It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Thyroid Disorders Message Board

  • Synthroid dosage - osteoporosis?

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 08-17-2004, 09:30 AM   #1
    cossette2
    Veteran
    (female)
     
    cossette2's Avatar
     
    Join Date: Dec 2003
    Location: Sault Ste. Marie, ON Canada
    Posts: 379
    cossette2 HB User
    Question Synthroid dosage - osteoporosis?

    Is there credible evidence that when taking synthroid for hypo and your blood work shows TSH below the range (example : 0.1) even where there are no hyper symptoms, that you are in danger of increasing the chance of osteoporisis and heart trouble, etc.?

    So far I've seen a nurse prac. and an endo who both will NOT increase the synthroid even though i have many symptoms still and here are my latest test results:

    Free T4: 11 (9 to 23)
    TSH .24 (.35 to 5.0)

    All I am asking for is to increase from .088 to .1. That's all. They won't do it. Are they afraid I might sue them if i get osteoporosis? Who knows!

    I thought I remember reading somewhere that there is no credible evidence that osteoporosis is likely to occur from taking synthroid.
    __________________
    hypo, Synthroid 75 mcg, estrace 1mg, prometrium 100mg, celexa 20mg, adrenal support (also have primary ovarian failure - extremely rare condition)

     
    Sponsors Lightbulb
       
    Old 08-17-2004, 09:42 AM   #2
    Gopherhead
    Senior Veteran
    (female)
     
    Gopherhead's Avatar
     
    Join Date: Jul 2004
    Location: Ontario, Canada
    Posts: 1,432
    Gopherhead HB User
    Re: Synthroid dosage - osteoporosis?

    Cossette, I was pretty sure midwest1 answered this yesterday (or the day before, my memory ain't what it used to be ) - I just pulled up another thread and sure enough, there it is...
    [url]http://www.healthboards.com/boards/showthread.php?t=199193[/url]

    hth
    Nat
    __________________
    A foolish consistency is the hobgoblin of little minds.

     
    Old 08-17-2004, 03:24 PM   #3
    midwest1
    Senior Veteran
    (female)
     
    Join Date: Jan 2003
    Location: Missouri, USA
    Posts: 12,925
    midwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB User
    Re: Synthroid dosage - osteoporosis?

    There is credible evidence, and I remember looking up studies about it online at one time. I'll search my PC files to see if I saved the references and post whatever I find. I just hope I haven't deleted them yet.
    Give me a couple of days... my life isn't quite my own these days, and I have less PC time than usual.

     
    Old 08-18-2004, 12:44 AM   #4
    cossette2
    Veteran
    (female)
     
    cossette2's Avatar
     
    Join Date: Dec 2003
    Location: Sault Ste. Marie, ON Canada
    Posts: 379
    cossette2 HB User
    Re: Synthroid dosage - osteoporosis?

    I did a search on the net with the words osteoporosis and synthroid and came up with a site that spoke 63 studies done on a total of over 3,000 hypo patients over a long period of time. the results were such that 31 of these studies show no adverse effects and 9 of the studies show adverse effects and 23 were somewhere in the middle with partial beneficial or adverse effects. These studies were done from 1990 to 2001. The summary of the article on this site states "In summary, the reviewers conclude that all the the current evidence considered together suggests no significant effect of levothyroxine on bone mineral density, but caution that this is a preliminary conclusion limited by the nature and quality of the studies conducted on this question thus far".

    The study also mention that post-menopausal women are more at risk (naturally) and that age was a factor.
    __________________
    hypo, Synthroid 75 mcg, estrace 1mg, prometrium 100mg, celexa 20mg, adrenal support (also have primary ovarian failure - extremely rare condition)

     
    Old 08-18-2004, 06:44 AM   #5
    midwest1
    Senior Veteran
    (female)
     
    Join Date: Jan 2003
    Location: Missouri, USA
    Posts: 12,925
    midwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB User
    Re: Synthroid dosage - osteoporosis?

