Thyroid Foundation of Canada - 'osteoporosis link incorrect'

I found the comment below quite interesting. (Some of the rest of the advice on this page is rather dubious however)

thyroid.ca/faqs.php#null

Answer to question 7: 'The treatment with thyroxine can be for two purposes, either to suppress thyroid tissue or merely to treat hypothyroidism. It would be appropriate to suppress TSH in the case of a goitre or previous treatment for thyroid carcinoma. A low (subnormal) TSH may be due to pituitary damage, or may be due to excess production of thyroxine or T3, or excess intake of these agents. In the latter situation, the TSH is supressed. However, when one is trying to treat hypothyroidism, the ideal treatment would be to bring TSH down into the normal range, but not suppress it necessarily. Nevertheless, concerns which many physicians have expressed over the past few years about osteoporosis if TSH is suppressed by thyroxine have proven recently to be incorrect. Studies have shown NO reduction in bone mineral density, and no osteoporosis when thyroxine is taken even in suppressive doses. Only when patients have had actual Graves' disease -- "overactive thyroid," is there a risk of osteoporosis and even that risk is small. Nevertheless, one should strive for ideal therapy and the ideal for hypothyroidism is to have all tests of thyroid function normal.'

Val

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  • Also see answer to question 4: 'The problem is that the serum thyroxine is not useful for monitoring patients who are taking thyroxine by mouth. For that purpose, the total serum triiodothyronine (total T3) is the best measure of the appropriateness of the dosage'.

    Plus the reference range for T3 is different to that used by the lab that took my tests in the UK (0.9-2.4)

  • The reference ranges differ from lab to lab even within the `UK, let alone from country to country.

    This is why it's essential to quote the accompanying reference range when posting test results.

    Most labs here do an FT3 test (if they can be persuaded to do it at all). Only a few will do Total tests.

  • Not much point in doing a total test anyway. It doesn't give you any useful info as far as I can see. Just a waste of money and resources.

    Grey

  • Dr Lowe's statement is here

    web.archive.org/web/2010122...

  • My endo was slightly concerned about the fact that my TSH levels have been too low to measure at all for the last 12 months, so he sent me for a bone density scan. I got the results back yesterday and they found that: (Quote) " The bone density is well in the middle or even above the middle of the normal range so there is no concern." So either I am extraordinarily lucky with my bones or their concerns about 'surpressed' TSH levels are obviously erroneous!

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