Thyroid results - advised to get bone scan

[BreatheHelen]

Hi everyone

Please can I ask about my recent Medichecks results. The results below are similar to my usual results over recent years.

The medichecks doctor suggested I get a bone density scan to monitor for development of osteoporosis, due to my long history of low TSH (0.01 to 0.001). They advise that although my frees are in range, and I do not feel at all over medicated, that bone density risks in this situation are not clear.

I wonder what experience others have with this, any thoughts or research to say if I should be pushing my GP for a bone scan?

I take four grains of NDT, four and half in winter, and do 40 mins of yoga at home 3-4 times a week. I also lift some weights most days.

I get no support from GP re my thyroid apart from an NHS blood test annually if I remind them I need one!

Thanks for any comments.

Latest Medichecks results, March 2023, are:

TSH 0.01 (0.27-4.2)

Free T3 5.18 (3.1-6.8)

Free T4 16.6 (12-22)

Thyroglobulin antibodies 10iu/ml (less than 115)

Thyroid Peroxidase antibodies less than 9 (less than 34)

Vitamin D 89 (50-200)

Vitamin B12 more than 150 (37-150)

Folate 10.56 (more than 3.89)

CRP 0.69 (0-5)

Ferritin 68 (13-150)

[SlowDragon Administrator]

If you’re GP won’t do one you could consider doing privately

[BreatheHelen in reply to SlowDragon]

Thanks, SlowDragon, I've just been reading about a new urine test that I'd consider doing privately, as i cant find a regular dexa scan near me. However, if the GP would take on board what the Medichecks Dr says, perhaps they'll help me on the nhs.

Thanks for your reply.

[jimh111]

It’s useful to have a bone density scan so you know where you stand. Another scan several years later will show you how you are progressing. This helpful website shows that bone density scans use very little radiation radiologyinfo.org/en/info/s... .

[BreatheHelen in reply to jimh111]

Thanks jimh111Bone density is something I've not thought of, but now the suggestion has been made, I'll ask my GP about it. If they won't do a scan, I'll probably do the new urine test for bone density.

I agree, it would be a good thing to do every few years. I have a few friends with painful osteoporosis and I wouldn't want to add that to my list of ailments!

I do some weight bearing at home most days, and yoga 3-4 days a week.

Thanks for your reply.

[Marymary7 in reply to BreatheHelen]

Please could you tell me about the urine test, I think I’m quite similar to you in this regard and I may need it.

[BreatheHelen in reply to Marymary7]

Hi MaryIt's £149 at osteolabs.co.uk

It's dear but they say it's a new test that's more thorough than a dexa scan.

It's on my wish list of things to do!

[Marymary7 in reply to BreatheHelen]

Thanks. I don’t think i will go for it at that price. X

[Brightness14]

I have had very similar results to you for years now. I did have a bone scan a couple of years ago, these are a good idea to put your mind at rest. I am the same Yoga for over forty years I also lift weights at home a few days a week. I am coming up for 77 years old. These two things on their own help so much with bone health especially weights. Plus of course walking up hills.

[Stourie]

because of my low tsh 0.01 for 10 years I was sent for a dexa scan and everything was fine apart from my lower back which I damaged 20 odd years ago and also had an operation on. Try not to worry too much. Jo xx

[BreatheHelen in reply to Stourie]

Thanks JoThat's very reassuring that your results were ok. I'm guessing mine should be as the frees are always in range.

Hope your back is ok now

[Batty1]

I have only one problem with doing a DEXA Scan and this comes down to thyroid medication because in my experience if your test reveals osteopenia or osteoporosis the doctor might want to reduce your medication based solely off this test by telling you your thyroid medication is too high and causing this issue with your bones …. In my personal experience of DEXA Scan and results this wasn’t the case at all but it didn’t matter I had to battle to stay on my dose of thyroid medicine at that time.

[BreatheHelen in reply to Batty1]

That's a good if worrying point!However, in my case, in twenty years of hypothyroidism and the GP has never shown any interest in my thyroid. I have to remind them I need an annual blood test. (Even tho I do private ones in between as needed)

I self medicate so that means I'm not at the mercy of NHS for my dose, im just at the mercy of the high cost of private meds.