    I know that there is a lot of evidence around that supports the "no osteo" crowd, and I know it isn't too hard to find. You would think more doctors would have run across it, too. But when super-egos and lack of ongoing effort to acquire knowledge get in their way, there's just no convincing them they might be wrong about something.
    Here's just a little of what I found... It appears you may no longer need it, but I'll post it for anyone else who may need it in the future.
    Truth be told, though, there really is no amount of evidence that will convince a stubborn doctor who wants to cling to their self-imposed ignorance.

    The following is an excerpt of a paper written by Dr. Barry Durrant-Peatfield. It also touches upon heart effects of T4 and/or T3 treatment. If you want the entire contents of the excerpt, look up the doctor's name using the Board's Advanced Search:

    "The net result very much too often in clinical practice is to under-dose. To provide full remission of symptoms, the level in the tissues of thyroid hormone should be as high as possible, short of too much. (The patient/doctor monitoring to achieve this is described later). The situation is worsened by a tightly held misapprehension in many quarters that there are grave risks associated with overdose. These are largely apocryphal and must be corrected. Probably most widely held, is that thyroid overdose is bad for the heart. The risk is there if coronary artery insufficiency, previous M.l or incipient failure already compromises the heart; the risk of over working a damaged heart is obviously undesirable. The healthy heart will not be damaged by minor degrees of overdose, whether by accident or design; and is rarely much affected even by high levels of thyroid hormone, as in Grave’s Disease.
    Another anxiety is osteoporosis. There is a risk in sustained overdose, and untreated hypothyroidism, but this is still not certain. There is NO risk of osteoporosis in thyroid supplementation in correct, physiological doses obviously; and in any inadvertent minor overdose is rapidly detected by monitoring, and therefore of no consequence either."


    Excerpt from an interview with Dr. John V. Dommisse on the effects of T4/T3 treatment, in particular, on heart and bones:

    "The commonest cause of palpitations, in my experience, is intracellular hypokalemia (a low potassium level in the red blood cells). This test is hardly ever done; the serum level is the one usually done but it won't pick up most cases of low potassium where it counts, which is INSIDE the cells, not outside them, in the serum. The red cell level reflects the level inside heart cells, muscle cells, etc.. It is tragic how many sportspeople are forced out of competitions because their physicians didn't measure the INTRACELLULAR potassium level and pick up their deficiencies that cause muscle cramps, heart problems, etc.. But a high T3 level can add to the risk of cardiac arrhythmias, so patients who have this tendency should have their free-T3 levels kept in the mid-range and not near the top of the normal range, which is where I like it in young, middle-aged otherwise-healthy people.

    The danger of osteoporosis is way-overblown and is the reason why many hypothyroid cases are not diagnosed as such (because then the physician has to subject himself to this supposed high risk of being sued for having caused or aggravated the osteoporosis). It is strange that the free-T3 level should be picked on in this fearful strategy because hardly any of the studies that have been done on thyroid treatment causing osteoporosis have even measured the free-T3 levels of those patients! In fact, the free-T3 level is seldom obtained, period. And this is the level that does 90% of the thyroid function! The main reason why I know the fear of osteoporosis is overblown is that all my patients who are both hypothyroid and osteoporotic see their bone mineral density x-ray scans not only not deteriorate every year, but actually improve - by as much as 30 percentage-points in one year! If osteoporosis can be caused or aggravated by aggressive, hi-normal thyroid treatment, then surely my patients would be prime suspects to show this phenomenon. But they don't. Admittedly, I do also correct many mineral, vitamin, amino-acid and other hormone deficiencies, many of which cause or aggravate osteoporosis, but at least I have proven that, in a fairly-unique practice that does attend to such deficiencies, there is not only no danger of osteoporosis, there is reversal of osteoporosis. And this is without the use of Fosamax, calcitonin or any other drugs that are usually prescribed for osteoporosis."


