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Thyroid Hormone Diseases and Osteoporosis
Open accessAbstract
Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone turnover osteoporosis. Subclinical hyperthyroidism, defined as low thyrotropin (TSH) and free hormones within the reference range, is a subtler disease, often asymptomatic, and the diagnosis is incidentally made during screening exams. However, more recent data suggest that this clinical condition may affect bone metabolism resulting in decreased bone mineral density (BMD) and increased risk of fracture, particularly in postmenopausal women. The main causes of exogenous subclinical hyperthyroidism are inappropriate replacement dose of thyroxin and TSH suppressive L-thyroxine doses in the therapy of benign thyroid nodules and thyroid carcinoma. Available data similarly suggest that a long-term TSH suppressive dose of thyroxin may decrease BMD and may induce an increased risk of fracture. These effects are particularly observed in postmenopausal women but are less evident in premenopausal women. Overt hypothyroidism is known to lower bone turnover by reducing both osteoclastic bone resorption and osteoblastic activity. These changes in bone metabolism would result in an increase in bone mineralization. At the moment, there are no clear data that demonstrate any relationship between BMD in adults and hypothyroidism. Despite these clinical evidences, the cellular and molecular actions of thyroid hormones on bone structures are not complete clear.
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“These findings are consistent with some studies [38, 45], suggesting that the duration of intervention may influence BMD.”
From Effects of levothyroxine therapy on bone and mineral metabolism in hypothyroidism: a systematic review and meta-analysis (2025) · cites this paper as [45]
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Metadata
- Authors
- Delitala, A. P., Scuteri, A., & Doria, C.
- Affiliations
- University of Sassari (IT)
- Corresponding author
- Delitala, Alessandro P.
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2020-04-06
- Volume
- 9
- Issue
- 4
- Pages
- 1034
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC7230461
- OpenAlex
- W3015134906
- Cited by
- 220
- References
- 100
- Citations by year
- 2026: 27 · 2025: 40 · 2024: 51 · 2023: 36 · 2022: 33 · 2021: 27 · 2020: 5
- FWCI
- 3.87
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- thyroid hormones, osteoporosis, subclinical hyperthyroidism, hyperthyroidism, overt hypothyroidism, bone mineral density, bone turnover, fracture risk, postmenopausal women, TSH suppression therapy, levothyroxine, thyroid nodules, thyroid cancer, bone metabolism
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