Glad you won your battle not to have your meds reduced.

[Ruthi]

There is nothing to worry about. I have similar results. Any medication containing T3 tends to suppress TSH. In fact you may be a bit under medicated and if you still have symptoms.

A bone scan as a baseline reading is always useful but there is nothing in those results to suggest you have osteoporosis. I do, but that is definitely hereditary.

[BreatheHelen in reply to Ruthi]

Thanks Ruthie

[DJR1]

My Medichecks report last week also recommended a bone density scan. It suggests that suppressed TSH even though both T4 and T3 are well within the reference ranges risks osteopenia. My TSH is measurable but below the reference range and has been for the last five years. The report is anonymous and I am guessing this is a new GP who is making this recommendation to all those with a low TSH. All previous reports have been by a named GP and they have not made this comment. Are there studies that have queried the assumption that low bone density and cardiac issues are caused by suppressed TSH? I think this had been discussed before SlowDragon tattybogle but I can’t quite remember the details.

[tattybogle in reply to DJR1]

See this post DJR1 healthunlocked.com/thyroidu.... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-as-long-as-ft4-and-ft3-are-in-range-.

Contains links to evidence that TSH 0.04 to 0.4 (on levo) had no greater long term risks than TSH in range, (all risks eg heart bones etc )

Also a link to evidence that long term supressed TSH ( when kept supressed deliberately as part of follow up from thyroid cancer) did not cause any significant reduction in bone density.

[DJR1 in reply to tattybogle]

Thank you! I knew I had seen this. Now printed off and filed!

[BreatheHelen in reply to tattybogle]

Very useful, many thanks for the link

[blondpalomino]

Hi, I have a long history of supressed TSH - the last blood test was 0.005. Although my T4 and T3 are always in range.

I saw an Endo in Nov 2016 who was concerned at this and she referred me for a bone density scan, which I had in Dec 2016. It showed I have Osteopenia, the next stage down from Osteoporosis. I was due another scan Dec 2019 but then covid came along and I haven't had another one. The thing is that my Mum (now deceased) had osteoporosis and my sister also has it, so it is in my family. My Mum only got a thyroid problem in her 80's and my sister doesn't have a thyroid problem, so it's difficult to say whether it is the supressed TSH that caused it or whether I would have got it anyway.

There isn't a lot they can do anyway, my Doctor said that the medication they can give you has a lot of side effects. I take vitamin D all the year round and make sure I have enough calcium in my diet, I don't think it's advisable to take calcium supplements as they can affect your heart,

I dance and walk every week, it's good that you exercise. Just be careful not to fall over as I broke my wrist when I did!

[BreatheHelen in reply to blondpalomino]

That's all really interesting, thanks. I'm sorry about your mum, and that osteoporosis is in your family. I think my mum must have had it as she shrunk a lot, about a foot or more, after 70.I plan to ask GP for a dexa scan but will do a private urine test at some point if the GP won't help.

[Locky1971]

Last year after A medichecks test they advised a bone scan. However when I talked to my GP he dismissed the idea. I'm 51, had a full hysterectomy in 2019 and my mum has osteoporosis. Recently I got out of bed awkwardly and hurt my ribs then hurt the other side ribs getting my shoes off literally a month between incidents. I have hashimotos and my thyroid is always suppressed. My endo has realised this and is not dosing by tsh as for the last 5 years my tsh is 0.01 and I've been on NDT and t4/t3 different amounts and it doesn't change.But I still think I should be offered a bone scan. So personally I think it might be worth getting it checked just for peace of mind. I may look into the urine test.

[BreatheHelen in reply to Locky1971]

Gosh, your poor ribs!

I hope if you try the urine test it's ok.

I'll ask my GP for a dexa.scan first, but if I'm told no, then I'll do the urine test to be sure, but from others' replies, it seems it's probably not a concern for me yet. But always good to know our bone status, if possible.

Wishing you well