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Thyroid replacement & bone density (Utahmomma, take note)
Utahmomma posted a Jan. 16th comment about a discussion with her endocrinologist, who said that post-menopausal women on high doses of thyroid replacement, but a low dose or no dose of estrogen, have an increased risk of osteoporosis. My response may have been overlooked, since I posted it quite a few days later.
I would like to repeat the response and add a paragraph of follow-up information, but the length limitation on a new question is getting in my way. Therefore, let me ask the question,
I would like to repeat the response and add a paragraph of follow-up information, but the length limitation on a new question is getting in my way. Therefore, let me ask the question,
You are hitting the nail on the head, Utahmomma, when you point out the way in which the idea "correlation does not presuppose causation" applies in this situation. As you say, while some studies have shown a higher incidence of bone density issues among women taking high levels of thyroid hormone, it does NOT automatically mean that thyroid hormone is the culprit.
In addition, only some studies have shown this. Others have not. It seems to be well established that, as you say, women who are NOT on hormone replacement have a higher risk for osteoporosis. It also is known that hyperthyroidism is a risk factor for osteoporosis. What is not known is whether taking a high level of synthetic thyroid hormone is a risk factor; some studies say "Yes," some studies say "No," but most importantly, a lot of those studies are so poor in quality that what they say--especially when looked at as a group--is not particularly helpful.
This is the point made in Mary Shomon's article--made in more articulate way that I am managing to make it, I am sure. If physicians did not tend to have a severe allergy to reading anything written by a mere layperson, I would suggest your giving the article to your endocrinologist to read. If he thinks that a high level of synthetic thyroid hormone increases a woman's risk for osteoporosis, then he does not realize that the jury is still out on that one.
Since you have a grad school education, I probably do not need to say that if your endocrinologist has a misimpression about one area of the research literature, it does not mean that he is not a competent doc. I will say it anyway, but I know that you know what an impossibly large challenge it is for any professional in any research-based vocation to keep up with the avalanche-size additions to the research literature.
I did not know that you have been handed a diagnosis of osteopenia, though, which does move you out of the question-mark category and squarely back into the high-risk category. Is there no way for you to win?!
Venora, I agree wholeheartedly about the value of weight-bearing exercise as a preventive strategy for various problems, including the hypohell tendency to gain weight. I also agree with Utahmomma that ALL of us women should be checked for bone density, thyroid problem or no thyroid problem. When I hit my 50th birthday a few years ago, long before my hypothyroidism was suspected, my physician's birthday gift was a referral for a baseline DEXA scan.
Cheryl, I feel for you if you are a kidney stone producer. I have never had one of those, but I am told that they cause pain on an unimaginable level. As if you do not have enough other medical challenges coming from your thyroid gland!! Is there a contest for really going through it medically to an unreasonable degree? If there is, then I think you could retire the trophy.
The information about calcium citrate is good to know. I have read that citrate is more fully absorbed, especially by us over-50 types, so several years ago, I switched to citrate from whatever the cheaper form of supplemental calcium is. Now I wonder if I am unknowingly preventing kidney stones? That would be a nice change of pace from the usual, which is to unknowingly make one of my medical problems worse, not better. Thank you for the news that I am doing something right for a change!
In addition, only some studies have shown this. Others have not. It seems to be well established that, as you say, women who are NOT on hormone replacement have a higher risk for osteoporosis. It also is known that hyperthyroidism is a risk factor for osteoporosis. What is not known is whether taking a high level of synthetic thyroid hormone is a risk factor; some studies say "Yes," some studies say "No," but most importantly, a lot of those studies are so poor in quality that what they say--especially when looked at as a group--is not particularly helpful.
This is the point made in Mary Shomon's article--made in more articulate way that I am managing to make it, I am sure. If physicians did not tend to have a severe allergy to reading anything written by a mere layperson, I would suggest your giving the article to your endocrinologist to read. If he thinks that a high level of synthetic thyroid hormone increases a woman's risk for osteoporosis, then he does not realize that the jury is still out on that one.
Since you have a grad school education, I probably do not need to say that if your endocrinologist has a misimpression about one area of the research literature, it does not mean that he is not a competent doc. I will say it anyway, but I know that you know what an impossibly large challenge it is for any professional in any research-based vocation to keep up with the avalanche-size additions to the research literature.
I did not know that you have been handed a diagnosis of osteopenia, though, which does move you out of the question-mark category and squarely back into the high-risk category. Is there no way for you to win?!
