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People suffering from hypothyroidism are given a synthetic form of thyroid hormone, levothyroxine, to cope up with the hormone deficiency.  As we grow older the quantity of this hormone needed by our body decreases, and if the dose is not regulated, it will develop hyperthyroidism, which raises the risk of fractures especially among elder women.  In many cases (over 20%)  it has been observed that the dose of levothyroxine is not monitored (either by doctor's negligence or as patient doesn't go for consultation) and their hypothyroidism turn to hyperthyroidism as they grow older.



Adults suffering from Chronic hyperthyroidism, especially women after menopause, have higher risk of fractures and osteoporosis if not treated properly as they aged.

What The Study Was ?

Lorraine L Lipscombe, from the Women's College Research Institute, Canada, and team decided to find out what effect levothyroxine doses might have on the risk of fractures among elderly patients.Team decided to monitor the people aged between 70 and 105 (excluding those who had received dialysis or palliative care in the six month before the study begun and those who had thyroid cancer and previous hyperthyroidism) years who has been prescribed levothyroxine between 1 April 2002 and 31 March 2007. These patients were followed to see the response of the dose till an outcome of interest, dialysis and palliative care required , thyroid cancer and others till the end of study.  The study was conducted on 213511 adults using levothyroxine during the study period.

Result

Out of 213511, 58063 (i.e. 27.2%) died during the follow-up, 10.4% i.e 22326 undergone at least one fracture, out of which 80% i.e 18108 were women. They found that the risk of a fracture was considerably higher among the current and past levothyroxine use patients, compared to the remote use ones. Current users on medium and high levothyroxine doses had a much higher fracture risk than those on low doses, the authors added.

Women has higher risk of hip fracture but both the sexes have equal risk of any fracture if the dose is not controlled.  The result proved that higher dose of levothyroxine is associated with higher risk of fracture in a dose-reponse manner. Elderly people and post menopausal women are at increased risk of fracture and osteoporosis with higher dose.  Thyroid hormone affect the bone cells directly which results in bone loss.  TSH, required for protecting bones lowers in the over treated patients. If the person suffers from hypothyroidism and treated with proper doses of thyroxine to keep the TSH normal, do not have elevated risk of fracture.  Don't stop getting your thyroid checked at an elderly age and get the the right dose required by the body.


 AWARENESS IS THE KEY TO PREVENTION

References
Journal published in http://www.bmj.com/content/342/bmj.d2238
Thyroid.org

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