Bone metabolism during anti‐thyroid drug treatment of endogenous subclinical hyperthyroidism
Abstract
Summary: OBJECTIVE There is recent evidence that both exogenous and endogenous subclinical thyrotoxicoses are associated with decreased bone mineral density. Scanty information is available on bone metabolism in these conditions when euthyroidism is restored. We evaluated the effect of anti‐thyroid drug treatment on bone metabolism in endogenous subclinical hyperthyroidism. DESIGN Prospective follow‐up study over 2 years during treatment with methimazole, with an untreated control group. SUBJECTS Sixteen post‐menopausal women with endogenous subclinical hyperthyroidism associated with multinodular goitre, eight of whom were treated with methimazole. MEASUREMENTS Serum concentrations of free T4, total T3, TSH, osteocalcin, urinary excretion of hydroxyproline and forearm bone mineral density were measured at regular intervals. RESULTS Significant changes in serum osteocalcin concentration or urinary hydroxyproline excretion were not observed in either group. Distal, but not proximal, forearm bone mineral density, expressed as a percentage of the base‐line value, was significantly (P < 0.05) higher in the treated than in the untreated subjects in the second year of treatment. CONCLUSION Treatment with methimazole In post‐menopausal women with endogenous subclinical hyperthyroidism associated with multinodular goitre can prevent excessive loss of bone, at least in the distal forearm.
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In untreated postmenopausal women with SHyper, BMD progressively declined.
“Prospective studies conducted in postmenopausal women with SHyper showed an improvement in BMD after ATDs or RAI therapy [99,100,[110][111][112][113] , while BMD progressively declined in untreated patients [99,100] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [100]
There are smaller, nonrandomized trials that have shown improvement in bone mineral density with therapy of SH with ATDs or RAI.
“There are smaller, nonrandomized trials that have shown improvement in bone mineral density with therapy of SH with ATDs or RAI (414-417).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [414]
The evidence rests only with small uncontrolled studies that have shown improvements in cardiac structure and function, heart rate and the frequency of premature atrial and ventricular beats, bone mineral density, and muscle strength.
“Thus, the evidence rests only with small uncontrolled studies that have shown improvements in cardiac structure and function, heart rate and the frequency of premature atrial and ventricular beats, bone mineral density, and muscle strength (393)(394)(395)(396)405,(414)(415)(416)(417)426).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [414]
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- Authors
- Mudde, A. H., Houben, A. J. H. M., & Kruseman, A. C. N.
- Affiliations
- Slingeland Ziekenhuis (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Mudde, A. H.
- ORCID
- Houben, A. J. H. M.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1994-10
- Volume
- 41
- Issue
- 4
- Pages
- 421-424
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2043001655
- Cited by
- 135
- References
- 16
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 5 · 2013: 8 · 2012: 11
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- subclinical hyperthyroidism, methimazole, bone metabolism, bone mineral density, postmenopausal women, multinodular goiter, osteocalcin, urinary hydroxyproline, thyroid hormone excess, bone loss prevention
- MeSH terms
- Bone and Bones, Female, Forearm, Goiter, Humans, Hydroxyproline, Hyperthyroidism, Methimazole, Middle Aged, Prospective Studies, Thyrotropin, Thyroxine, Triiodothyronine, Bone Density, Osteocalcin, Postmenopause
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