    Excerpt from a paper by Dr. Dommisse that you can also find in the Board's archived posts listing the ten most common thyroid myths. This is Thyroid Myth #9 and the author's comments on it:
    "(9) "Keeping both the FT4 and FT3 levels at the high ends of their normal ranges will cause osteoporosis": This concern was merited 30-50 years ago, when much-higher doses of thyroid hormone were used in the treatment of most cases of hypothyroidism. One of us (JVD) has not observed this complication in over eleven years of this more-aggressive treatment (unpublished data). In fact, his treatment_optimized hypothyroid osteoporotic patients' bone density scans not only don't deteriorate from one year to the next but almost-invariably improve, without the use of elindronate, calcitonin or any other drugs. This means that, for there to be 'overtreatment' of hypothyroidism, it has to be more substantial than is currently thought. Concurrent correction of other factors, such as deficiencies of vitamins, minerals, other hormones, and amino-acids, seems to maintain and extend bone density, even in the presence of optimal or 'aggressive' treatment of hypothyroidism."

    Four studies and their references showing no ill-effect on bones ~
    Study #1 ~ Journal of Gynecological Endocrinology
    Gynecol Endocrinol 1998 Oct;12S(5):333-7, "Bone mineral density in premenopausal women receiving levothyroxine suppressive therapy." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=9859026&dopt=Abstract

    Study #2 ~ Journal of Clinical Endocrinology and Metabolism
    J Clin Endocrinol Metab 1994 Apr;78(4):818-23, "Carefully monitored levothyroxine suppressive therapy is not associated with bone loss in premenopausal women."
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=8157704&dopt=Abstract

    Study #3 ~ Thyroid
    Thyroid, 1995 Feb;5(1):13-7, "Suppressive doses of thyroxine do not accelerate age-related bone loss in late postmenopausal women." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=7787427&dopt=Abstract

    Study #4 ~ Journal of Hormonal and Metabolic Research
    Horm Metab Res 1995 Nov;27(11):503-7, "A slightly suppressive dose of L-thyroxine does not affect bone turnover and bone mineral density in pre- and postmenopausal women with nontoxic goitre." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=8770627&dopt=Abstract

    This statement is from Dr. John Lowe, noted expert on fibromyalgia, CFS, osteoP, and hypoT:
    " In the 1970s and 1980s, many faulty studies were published that led to the erroneous conclusion that TSH-suppressive dosages of thyroid hormone decrease bone mineral density in most patients. Some conventional endocrinologists wrongly extrapolated from these studies that TSH-suppressive dosages lead to osteoporosis and increased risk of bone fracture. Better designed studies have shown that these conclusions were wrong, and the only group of patients really at risk for substantial loss of bone density from the use of TSH-suppressive dosages are post-menopausal women who previously had Graves’ disease."

     
    Old 08-18-2004, 09:28 AM   #6
    cossette2
    Veteran
    (female)
     
    cossette2's Avatar
     
    Join Date: Dec 2003
    Location: Sault Ste. Marie, ON Canada
    Posts: 379
    cossette2 HB User
    Re: Synthroid dosage - osteoporosis?

    Wow. Thanks for the ample info Midwest. With my foggy brain, it'll take me a while to go through it and digest it.

    I have a comment where the concern about heart problems is concerned. In my case, my hypothyroidism has caused my cholesterol to go really high even though my died is basically low fat and my weight is avg. When i was diagn. as hypo in 2002 my total chol. was about 350! and after being on .075 mgs for over a year, it dropped to 277. I am now on .088 mg and as far as my symptoms, feel i am still undertreated. I have to wonder how much lower my cholesterol will go once i start feeling better and get my Free T4 at a proper level. Having said all that, isn't it better for me to have a higher dose of synthroid to get my Free T4 at a proper level even though my TSH might be really low?
    __________________
    hypo, Synthroid 75 mcg, estrace 1mg, prometrium 100mg, celexa 20mg, adrenal support (also have primary ovarian failure - extremely rare condition)

     
    Old 08-18-2004, 11:44 AM   #7
    midwest1
    Senior Veteran
    (female)
     
    Join Date: Jan 2003
    Location: Missouri, USA
    Posts: 12,925
    midwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB Usermidwest1 HB User
    Re: Synthroid dosage - osteoporosis?

