Frax score calculations in postmenopausal women... - Thyroid UK

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Frax score calculations in postmenopausal women with subclinical hypothyroidism.

helvella profile image
helvellaAdministrator
10 Replies

Do you get sick of doctors who suggest a relationship between thyroid hormone supplementation and risk of broken bones, especially femurs in post menopausal women?

Well, there is a relationship according to this paper. But it says that insufficient thyroid hormone, even subclinical, is a risk factor. Implying that subclinical hypothyroidism should indeed be treated - especially if of autoimmune origin.

Hormones (Athens). 2013 Jul;12(3):439-448.

Frax score calculations in postmenopausal women with subclinical hypothyroidism.

Polovina S, Popovic V, Duntas L, Milic N, Micic D.

Source

Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Abstract

OBJECTIVE:

The aim of our study was to evaluate the relationship between the elevated TSH and fracture risk in postmenopausal women with subclinical hypothyroidism for evaluation of individuals with a high risk for osteoporotic fractures.

DESIGN:

FRAX score calculation (10-year estimated risk for bone fracture) and measurement of bone markers (osteocalcin and beta cross-laps) were performed in 82 postmenopausal women with newly discovered subclinical hypothyroidism (mean age 59.17±7.07, mean BMI 27.89±3.46kg/m2, menopause onset in 48.05±4.09 years of age) and 51 matched controls (mean age 59.69±5.72, mean BMI 27.68±4.66kg/m2, menopause onset in 48.53±4.58 years of age) with normal thyroid function.

RESULTS:

The main FRAX score was significantly higher in the group with subclinical hypothyroidism than in the controls (6.50±4.58 vs. 4.35±1.56; p=0.001). Hip FRAX score was significantly higher in the group with subclinical hypothyroidism (1.11±1.94 vs. 0.50±0.46; p=0.030). There was no significant difference in bone markers: osteocalcin (23.99±12.63 vs. 21.79±5.34 ng/mL; p=0.484) and beta cross-laps (365.76±184.84 vs. 306.88±110.73 pg/mL; p=0.21) between the two groups.

CONCLUSIONS:

Postmenopausal patients with subclinical hypothyroidism, in particular of autoimmune origin, have higher FRAX scores and a thus greater risk for low-trauma hip fracture than euthyroid postmenopausal women. Our results point to the need to monitor postmenopausal patients with subclinical hypothyroidism for avoidance of fractures.

PMID:

24126312

[PubMed - as supplied by publisher]

ncbi.nlm.nih.gov/pubmed/241...

Rod

Image: Posterior view of the femur - annotated. Image created to illustrate Radiopaedia.org article on the femur. Date: 7 November 2009 Author: Frank Gaillard

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PinkNinja profile image
PinkNinja

Great find! This is just the sort of ammunitions... er, I mean evidence that people need to get the treatment that will help them.

Thanks for posting :)

Carolyn x (or is it?)

helvella profile image
helvellaAdministrator in reply toPinkNinja

By heck that was fast!!!! :-)

Rod

PinkNinja profile image
PinkNinja in reply tohelvella

It was nice and short and I have my brain back :D I can also type at almost 60 words per minute!

PinkNinja profile image
PinkNinja in reply tohelvella

I have just emailed this to my dad after he emailed me about my mum.

My mum has many symptoms of hypothyroidism yet they only checked TSH. She had radiotherapy a couple of years ago for a massive brain tumour, a great chunk of which was near her pituitary. There is a very good chance she may have secondary hypothyroidism. Even if they do test T4 (my dad is going to insist), I know they will trot out the usual "we can't prescribe until you are very hypothyroid or you'll get osteoporosis". I am pre-empting such statement by sending this paper :D

My mum has quite bad cognitive impairment at the moment although she has been feeling a little better the last few days - remembering more, less confusion, better mood and less joint pain and stiffness. My dad had seen about how statins are pretty much useless, especially for women, and suggested that my mum stop hers or at least reduce her dose. It was at that point that my mum realised she had been forgetting to take them, hence the improvement in her health. They are going back to the doctor asap to discuss this. A little bit of good news for the family :)

Thanks for posting this with such amazing timing!

Carolyn x

helvella profile image
helvellaAdministrator in reply toPinkNinja

Sincerely hope it helps - even if only as a nudge.

Rod

Glynisrose profile image
Glynisrose

I just wish that doctors would not ignore what they don't want to read!!!

Vivante profile image
Vivante

I am looking at an American magazine, Yoga Journal, March/April 1988. it was written by Mary Pullig Schatz, MD. She provided a list of risk factors, this is just a few---overactive thyroid or parathyroid glands, use of steroid drugs, (provided for asthmatics and rheumatoid arthritis etc). There are more on the list. My GP did not know until I provided him with a copy of the article. Over the years more information has been provided due to the research that has been done. The anti co-ags such as warfarin and heparin. I have osteopenia, the info provided this time, after the dexa scan should there is an increased risk of fracture in my lumber spine. Once you are provided with the information you need, there is so much you can do to help yourself. The Irish osteoporosis society provides a full list of conditions that put you at risk. The National osteoporosis society provides information about the foods that will help you.

If you look on the website of the National Osteoporosis Foundation, Safe movements.

I take thyroxine.

You can only go forward now. So much you can do and by finding out what is right for you, you can also help others. Look on Osteoporosis Canada, Austeoporosis Australia,

Take care.

Vivante profile image
Vivante

Today is the National osteoporosis day. 20 October. Look on the National osteoporosis website. They should be providing a questionnaire.

helvella profile image
helvellaAdministrator in reply toVivante

Well that was lucky timing! :-)

Thank you.

Rod

Equi-crazy profile image
Equi-crazy

Great news for when I have to argue my case for continuing getting T3.

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