This paper relates sensitivity to thyroid hormones in the elderly to thyroid hormone levels - obviously relevant to thyroxine/triiodiothyronine levels on treatment. That is, perhaps higher dosages in therapy inhibit osteoporosis rather than cause it. This puts the idea that elevated FT4/3 is responsible for OP on its head.
Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals
February 2023 Journal of Endocrinological Investigation
DOI: 10.1007/s40618-023-02035-1
LiuL, Hua K, Li Zhong
Written by
diogenes
Remembering
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Many members have been diagnosed with osteoporosis, and myself osteopenic which has reversed with the addition of T3, HRT, Vit D and magnesium, and weight bearing exercise.
It seems bone health is fussy in its needs with too much or too little thyroid hormone having detrimental effects. Your thyroid hormones are sounding low even without ranges. It will be good to see your latest BH results.
We know a low TSH alone doesn’t cause osteoporosis but I guess it depends on the definition of ‘elevated’ and how much of that elevated becomes 'excess'.
I assume deiodinase behaviours are skewed if thyroid hormone sensitivity is present, so the D3 in bones equipped to deal with excess thyroid hormones is defunct.
I guess healthy bone metabolism requires good working thyroid levels that are neither too high nor too low. Shame the guidelines are to lower thyroid hormone replacement in the elderly because of their sedentary lifestyle.
My #s are so bizarre - I'm [supposed to be ] 'elderly' - exercising x8 times on the hour each day + 12 mins of stretching + press-ups before bed to keep pain at bay, so as to avoid any meds... 'they're' not taking away my 'critical faculties' with their drugs! 😆😎
Just got Thyroid function test results today: 75 mcg per day (needed to not have freezing shins/punch-drunk ++).
Taken T3 since 2011, with Armour, but gradually raised T3 and then Armour was removed 2015/16. T3 alone from 2016 [was 62.5 mcg in summer and 75 mcg in winter]. Had to go back up to 75 mcg due to endo interference, where he didn't prescribe or do anything but sneer at low temperature.
Bones were fine until 'osteopenia' in 2018.ish? Mother had osteoporosis + Paget's in family too. 2023 just yesterday told I have osteoporosis in right forefinger and my thumb has a bone spur. To say 'bones fine...' long ignored issues finally led to a cervical spine problem in 2018 and 'Abnormal' spine dx in 2019?? [Potentially due to lots of exercise - weights - re weight, you know that good old 'Calories In-Calories Out' garbage.] But, no one would ever know to see me walk, dance and exercise - which is another reason for my scrupulously keeping fit: I fully acknowledge how lucky I am to be able to do so.
TSH < 0.05 mu/L [0.3 - 4.5]
Free T4 < 1.3 pmol/L [9.5 to 21.5]
Free T3 12.6 pmol/L [3.1 - 6.8] Not usually this high but I'd forgotten and taken my daily...
My bloods are all good. My BP is excellent. Weight, top end of 8 stone [small amount on due to no informed consent steroid being prescribed!] - I'll get shot of! Heart issues [since 2003 + 2007 - not dx'd when could have been, even on 'their' #s]; endos ignored in 2008 + 2009. 'Saved' in 2010 by Dr S and Dr P. Heart still managing itself well, despite... hey, we've just got to do what we can in the absence of anyone, anywhere, within medicine. So much more on here than 'they' could ever muster! xox
Yes, the body loves movement - a medicine in itself 🧘🏼♀️🏃🏼♀️🚴♀️.
It’s a sorry state when we feel privileged to be able to move. That and be warm - every hypos luxury.
These high T3 numbers always astound me but there are a few members taking high T3 meds. Not sure on the long term implication on bones with all those peaks but hey, we have to live for today and especially when ‘elderly’. Keep up the walking, dancing and press ups (impressive 🏆) and long live our ‘critical faculties’ 👏😁
Absolutely - I'm not sure that some people realise what it can do; not for weight loss, though. Being warm and exercising is great! Ignored for so long, with several health aspects worsening, I had to really, REALLY, look after myself. Also, tried everything to lose weight - medicine having nothing on offer - I found my way out of it. No pain pills for me - until at some point essential - exercise does the job, albeit not right now with for the pain from damned [no consent] steroid. Yes, 'critical' faculties hugely helped when fit.
