The in-vivo precision was 1.6 for measurements of femoral neck, 3.2 for Ward's triangle, 2.2 for femoral trochanter, and 0.8 (anterior-posterior) and 3.6 (lateral) for lumbar spine. A Z score was calculated for each bone density measurement from the mean (SD) for the relevant control group (Z score patient's value - group mean ö group.KEEP UP THE GOOD WORK! and God bless you. For more information on how to take your thyroid medications, see the resources in the sidebar on the right, and in particular, How To Take Your Thyroid Medication.
No patient or control had a history of osteoporotic fracture, rheumatoid arthritis, diabetes mellitus, any other serious medical disorder, alcohol abuse, chronic amenorrhoea ( 3 months in women aged less than 45 years late menarche, early menopause, or oophorectomy.We suggest that thyroxine alone does not have a significant effect on bone mineral density and hence on risk of osteoporotic fractures. Introduction The relation between thyroid disease and osteoporosis was first recognised 100 years ago.
Val Loh/The Image Bank/Getty Images Updated May 11, 2015. Here's a letter recently received from a reader that is important to share. Dear Mary, Last year my mother was diagnosed with hypothyroidism.Patients and Methods 49 patients (18 premenopausal women, 26 postmenopausal women, 5 men) took part in the study (table 1). No patient had evidence of recurrent or metastatic disease (all had persistently undetectable serum thyroglobulin; all radioisotope scans done were negative).
After the next couple of weeks, the blood tests still showed no improvement. This time my mother had NOT missed taking her medication, but the nurse didn't seem to believe us.Studies of the effect of thyroxine replacement therapy on bone mineral density have given conflicting results; the reductions in bone mass reported by some have prompted recommendations that prescribed doses of thyroxine should be reduced.
Patients and controls completed a questionnaire on dietary calcium intake, smoking history, and physical activity. Venous blood samples were collected from patients and controls and serum was stored at -70C until tests of thyroid function and measurements of calcium, inorganic phosphate, alkaline phosphatase, and parathyroid hormone were done.Serum free thyroxine and free T3 were measured by Amerlex M radioimmunoassay (Amersham International, UK: normal ranges 9-24 pmol/1 and pmol/l, respectively) and thyrotropin by immunoradiometric assay (IDS Gamma-BCT, Boldon, UK; detection limit 0.05 mU/l, reference range Mu/l).
We have examined the effect of long-term thyroxine treatment in a large homogeneous group of patients; all had undergone thyroidectomy for differentiated thyroid cancer but had no history of other thyroid disorders.For the whole group and for the male subgroup, serum calcium was significantly lower in patients than in controls, presumably as a result of previous thyroid surgery and radioiodine ablation, although there were no differences in serum parathyroid hormone or alkaline phosphatase (table II).
They had never heard of this before. They assumed that the tests were normal because she hadn't skipped a day of taking her meds like they had advised her! This is such a simple fact but, WITHOUT YOUR WEBSITE, Mary, we would never have known this!Serum thyrotropin was below the limit of assay detection ( 0.05 Mu/l) in 13 premenopausal female patients, 20 postmenopausal women, and 2 men. Thyrotropin was below the normal range but detectable in 5 of the remaining 14 patients and within the normal range in 9.
There was no significant difference in bone mineral density between patients and control in any subgroup for any of the femoral and lumbar spine sites measured (table III). Analysis of data from the whole group of patients and controls again showed no difference in bone density.Nor was bone mineral density correlated with dose, duration of therapy, or cumulative intake, or with tests of thyroid function. There was a decrease in bone density with age in both groups.
Since thyroxine replacement therapy is needed by many people, especially those over 60 years old, any association between hyperthyroidism secondary to thyroxine therapy and a reduction in bone density could be an important clinical problem.You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site.
Subjects with hypoparathyroidism were excluded. Each patient had received a constant dose of thyroxine since thyroidectomy; in most the dose was sufficient to suppress thyrotropin concentrations to below normal. The mean thyroxine dose was similar in women and men (premenopausal women 217 range 10-300 /day; postmenopausal women /day; men /day as was the duration of.Results There were no significant differences between patients and control in male and premenstrual female subgroups in smoking history, physical activity score, and dietary calcium intake, apart from the number of smoking years in the male subgroup (table 1).
