Hypothyroidism osteopenia and hyperparathyroidism

Hi everyone I'm looking for a bit of advice. I've been diagnosed with hypothyroidism and hyperparathyroidism. ...

However there has been a bit of controversy over whay is causing what. I have had a Dexa scan which found osteopenia in my arms and spine. .. could be what's causing the high calcium in my blood due to an overactive parathyroid. But I've heard hypothyroidism can cause problems with bone turnover and cause osteopenia.

I had 2 parathyroid scans an ultrasound and mibi and both were negative which I know can still happen if there still is a problem. I have all the symptoms of an overactive parathyroid and blood work. Calcium levels, 2.62 2.74 2.69 2.72. 2.69 ect.... However my pth is always within the normal ranget 2.9 4.8 but this could be innapropriatly hight for the calcium. I have a slight vit d deficiency, always dehydrated even though I look after my fluid intake my urea is always high. 7.8 9.1 ect...

I have pains in my arms and legs palpitations muscle weakness increased urininaton and thirst hair snapping off... bit I know this can be hypothyroidism symptoms too. I'm 24 and worried that the loss of bone density maybe being caused by a parathyroid problem or an ongoing underactive thyroid problems which had put all the minerals out of balance. I have been started on cinacalcet to lower my calcium and pth and see if thays helps my symptoms and maybe they will get to the bottom of it. Any advice on hypothyroidism and bone loss ect... would be great.

Thanks x

9 Replies

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  • Hi rach260190,

    Your post caught my eye because I am hypothyroid and I also have osteoporosis. I am unaware, however, that I have any particular problems with hyperparathyroidism (and I am afraid I don't know a great deal about that). I too am convinced that the hypothyroidism and osteoporosis are linked, even though medically-speaking no-one has ever made that connection to me. I believe that the osteoporosis developed because I was a long time (approx.10years with symptoms) before getting a diagnosis of the hypothyroidism and all that time I just think that my thyroid problem was knocking my hormones "out of whack" (as you can see this is going to be a very technical discussion!). But like you, I have been keen to find answers. Bear with me the discussion is going to get a bit more helpful........I hope!

    Osteoporisis is usually associated with HYPERthyroidism, and if you do an internet search you keep coming up with HYPER rather than HYPO. But I think it is interesting that the NICE guidelines on HYPOthyroidism under “Management: Screening of asymptomatic people” and "Who should I screen for hypothyroidism?" state the following:

    And I quote:

    "Routine testing of asymptomatic people for hypothyroidism is not recommended, but targeted testing is recommended for certain groups with the following conditions. Measuring thyroid-stimulating hormone (TSH) is sufficient unless stated otherwise.

    Osteoporosis: At Initial Presentation".

    There must be some sort of link.

    You don’t say what your hypothyroidism is caused by? Do you mind me asking, is it Hashimoto’s? (Mine is.)

    I recently came across an article that I think you will find interesting:

    Is there a link between Hashimoto’s thyroiditis and primary hyperparathyroidism?

    Here’s the link

    nuclmed.web.auth.gr/magazin...

    I also think you would find it very useful to read "The Magnesium Miracle" by Carolyn Dean, which touches on the role of Magnesium in regulating calcium levels.

    Hope you find the answers you are looking for.

  • Hi MacG,

    Thankyou so mucheck for your reply. It's very interesting. I have not been told much about my hypothyroidism and what's caused ect.... All I know if for the last however many years in my late teens and early 20s I have felt miserable. I was put on beta blockers for my palpitations and anti depressants for my low mood.... which was just masking what was reallt going on. I know it's all very complicated and I too feel all my hormones and minearly are just out of whack.

    I can't get my head around why I have high calcium if it's not being drawn from.my bones by a parathyroid problem. ... but then om the other hand if my thyroid is completely out of balance calcitonin will not have been produced properly. Calcitonin acts against pth and helps lower calcium levels. So my theory maybe that hypothyroidism can cause da mage to bones as calcitonin is not produced properly to balance parathyroid hormones. However I maybe wrong and just have a parathyroid problem and hypothyroidism.

    Have you had your calcium levels checked?

    It's all so complicated but i know at 24 a t score of -1.8 isn't that great and nor is high calcium.

