One of UK's most commonly prescribed drugs (Levothyroxine)is linked to Osteoporosis

[Sly Saint]

Thousands of Brits who take drugs for a common hormone condition could be at risk of bone loss, concerning research suggested today.

Roughly one in five Britons are affected by an underactive thyroid, caused by problems with the butterfly-shaped gland in the neck which governs functions from digestion to heart rate and mood.

Yet levothyroxine, pills that cost just a few pence a day to combat the condition, could raise the risk of the bone-thinning disease osteoporosis.

Research has long suggested too much thyroid hormone speeds up bone loss heightening the risk of the disease.

But now, the US scientists who assessed the drug on dozens of patients, found this risk was still raised among those with 'normal' levels of the thyroid-stimulating hormone.

Professor Shadpour Demehri, an expert in radiology at John Hopkins University in Maryland and study co-author said: 'Our study suggests that even when following current guidelines, levothyroxine use appears to be associated with greater bone loss in older adults.'

Dr Elena Ghotbi, study lead author and postdoctoral research fellow at John Hopkins University added: 'Data indicates that a significant proportion of thyroid hormone prescriptions may be given to older adults without hypothyroidism.

'This raises concerns about subsequent excess of thyroid hormone even when treatment is targeted to reference range goals.'

One of UK's most commonly prescribed drugs is linked to bone disease

 

[Jonathan Edwards]

This seem pretty irresponsible reporting. Thyroxine will lower bone density. We have known that for forty years. (I assume T3 will as well.) If you take more thyroid hormone than you need then your bone density is likely to be lower than it needs be. If you are hypothyroid you need to have enough thyroxine - which is generally reflected in a normal TSH level. It may be that for some patients it is better to err on the side of a slightly higher normal TSH level.

One sentence above suggests that they are targeting the use of thyroxine in older people when they do to need it. That will obviously be a source of osteoporosis. It may also cause atrial fibrillation and stroke. But we have known that all my medical life.

The worry is that people may stop taking their thyroxine if they read this, for no good reason.

 

[Kitty]

They seem to prescribe horse-tablet sized doses of calcium for older people on thyroxine anyway. I don't know whether it does any good, but it seemed remarkably consistent across my parents' generation, who lived in different areas of the country.

 

[PrairieLights]

I am aware that having your levels in the higher ranges (t4 & t3) can increase your risk.

I am also aware that my vit D and calcium levels were bottom of the range BEFORE I was diagnosed as hypothyroid. So, I wonder if they also factor in absorption issues many hypothyroid patients face.

 

[PrairieLights]

And why are doctors giving thyroid medication to patients without thyroid issues??

 

[Arnie Pye]

And why are doctors giving thyroid medication to patients without thyroid issues??

As someone who is hypothyroid and who struggled for many years to get treatment, I haven't heard that treatment of people without thyroid issues ever happens. Or if it does it must be very rare. In fact it appears that many sufferers find that doctors simply don't want to diagnose people with hypothyroidism at all if they think they can get away with it. (And they can get away with it very easily, I think.) In the UK the average TSH amongst the healthy is roughly 1.0 - 1.5. But most doctors won't treat until TSH is 10 or more. Some go further and won't treat until TSH is 10 or more and Free T4 is under range. If you have Central Hypothyroidism (as opposed to the more common Primary Hypothyroidism) the chances are quite high that you might never get diagnosed at all.

I don't think the article quoted is suggesting that patients are getting treated without any thyroid issues. I got the impression that people who are hypothyroid and have been treated to the extent that their TSH is within the "normal" range are still developing osteoporosis despite their treatment being "right" according to doctors.

 

[Jonathan Edwards]

I don't think the article quoted is suggesting that patients are getting treated without any thyroid issues.

The text implies that they are. I am pretty sure that in the USA older people quite often get given a 'little bit of thyroxine' to pep them up on the grounds that even if the TSH is normal they might benefit. It is not so different from the European practice of giving a bit more than the TSH suggests because the patient is still feeling symptoms.

Thyroxine will probably statistically lower bone density whether or not it is too little too much or just right so I am not sure they are telling us anything unexpected. The risk is that people will become frightened of using thyroxine when they need it.

 

[Arnie Pye]

The text implies that they are.

That must be a difference in practice between the UK and the USA then. Lots of people complain that getting treatment in the UK is very, very difficult or even impossible. The main UK Thyroid forum has approx 143,000 members and although members come from all over the world, the largest group of members by country are from the UK.

 

[Jonathan Edwards]

That must be a difference in practice between the UK and the USA then.

Everything is completely different over there. Medicine is a money-making business, full stop. Private physicians in the UK used to do the same but I suspect less keen on the litigation these days.