Venora, I agree wholeheartedly about the value of weight-bearing exercise as a preventive strategy for various problems, including the hypohell tendency to gain weight. I also agree with Utahmomma that ALL of us women should be checked for bone density, thyroid problem or no thyroid problem. When I hit my 50th birthday a few years ago, long before my hypothyroidism was suspected, my physician's birthday gift was a referral for a baseline DEXA scan.
Cheryl, I feel for you if you are a kidney stone producer. I have never had one of those, but I am told that they cause pain on an unimaginable level. As if you do not have enough other medical challenges coming from your thyroid gland!! Is there a contest for really going through it medically to an unreasonable degree? If there is, then I think you could retire the trophy.
The information about calcium citrate is good to know. I have read that citrate is more fully absorbed, especially by us over-50 types, so several years ago, I switched to citrate from whatever the cheaper form of supplemental calcium is. Now I wonder if I am unknowingly preventing kidney stones? That would be a nice change of pace from the usual, which is to unknowingly make one of my medical problems worse, not better. Thank you for the news that I am doing something right for a change!
... and for those of us who produce calcium kidney stones taking extra preventative calcium is a real issue .... I've been told that I have to be clinically defined as in need of the calcium to take it ... luckily not menopause yet so doing ok ... also, will be hyper induced via Synthroid so I guess they will ck the bone density, etc. very carefully as I get a few yrs older ..... the way around the calcium intake if one produces kidney stones is to take citrate as that does something to help prevent formation. Ugh.
C~
C~
One thing we can do to prevent bone loss is weight bearing exercises.It builds up the bone as well as defines the muscle.I was on weight training before my surgery and I am planning on going back to it as soon as my sternum is healed.it feels good ,it looks good and I think that is why i havent gained as much weight as I could have during hypohell.I cant wait to get back to weight lifting..
Preggo daughter and I have been walking too everyevening.too.
Love Venora
Preggo daughter and I have been walking too everyevening.too.
Love Venora
One more thing . . . as they said in my Master's classes "correlation does not presuppose causation". While some studies have shown a higher incidence of bone density issues that does NOT automatically mean that thyroid hormone is the culprit. Age is also a factor.
Still . . . all that being said it's a good thing to get checked; especially for those of us who have passed the 30-somethings.
Still . . . all that being said it's a good thing to get checked; especially for those of us who have passed the 30-somethings.
P.S. Just after clicking on "submit comment" a minute ago, I realized that the comments I just posted mentioned "American women," thereby failing to acknowledge the international reach of this forum. What I said about women's intimidatingly long life spans undoubtedly applies to all of you Aussies, Brits, and other soul sisters who participate in the forum from places other than the United States.
Sorry about my oversight, but then, I am sorry, too, to include all of you in the bad news that we women face quite a challenge in keeping our bodily equipment running for a long, long time. Although I am fairly healthy for someone who is 56, my day-to-day functioning makes me think that if I were an automobile, I would be called an old jalopy and be traded in. It does not cheer me up to think that based on my family history, I may have another 45 years of jalopy maintenance ahead.
Sorry about my oversight, but then, I am sorry, too, to include all of you in the bad news that we women face quite a challenge in keeping our bodily equipment running for a long, long time. Although I am fairly healthy for someone who is 56, my day-to-day functioning makes me think that if I were an automobile, I would be called an old jalopy and be traded in. It does not cheer me up to think that based on my family history, I may have another 45 years of jalopy maintenance ahead.
I agree with you wholeheartedly. I really wish there was SOMEONE out there doing a lot more research on thyroid conditions and long-term health effects.
The reason my endo is concerned is because post-menopausal women (even those of us who are only 40) who are NOT on hormone replacement have higher risk for osteoporosis and women with high levels of thyroid (hyper naturally or synthetically) have higher incidence of bone issues. I have a double whammy since I have to stay hyper because of cancer and am avoiding hormone replacement because of a family history of breast cancer. My official diagnosis is osteopenia. :-(
So until there is some good research, all you women who are on high levels of thyroid replacement, please talk to your doctors about checking your bone density.
The reason my endo is concerned is because post-menopausal women (even those of us who are only 40) who are NOT on hormone replacement have higher risk for osteoporosis and women with high levels of thyroid (hyper naturally or synthetically) have higher incidence of bone issues. I have a double whammy since I have to stay hyper because of cancer and am avoiding hormone replacement because of a family history of breast cancer. My official diagnosis is osteopenia. :-(
So until there is some good research, all you women who are on high levels of thyroid replacement, please talk to your doctors about checking your bone density.
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