    Thankyou for the link I will have a read but like you I have read it'd more linked with hyper. ... but there must be a link

    x

  • Hi again,

    Your theory re. calcitonin/calcium levels etc... sounds logical, but then, as I said above, I don't know about hyperparathyroidism. Have you read the chapter 12 in Peatfield's book. The whole chapter is on the parathyroid glands and how they function in relation to the thyroid. I think he explains things very well.

    Yes, I have had my calcium levels checked, but I must admit I have not been specifically monitoring that. That sounds weird doesn't it!! Let me explain... I see a haematologist on a fairly regular basis, because of anaemia and neutropenia (on top of the osteoporosis and hypothyroidism....when something goes wrong hormonally- speaking it really affects you across the board doesn't it!) and as part of the whole range of blood tests that I have every 4 months or so, they check my bone profile. To be honest, we haven't paid much attention to the bone profile (that's because the rheumatologist treats the bones, the haematologist the blood and my GP the thyroid problem - nothing seems joined up even though I am sure they are all connected). Last time I saw the haematologist we were discussing all the other stuff - ferritin...neutrophils etc.... and I just mentioned in passing. "What does the bone profile show?" He said, "it shows that you have plenty of calcium circulating in your blood". I thought that was OK because I have been taking a calcium supplement since I saw the rheumatologist about 2 years ago about the osteoporosis. It is really interesting, that I was not told that if I am taking a calcium supplement I should also be taking magnesium. By chance, I was in fact taking a magnesium supplement, but I have since become a bit more savvy about balancing the ratio of calcium and magnesium. Once again, this brings me back to the Carolyn Dean book. I think you would find this useful.

    This discussion has certainly flagged up for me that the next time I see the haematologist I'll push for some details on the bone profile.

    I hope someone else who is a bit more savvy about parathyroid glands etc....joins in this discussion.

  • Hi MacG,

    thanks again for your reply. That book you mentioned, your thyroid and how to keep it healthy I have recently brought. It's brilliant and really helped me understand things

    this is really interesting and definitely worth a read it's cleared alot up for me...

    yourhormones.info/hormones/...

    There is only one thing left that I'm thinking could have caused my osteopenia apart from a parathyroid problem. My oestrogen has been low only for about a year now and I doubt that osteopenia can be thay accelerated within a year.

    I think it would be interesting if you had your calcium levels checked

    x

  • Me again!

    Thanks for the link. I've had a look at that- really interesting. I knew that the thyroid produced calcitonin, but had never really thought much about it, concentrating on T4 and T3 instead.

    I am going to pay more attention to my calcium levels.

    Re. the Carolyn Dean book - I remembered reading something about parathyroid hormone/calcitonin in there and I found it:

    In the introduction (pg. xlvii), where she is giving an overview. She states the following:

    "Three hormones - parathyroid hormone, calcitonin, and vitamin D (which is a hormone) - are involved with the level and location of calcium in the body. Furthermore, all three of these hormones depend upon magnesium for their activation and regulation......(pg.li) ....magnesium in adequate amounts is essential for the absorption and metabolism of calcium and vitamin D. Magnesium converts vitamin D supplements or vitamin D in storage form (calcidiol) into its active form (calcitriol), which can be absorbed in the gut Magnesium also activates the hormone calcitonin, which helps to preserve bone structure and draws calcium out of the blood and away from the soft tissues and into the bones".

    She goes on to unpick this in more detail...... According to what I have read, the role of magnesium in all that you have outlined may be worth considering??

  • Some people have found this site very useful:

    parathyroid.com/

    You do have to bear in mind that it is a site intended to promote their surgical practice, but they have a LOT there on the whole subject of parathyroids. Be careful of units when they mention tests - I think some are different to those in the UK.

    Also:

    hypopara.org.uk/home.php

    Rod

  • Hi Rod,

    Thanks for your reply. I am familiar with parathyroid. Com it's very useful although like you said it's intended to make people goto their surgery. This website makes me think I do have a parathyroid problem and I have been diagnosed but I've seen a surgeon and he's on the fence I'm petrified of being stuck with a parathyroid problem

    Rachel

  • Please do what you can to make sure the surgeon is particularly experienced with parathyroids.

  • Your very right! I have seen a surgeon and he is on the fence about my parathyroid problems. He wants more evidence before he ddecides to act. My scans were negative making the op explanatory.

    I have been put on calcinicet to see if that lowers my pth and calcium if it does then maybe I will be reffered to him.

    I'm very confused about what's going on.

    X

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