Overactive Thyroid Increases Risk of Bone Fracture in Thyroid Patients

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According to research findings published in March of 2015, if you have even a slightly overactive thyroid, you face an increased risk for dangerous bone fracture and loss of bone mass as you age.

A meta-analysis published in the Journal of the American Medical Association looked at 13 studies conducted in the United States, Japan, Europe, and Australia. Combing through records of more than 70,000 patients, Swiss researchers sought an answer to the question of whether subclinical thyroid dysfunction leads to a higher risk of bone fractures.

Importantly, this study looked at both subclinical hyperthyroidism and hypothyroidism. Subclinical refers to a condition with no symptoms or very mild symptoms. But an undiscovered thyroid condition – even without symptoms - is not good news, as researchers discovered.

Findings of the study include:

  • Subclinical hyperthyroidism was associated with an increase in hip fractures. The research does not suggest hyperthyroidism causes fractures but is a condition closely associated with fragility fractures.
  • No increased fracture risk was found in patients with subclinical hypothyroidism.

If hyperthyroidism does not cause fractures—do you need to worry about mild thyroid overactivity? The answer is yes.

HIP FRACTURES AND HYPERTHYROIDISM -- WHAT YOU NEED TO KNOW

This study follows years of discussion about the role of thyroid dysfunction and bone health, especially for women moving through menopause.

Thyroid hormone affects special cells known as osteoclasts and osteoblasts.

These cells participate in the turnover and remodeling of bone in your body. Osteoclasts dissolve old bone and osteoblasts create new bone.

Healthy bone metabolism keeps your skeleton strong. Excessive amounts of thyroid hormone increase the rate of bone dissolution faster than osteoblasts can lay down new bone structure.

This imbalance results in weakening of your bones—and a higher risk of fracture.

For either gender, understanding the role of thyroid disease in bone loss is important to avoid a fracture. Consider these points:

  • Hypothyroidism: As noted in the study, an underactive thyroid gland is not, by itself, considered a risk factor for osteoporosis or thinning of the bones. Poorly gauged or monitored thyroxine replacement therapy can lead to bone loss if you are overmedicated, however. (It is also important to note that this is controversial,  and some physicians believe that proper metabolism and hypothyroidism treatment is necessary for healthy bone development, and do consider undertreated or untreated hypothyroidism to be a risk factor for bone loss or reduced bone density.)
  • Hyperthyroidism: Because subclinical hyperthyroidism increases fracture risk, evaluation and appropriate treatment is needed. Given a lack of clear symptoms, or clinical numbers, it is essential to find the right healthcare practitioner to help you avoid a potentially disabling break. Graves’ disease commonly causes hyperthyroidism. If you suffer this condition, your risk of reduced http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169869/ bone mineral density is greater.

    At any age, healthy bones are important. While a broken bone is an inconvenience at a younger age, a hip fracture at an older age can spell disability or worse.

    At an annual meeting of the Clinical Orthopaedic Society, speaker Dr. Erika J. Mitchell noted, “Hip fractures kill…Statistically speaking, up to half of all women will have fragility fractures in their lifetime, and up to a third of all men.”

    TIPS FOR SELF-CARE

    Here are some ideas to help reduce your risk of bone fractures. 

    • Reduce your likelihood of falling: People fall and suffer broken bones every day. Reduce your risk through regular vision examination and an annual physical. Check your house and office for potential dangers like poor lighting, loose flooring, or slippery surfaces. Take necessary steps to keep yourself, family, and friends, from accidental falls. Keep muscles strong with regular exercise, and make sure to include balance exercises as you get older, to reduce your risk of falling.
    • Understand your risk for a fracture: In addition to thyroid disease, there are other physical conditions, and medications, that can cause you to be unsteady on your feet. You may be genetically predisposed toward osteoporosis. Work toward better bones through a healthy lifestyle, diet, and medical support when needed.

    THE SCREENING CONTROVERSY

    While there are millions of patients with a thyroid diagnosis, there are tens of millions who may not know they have a problem until their symptoms intensify—or a broken bone leads to further investigation. Still, there is no agreement regarding screening at-risk patients and the elderly for subclinical hyperthyroidism. Notes study author Dr. Nicolas Rodondi, “And the problem, of course, is that most of the patients with a subclinical condition have no symptoms. So if we don't screen, we don't know there's a problem."

    The thyroid gland plays a complicated role in your health. Be sure you understand common symptoms of thyroid dysfunction. If you wonder whether your thyroid is overactive, avoid the risk of a bad break and see a knowledgeable physician sooner than later.

    Source:

    Blum, Manuel R. MD, et.al. “Subclinical Thyroid Dysfunction and Fracture Risk: A Meta-analysis.” Journal of the American Medical Association. 2015;313(20):2055-2065. doi:10.1001/jama.2015.5161, May 26, 2015, Vol 313, No. 20. Abstract

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