    The "heart problems" you're asking about are different from the ones talked about during treatment with T4/T3. The high cholesterol-caused atherosclerosis is a clear and present danger from undertreatment. Osteoporosis is also caused by un- or undertreated hypoT. Yet doctors too frequently ignore all this and continue to undertreat.

    The heart effects that happen with overtreatment are rhythm problems, and these are not of concern except in the elderly or those with pre-existing heart rhythm problems. A young, otherwise healthy heart can adapt to the temporary disturbances that the meds can sometimes cause.

    TSH is sometimes a useful screening test for thyroid problems, but it should not be given much - if any - consideration once treatment begins. It's fact that some people never feel well until the TSH is below 1.0 or even completely suppressed. My own is currently .02... considered "suppressed", but I'm not considered hyper because my free T levels aren't excessive. So to answer your question, yes! You should be given enough thyroid hormone to get your free T levels into the upper part of their ranges.

     
    Old 08-18-2004, 03:53 PM   #8
    cossette2
    Veteran
    (female)
     
    cossette2's Avatar
     
    Join Date: Dec 2003
    Location: Sault Ste. Marie, ON Canada
    Posts: 379
    cossette2 HB User
    Re: Synthroid dosage - osteoporosis?

    Quote:
    Originally Posted by midwest1
    The "heart problems" you're asking about are different from the ones talked about during treatment with T4/T3. The high cholesterol-caused atherosclerosis is a clear and present danger from undertreatment. Osteoporosis is also caused by un- or undertreated hypoT. Yet doctors too frequently ignore all this and continue to undertreat.

    The heart effects that happen with overtreatment are rhythm problems, and these are not of concern except in the elderly or those with pre-existing heart rhythm problems. A young, otherwise healthy heart can adapt to the temporary disturbances that the meds can sometimes cause.

    TSH is sometimes a useful screening test for thyroid problems, but it should not be given much - if any - consideration once treatment begins. It's fact that some people never feel well until the TSH is below 1.0 or even completely suppressed. My own is currently .02... considered "suppressed", but I'm not considered hyper because my free T levels aren't excessive. So to answer your question, yes! You should be given enough thyroid hormone to get your free T levels into the upper part of their ranges.
    Thanks Midwest. You have been a big help to me. I'll let you all know how I make out with the osteopath in Michigan next week.
    I wonder why there are so many more osteopathic docs in the US than there are in Canada.
    __________________
    hypo, Synthroid 75 mcg, estrace 1mg, prometrium 100mg, celexa 20mg, adrenal support (also have primary ovarian failure - extremely rare condition)

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    L-Tyrosine and Synthroid Hersheykiss Vitamins & Supplements 1 04-21-2010 10:21 AM
    stroke and osteoporosis Elisimova Osteoporosis 1 04-19-2010 06:28 PM
    What affects your dosage of synthroid? tdooders1 Thyroid Disorders 2 02-14-2008 09:34 AM
    Synthroid and Bone Loss susan monty Thyroid Disorders 6 10-10-2007 05:16 PM
    Anyone better on Synthroid than Armour? librarygirl2 Thyroid Disorders 14 03-22-2007 07:38 AM
    Has anyone switched from Armour to Synthroid? Insomnia... boata Thyroid Disorders 3 02-26-2007 02:16 PM
    Continued Hypothyroidism even with increasing Synthroid dosage ajbrandish Thyroid Disorders 8 10-03-2006 04:48 AM
    New With Synthroid Questions Zip Thyroid Disorders 5 10-22-2004 09:15 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 07:10 AM.





    © 2021 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!