She complained of extreme fatigue, unintentional weight loss, and a sense of heat intolerance. Her bowels were often loose and she had trouble sleeping. She was taking thyroid hormone replacement medication because she had had her thyroid removed years ago for a goiter.Our doctor put her on the smallest dose of synthroid for two weeks, after which she was supposed to return for a blood test. The blood test showed that there was no improvement but, because my mom had not taken the medication three times during the two week period, she was asked to continue the.
When I told the doctor and the nurse what we had discovered on YOUR website, and how my mom had separated her calcium and thyroid supplement, they looked at me like I was full of it.Increasing sophistication of tests of thyroid function, especially assays for serum thyrotropin that can distinguish low from normal values, has led to growing recognition that slight abnormalities of thyroid function are common.
Despite long-term thyroxine therapy (mean duration 7-9 range 1-19 years) at doses (mean 191 SD 50 g/day) that resulted in higher serum thyroxine and lower serum thyrotropin concentrations than in the controls, the patients showed no evidence of lower bone mineral density than the controls at any site.Between-assay coefficients of variation for free thyroxine, free T3, and thyrotropin were less than 7 over a wide range of concentrations. Serum calcium, phosphate, and alkaline phosphatase were measured by routine laboratory methods and serum parathyroid hormone by immunoradiometric assay (N-tact Incstar, Wokingham, UK; between-assay coefficient of variation 8).
Ebix, Inc. All Rights Reserved. All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice.Two studies in the USA suggested that thyroxine therapy resulted in a reduction in bone mineral density. Despite the lack of evidence of an increased risk of osteoporotic fractures in patients taking thyroxine, these studies have had a strong influence on clinical practice, especially in the USA; the American Thyroid Association has recommended that prescribed.
For the whole group, there were no differences between patients and controls apart from a small difference in physical activity score (p 0.05). In subgroup analysis there were no significant differences between patients and controls in inorganic phosphate, alkaline phosphatase, or parathyroid hormone (table II).AREN 'T DOCTORS SUPPOSED TO KNOW THESE THINGS? Can you imagine what my mom would have gone through as they would have kept fiddling with the dosage until her TSH levels were normal?
Many patients taking conventional doses of thyroxine (100-200 g/day) have high concentrations of serum total and free thyroxine, and serum thyrotropin is frequently undetectable in such subjects; some argue that these findings indicate overtreatment and hyperthyroidism.The controls were selected by an alphabetical search of the register of a single general practice. 42 of those identified by age and sex satisfied our other inclusion criteria. 50 of eligible controls agreed to take part.
THANK YOU SO MUCH MARY! I read your newsletter religiously. You are a life saver for many women out there who have thyroid problems! I know for a fact that you may have saved my mom's life!Although effective antithyroid treatment means that the association of overt thyrotoxicosis and osteoporotic fractures is now rare, lately much attention has focused on the potential effect of mild to moderate hyperthyroidism on bone mineral density.
Applies only to oral form of both agents. Separate by 2 hours. Clinical Drug Interactions Source: Medscape from WebMD WebMD, LLC.The 49 patients were matched with controls for age, sex, menopausal status, body mass index, smoking history, and calcium intake score; in all subjects bone mineral density at several femoral and vertebral sites was measured by dual-energy X-ray absorptiometry.
Such a change in prescribing practice would increase the cost of biochemical monitoring and inconvenience to patients, and might lead to undertreatment of hypothyroidism. In view of the conflicting results of previous studies on thyroxine treatment and bone density, we have examined the effect of long-term thyroxine treatment in a group of patients who had.Other Publications Articles Long-term Thyroxine Treatment and Bone Mineral Density. J.A. Franklin, J. Betteridge, J. Daykin, R. Holder, G.D. Oates, J.V. Parle, J. Lilley, D.A. Heath, M.C. Sheppard. Reprinted from The Lancet, Vol., July 4, 1992 with permission of the authors.
Take these drugs 2 hours apart. Patient Drug Interactions Source: RxList 2015 RxList, Inc. Significant - Monitor Closely Significant interaction possible, monitor closely. calcium citrate oral and levothyroxine oral calcium citrate oral decreases levels of levothyroxine oral by inhibition of GI absorption.Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our. Terms Conditions.