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Conventional thyroxine replacement therapy may be associated with some degree of biochemical or tissue hyperthyroidism, increasing the risk for late onset osteoporosis. This has led to recommendations for reductions in L-T4 dosages.
If your bone density is actually low, there are many therapies out there to treat osteoporosis. These treatments can be given while continuing on your thyroid replacement regimen. Thank you for your question.
People who cannot swallow the capsule whole (such as infants or small children) should use the tablet form of the medication. For infants or children who cannot swallow whole tablets, crush the tablet and mix in 1 to 2 teaspoons (5 to 10 milliliters) of water, and give using a spoon or dropper right away.
Take this medication with a full glass of water unless your doctor directs you otherwise. If you are taking the capsule form of this medication, swallow it whole. Do not split, crush, or chew.
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Perhaps the biggest question question mark over long term thyroxine is its ability to cause osteoporosis. One study of long term thyroxine users showed no evidence of reduced bone density (Lancet, 1992; 340: 9-13 while another study of premenopausal women with Hashimoto's disease on thyroid replacement therapy demonstrated that they had lower bone mineral density.
Thyroid replacement treatment is usually taken for life. There are different brands of levothyroxine available. Do not change brands without first consulting your doctor or pharmacist. Certain medications (such as cholestyramine, colestipol, colesevelam, antacids, sucralfate, simethicone, iron, sodium polystyrene sulfonate, calcium supplements, orlistat, sevelamer, among others) can decrease the amount of thyroid hormone that is.
693 694 Selected References These references are in PubMed. This may not be the complete list of references from this article. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA.
Hyperthyroidism itself produces an increase in bone loss, and if the disease is treated early, this can be minimized. In the same manner, excessive amounts of thyroid hormone replacement can result in bone loss.
Am J Med. 1987 Jun; 82 (6 11671170. PubMed Paul TL, Kerrigan J, Kelly AM, Braverman LE, Baran DT. Long-term L-thyroxine therapy is associated with decreased hip bone density in premenopausal women.
For this reason, it is important that patients on thyroid hormone replacement be checked regularly ( every 6-12 months) to make certain that the dose of replacement results in a TSH within a normal range.
If you have concerns about your bone density, you should speak with your physician about ways to assess your bone mass (a bone density test). In addition, you should seek out information on ways to maintain healthy bones such as calcium supplementation and weight bearing exercises.