The #s are a bit scary to 'them' but, as you say, we have to live [as best we can!] when medicine will do nothing for many of us. I keep a check on my numbers = mostly all good, so that will do for me. Yes, 'elderly' is a bit of a joke - never been into labels - and I look after myself in all ways. So long as we're here, make most of! xox
”we’ve just got to do what we can in the absence of anyone, anywhere within medicine.” My problems are heart and muscle (heart being a muscle too off course). I could not agree more with your observation. I have had a heart problem of 25 years standing, that no-one could even name, never mind treat in any way successfully. For twenty years (post heart attack) or so, I was left to fend for myself - at my own arrangement because all that was offered was huge amounts of drugs which provided no release from pain and just did not work. Whilst finally starting levo, (two years ago) the pain more or less suddenly disappeared. It’s a comedy of errors, if it was not so damn serious to our quality of life. I just fail to get my head around (presumably) the cleverest people in the country, much of their education paid by the tax payer, not being ‘allowed’ to treat thyroid patients. They are controlled by endos with big egos, who seem to know very little about their specialism. I can add cardiologists to that list too. It seems we are so much better off right here on the forum!
WoW! Couldn't agree more than with all you say above! What a sick state of affairs in this 21st Century - we may have done better in the late 1800's!
That is so awful for you, to have to go through it with no support from medicine other than drugs that don't work; seen enough within my own family not to go near them. So you were just palmed off, where looking to your thyroid may well have solved those problems... looks like Levo HAS helped. Appalling - yes, years wasted for nothing. I know that too and, worse still, it can impact on other bodily functions. I also have heart issues [via ignored hypothyroidism from 2003 until I saw Dr S], but I actually thought that someone who'd had a heart attack... that is so sickening. I really feel for you! So sorry 'they' treated you that way. 😪😢💚 xox
Private [due to 4 years of being ignored] cardiologist I saw, summer 2007, first Q he asked was, "Any thyroid problems": I had to say I didn't know because I didn't and the referral letter made no mention of it. On getting my medical records in 2018 [oh, a whole host of garbage has gone on - particularly since my challenging endocrinology in 2015/16 - I've had all manner of weird attitudes towards me from other Depts... you see, you're "Not Meant To Say Anything" to the charlatans!] to find that I'd actually - even using their ludicrous population ranges - been hypothyroid from 2003 [just within range by 0.14 = need to know your job Dr, THAT'S hypothyroidism], then 2007 [just within range by 0.11 = again...!]. Heart just trundling along waiting... heart issues in family: 2010 finding Dr S and Dr P 'saved my life'! Ostracized doctors - saved many lives, whilst the 'proper people' ignore with contempt, sneer and gossip about patients!
You take care - all of us take care! Someone, somewhere needs to do something! xox
Yes I find as my awareness is being raised by everything I read on this forum, I am both being comforted and educated. Mostly my head is clearer but it has had to be for learning here. I can’t tell you what I feel like on the odd occasion of speaking to a medic. It’s not an exaggeration to say it feels like I am talking to someone who cannot grasp the language, which in effect works both ways! Roll on when the penny finally drops for someone with some clout to be able to do something about this ridiculous situation. XX.
The endos I've seen - all but one [old school gentleman] who still said 'Not hypothyroid' - were simply weird; staring the evidence [patients before them] hard in the back of the neck - with utter contempt. Given patients are their pay cheque... imbeciles!
As an aside I am on liothronine, I had a DEXA scan in 2015 and one last week. My bone density has hardly changed (it should get a little worse as we age). I will raise a separate post about it within a week or so.
Oh that’s disappointing. I know you medicate T3. Are you practicing the accompanying supports, ie clean calcium rich diet, Vit D & magnesium sups, weight bearing exercise, etc? Perhaps you need some testosterone/HRT replacement.
🤔 Or perhaps depending on your age, by preventing further degeneration is an improvement in itself.
No it's good news my bone density was about average for a 30 year old (the age at which the T-score is set) and it is still average for a 30 year old. I am 70.
We're so used to substandard or deterioration, so having constant strong from the beginning is a refreshing change. Long live Jims bones 💪. I'm catching you up 😁.
I seem to be getting snowed under with the information I have unearthed to further our coming ebook. Head's buzzing with papers and data and trying to home in on best ways forward. Sorry if in all this, I repeat myself. It'll happen again I'm sure, as we have a mammoth task ahead.
Absolutely no apology needed diogenes ! Regardless of how many times it is posted, re-posting can bring it to the attention of those that missed it previously.
Just keep doing what you do diogenes , we are all so very thankful for what you and your colleague/s are doing.
That’ll be interesting. On Levothyroxine (and low T3) I had a few ribs break, but this stopped once I switched to NDT (T3 good). I had a dexa scan a few years later & was fearing the worst, but I was deemed in the top 1% of the population for bone strength. I’d be late 50’s/60 ish.
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