Hyperthyroidism and Osteoporosis

By November 10, 2017The Bone Bandits

What is Hyperthyroidism?

Hyperthyroidism refers to any condition which causes elevated thyroid hormone levels in your body. Most often, this is caused by an autoiummune disease—meaning your body starts producing antibodies that attack the thyroid gland and cause it to produce too much hormone. Other possible causes include thyroid nodules which produce excessive thyroid hormone, as well as taking thyroid hormone replacement doses that are too high.

How is Hyperthyroidism Diagnosed?

Your thyroid is one of the primary regulators of your metabolism. Too little thyroid hormone will leave your feeling sluggish, while elevated thyroid hormone levels (hyperthyroidism) can dramatically increase your metabolic rate. This leads to a variety of symptoms including a rapid heart rate, the sensation of an abnormal heartbeat (palpitations), weight loss, anxiety, restlessness, insomnia, swelling in the lower legs, and even protruding eyes (exopthalmus).

To diagnose hyperthyroidism, we use the TSH and free T4 lab tests.

  • Thyroid Hormone (Free T4). This lab is a measure of the amount of active thyroid hormone circulating through your bloodstream. If you have hyperthyroidism, this lab will be elevated.
  • Thyroid Stimulating Hormone (TSH). Your body keeps tabs on the amount of thyroid hormone (free T4) in your bloodstream and attempts to control this level within a normal range. If free T4 levels are too high (indicating hyperthyroidism) then thyroid stimulating hormone will be low in an effort to decrease the amount of free T4.

How Does Hyperthyroidism Impact Your Bones?

Hyperthyroidism has been shown to increase the activity of bone-breakdown osteoclast cells, which leads to progressive bone loss. Longstanding disease can increase your risk of hip fractures 4-fold and spine fractures 5-fold. Even temporary increases in thyroid hormone levels may lead to a slightly increased lifetime risk of broken bones.

How Can Those With Hyperthyroidism Improve Their Bone Health?

If you experience any of the symptoms of hyperthyroidism, discuss these with your medical provider to determine if you need to be screened for the disease. Early identification and treatment can reverse bone loss and reduce your risk of breaking bones. How is hyperthyroidism treated?

  • Methimazole. This is a medication which decreases your thyroid gland’s ability to produce thyroid hormone. It comes in pill form and is effective in managing hyperthyroidism, but requires occasional follow up appointments to ensure side effects do not develop.
  • Radioactive Iodine Ablation. This treatment option uses radioactive iodine to selective “kill off” the overactive portion of your thyroid. While it may sound intimidating, it is a very safe and effective treatment for hyperthyroidism. Dosing can be tricky, and it is not uncommon that you may develop an underactive thyroid gland following treatment. In this scenario, you would need to take daily doses of supplemented thyroid hormone to maintain the hormone level in the proper range.
  • Surgery. Certain forms of hyperthyroidism are best managed by surgically removing the overactive thyroid gland. Similar to radiofrequency ablation, this can lead to underactive thyroid and the need to take daily hormone replacement.