Thyroxine induced Osteo- Endo update 2

[FitnessFreakOz]

Just an update to my story , so as a recap, I have Hashimoto's, always felt best with T4/T3 near the top of the range and TSH suppressed. Diagnosed with osteoporosis. I have a healthy diet and exercise heaps including resistance work.

So off to an endocrinologist who insisted we must reduce my medication levels. I was horrified, I have done this before and always ended in a hypo slump, but the endo insists this is achievable if done slowly to give the body a chance to adapt. He wanted me to go from 150 daily to 130.

So I followed instructions, first dropped from 150 to 140, then finally to 130 over about a 4 month period. The endo ordered blood tests of just about everything! He wanted to be sure there is nothing else that could explain the osteo, and indeed, nothing else was found.

Had the follow up visit today, my thyroid results are:

T4 16.9 (9 - 25.0 ) previously 20.3

T3 4.0 (3.5 - 6.5) previously 4.8

TSH 0.02 (0.5 - 5.0) previously unreadable

I can't remember when my levels were so low and yet I feel just fine, really well in fact! I am shocked, but happy! The slow reduction seems to be working for me, I don't really understand why, but I will take it!

So now the endo wants me to drop further to approx 115 per day which he feels may just do the trick and get my TSH in a range he is happy with. I will give it a try.

Sometimes it all just seems guess work doesn't it?

[shaws]

Yes - I think it is guess work because what suits you and keeps you well may not work for another person.

This states that levo can harm bones:-

Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women

ncbi.nlm.nih.gov/pmc/articl...

This states liothyronine does help:-

Conclusions:

The substitution of l-T3 for l-T4 at equivalent doses (relative to the pituitary) reduced body weight and resulted in greater thyroid hormone action on the lipid metabolism, without detected differences in cardiovascular function or insulin sensitivity.

ncbi.nlm.nih.gov/pmc/articl...

[Baobabs in reply to shaws]

Some flaws in these studies. I vote we have more research into the effects of Levo and T3 levels in the body to accrue some body of evidence to shut medics up with their pontifications and ramblings regarding the consequences of 'high' levels of these hormones in the body.

[marsaday]

This type of reduction is the way to go. Slow and steady which can then flag up issues if not going well, but not major ones.

You also get to adapt slowly which is important. So yes you can feel a little off initially, but with the greater time length the body can adapt itself and start to up the T3 production which is key.

Your Ft3 is dropping as is the Ft4, but currently you still feel good. I hope this continues.

It is impossible to say what levels suit all people, but the key thing is to have a system which allows you to settle on thyroid doses which are certainly working or they are not. From there you can adjust slowly up or down. So one day you may feel good and the next (say 3 days after a 10mcg T4 reduction) you don't. After a week or two you can be pretty sure this reduction is one to far and then go back to explain to the endo.

[Baobabs]

Just to put the cat amongst the pigeons. I am in a similar situation to you, good diet, always, probably not as much exercise as you but enough and i was horrified to also be diagnosed with osteoporosis a few months ago. I have only received treatment for Hashi's the last 20 months so know meds have not contributed. My levels are still not high enough, however my Endo has a death wish to blame my levels and sometimes suppressed TSH. I am by no means an authority on osteoporosis and I am am taking vit k, d, calcium and magnesium BUT like many metabolic issues, I am certain bone break down and formation is a highly complex process. If the prevention and resolve was as easy as the info I read then I'm sure we would have erradicated the disease by now. I am convinced there is a missing link or links to this.

[shaws in reply to Baobabs]

This is from an archived site of an Adviser (now deceased) to TUK and he stated:-

Date: May 29, 2000

Question: Is the concern over thyroid hormone causing lost bone density justified? One of my doctors says yes; another says no.

Dr. Lowe: The possibility of reduced bone density from the use of thyroid hormone has been seriously overblown. We must consider each patient on an individual basis, but ordinarily, bone thinning isn’t a problem. In fact, the use of thyroid hormone enables many patients to exercise more, and due to this, their bone density actually increases.

web.archive.org/web/2010103...

[Baobabs in reply to shaws]

I would love to believe what he says but once again where is the evidence? I appreciate that exercise is increasingly possible if you are appropriately medicated and have the necessary energy ( this is where I feel I am getting to now) but where is the evidence to prove exercise will rebuild lost bone? You can see how paranoid I am becoming regarding this topic. I could of course frequent a recommended bone dealing 'medicine man' at the local hospital but I could predict the answer ............. Bone building medication devoid of good diet, exercise and supplements.

[Angel_of_the_North in reply to Baobabs]

T3 is needed to make osteoblasts - new bone. Treatment for osteoporosis tends to concentrate on preserving old brittle bone - not generally a good idea - and also seems to think that a 70 year old should have the bones of a 30 year old - not sensible.

[Baobabs in reply to Angel_of_the_North]

Thank you, not just interesting information but relief inducing also!

[shaws in reply to Baobabs]

Dr Lowe rarely made statements which were not researched first.

[Baobabs in reply to shaws]

Yes I am sure as I know he was and still is very well regarded. I may quote your reference on Saturday when I go to battle with my Endo. I'm starting to feel better and I just know he will be the Prophet of Doom over something.

[FitnessFreakOz]

Truly it is a complex problem and until I get another DEXA we will not know if this is working for me. And even if it does work, it doesn't mean it is the answer for everyone.

In my case my TSH has been running at unreadable (too low) levels for 20 years or more, so if over medication is a factor, it has had a long time to cause or contribute to my osteo. Given we have ruled out any other factor, except for me being postmenopausal, I had to try something.

Only time will tell, but I did want to share my experience, particularly regarding the slow reduction of Thyroxine, I never thought I could go this low and still do well.

[Baobabs in reply to FitnessFreakOz]

I am sure dropping levels of estrogen have a significant affect on bone loss post menopause. I am not sure what to believe regarding positive effects of HRT on prevention of osteoporosis.

[FitnessFreakOz in reply to Baobabs]

Indeed, but due to my age (59), doctors will not consider HRT due to increased risk of heart disease. Ever feel like you are on a carousel., just going round and round....sigh

[Baobabs in reply to FitnessFreakOz]

Exactly, couldn't put it better. Personally I wouldn't have considered HRT because of side effects.