune or idiopathic

hypothyroidism for a minimum of 5 years, 44 with TSH persistently suppressed

and 34 non-suppressed. One hundred and two control subjects. MEASUREMENTS:

Forearm bone mineral density at proximal and distal sites as measured by

single-photon absorptiometry. RESULTS: Results were expressed as Z-scores, i.e.

number

of standard deviations from the mean of a 5-year age-band from the local

control population. Mean Z-scores at proximal and distal sites for the

non-suppressed patients were -0.03 and -0.07 and for the suppressed patients

were -0.20

and -0.25, representing a decrease in bone mineral density of at most 5% in the

suppressed patients. The differences between the three groups were not

statistically significant. CONCLUSION: In this patient population, the reduction

in

bone mineral density due to thyroxine is small. It is unlikely to be of

clinical significance and should not on its own be an indication for reduction

of

thyroxine dose in patients who are clinically euthyroid.

PMID: 8252740 [PubMed - indexed for MEDLINE]