Influence of Thyroid-stimulating Hormone Suppression Therapy on Bone Mineral Density in Patients with Differentiated Thyroid Cancer: A Meta-analysis
Open accessAbstract
BACKGROUND: The effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with differentiated thyroid cancer (DTC) remains unclear. We conducted a meta-analysis to determine the influence of TSH suppression therapy on BMD. METHODS: We performed a systematic search to identify studies which included BMD measurement of femoral neck, total hip or lumbar spine in patients on TSH suppression therapy for DTC. Main outcome measures were difference of BMD of femoral neck, total hip or lumbar spine measured by dual energy X-ray absorptiometry between patients and controls. RESULTS: <0.001) in postmenopausal women with DTC, while it was not associated with that in premenopausal women and men with DTC. CONCLUSIONS: Although the included studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the lower BMD of spine and total hip in postmenopausal women (but not in premenopausal women and men) with DTC. A large, well-designed study with long-term follow-up would provide further insight into the influence of TSH suppression therapy and loss of BMD.
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The results of this meta-analysis reinforce previous reports that levothyroxine treatment-induced subclinical hyperthyroidism affects bone mineral density reduction in postmenopausal women.
“The results of our meta-analysis reinforce the previous reports that levothyroxine treatment-induced subclinical hyperthyroidism affects BMD reduction in postmenopausal women (16,17,34) for various causes other than DTC were mixed, and the degree of TSH suppression varied considerably.”
From Effect of TSH Suppression Therapy on Bone Mineral Density in Differentiated Thyroid Cancer: A Systematic Review and Meta-analysis (2021) · cites this paper as [34]
The Results (Postmenopausal women) report lower hip and spine BMD with TSH suppression therapy, and the Discussion identifies postmenopausal women with differentiated thyroid cancer receiving that therapy as a risk group for bone loss. The paper limits its analysis to patients with differentiated thyroid cancer and says the finding is not conclusive; it does not establish a causal effect of levothyroxine-induced subclinical hyperthyroidism in postmenopausal women generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe cytotoxic effect of PDT is caused by three components: light of a specific wavelength, photosensitizer, and molecular oxygen.
“The cytotoxic effect is caused by 3 components: light of a specific wavelength, photosensitizer (PS) and molecular oxygen.[28,30,31]”
From Photodynamic Therapy for Thyroid Cancer (2025) · cites this paper as [31]
The Introduction and Methods describe a meta-analysis of TSH suppression therapy and bone mineral density in differentiated thyroid cancer. Searches of our copy for photodynamic therapy, photosensitizer, molecular oxygen, and light wavelength found no passage addressing the claimed components of PDT cytotoxicity. (LLM, conf=0.78)
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- Authors
- Yoon, B.-H., Lee, Y., Oh, H. J., Kim, S. H., & Lee, Y.-K.
- Affiliations
- Inje University Seoul Paik Hospital (KR)
- Seoul National University (KR)
- National Cancer Center (KR)
- Corresponding author
- Lee, Young-Kyun
- Venue
- Journal of Bone Metabolism
- Published
- 2019
- Volume
- 26
- Issue
- 1
- Pages
- 51
- ISSN
- 2287-6375 (ISSN-L)
- 2287-7029
- PMC
- PMC6416150
- OpenAlex
- W2922377130
- Cited by
- 46
- References
- 57
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 4 · 2023: 5 · 2022: 9 · 2021: 7 · 2020: 7 · 2019: 3
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Journal of Bone Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Korea Health Industry Development Institute (HI18C0284)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- bone mineral density, differentiated thyroid cancer, subclinical hyperthyroidism, postmenopausal women, bone loss, femoral neck, lumbar spine, total hip
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