I am a 30-year old woman, has been on the thyroid replacement (levothyroxine 88mcg) for 3 years since the Hashimoto thyroiditis diagnosis after my daughter was born. My TSH usually fluctuates around 2 on the meds which according to my endo is great. I feel fine, although I do have concerns about the long term thyroid replacement and osteoporosis later in life. My endo refuses to order bone density scan, just laughs and says "you don't have to worry about that until you are menopause". I am fine now and no issues with my bones, but I don't want to do anything to hasten osteoporosis later on. Does anyone know anything about this? I tried to search the literature, but the data is very conflicting. Please help if anyone has dealt with this.
To my knowledge, thyroid replacement does not cause osteoporosis unless you are on too high a dose and are in a hyperthyroid hormonal state. Getting adequate calcium and Vit D is a good preventive measure, as is not drinking too much or smoking.
Thanks ladybud! Do you have any idea on how much is too much? The majority of works I found seem to indicate that TSH somewhere at or above 1.4 is a safe dose. I think I am just trying to play it as safe as possible, since I know I will have to take it for the rest of my life and I don't want osteoporosis - either now or in the future.
Yes, I take enough vitamin D and calcium, I exercise and watch my weight, I don't smoke, drink only in moderation. Hopefully all these works for osteoporosis prevention.
I would only be concerned if your TSH goes and stays below 0.5. The effect of that of course is slow so don't panic if you see it there. It would take months for it affect your bones significantly. I would get a bone density as a baseline. Maybe you can twist your Drs arm or get another one to order it.
I could find no legitimate, ie accredited source, saying that replacement therapy in and of itself causes osteoporosis. Hyperthyroidism or taking too much replacement hormone can be problematic. Unless you have some sort of other factor going on, such heavy use of steroids like that seen in some lupus patients, you would just be wasting your money, time and health resources in getting a DEXA (or bone density) scan. The replacement dosage is that which is correct for each individual to acheive an optimal range as measured both by labs and relief of symptoms. I have Hashi's myself and need much more replacement levothyroxine to keep in my optimal range than say you, but less than someone else. I believe the reference range for most labs of TSH is now 0.1 to 3.0, but even my own lab has a reference range of 0.27 to 4.20 uIU/mL. If you wish to do the best for your bones, keep your thyroid levels in the optimal range, eat right, get plenty of rest and do weight bearing exercises, lol just like Dr's tell you to.
Hi TMJ. I've been on total thyroid replacement (112 mg synthroid) for 9 years. You have been given good advice from both luca and Ladybud. I have treated Graves Disease(hyperT) and did have some density loss during the hyper period. I have no family history or or any other factors for the bone loss so i believe the density loss came from being hyper. As long as your dose is the right dose for you and you keep up the things you are doing you should be fine for many years to come.
Since your dr. won't order a DEXA scan you could look for a health fair in your area and take the heel test if offered. Its not as reliable as a DEXA, but will give you an idea of your bone density. You can also look up the FRAX test and take it. It a list of lifestyle and health questions that can give you a good indication of your bone health. Keep up the good work and enjoy being a Mom.take care, phyllis
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