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Thyroid Hormone Diseases and Osteoporosis

Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 1034;
Received: 19 February 2020 / Revised: 24 March 2020 / Accepted: 3 April 2020 / Published: 6 April 2020
(This article belongs to the Section Endocrinology & Metabolism)
Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone turnover osteoporosis. Subclinical hyperthyroidism, defined as low thyrotropin (TSH) and free hormones within the reference range, is a subtler disease, often asymptomatic, and the diagnosis is incidentally made during screening exams. However, more recent data suggest that this clinical condition may affect bone metabolism resulting in decreased bone mineral density (BMD) and increased risk of fracture, particularly in postmenopausal women. The main causes of exogenous subclinical hyperthyroidism are inappropriate replacement dose of thyroxin and TSH suppressive L-thyroxine doses in the therapy of benign thyroid nodules and thyroid carcinoma. Available data similarly suggest that a long-term TSH suppressive dose of thyroxin may decrease BMD and may induce an increased risk of fracture. These effects are particularly observed in postmenopausal women but are less evident in premenopausal women. Overt hypothyroidism is known to lower bone turnover by reducing both osteoclastic bone resorption and osteoblastic activity. These changes in bone metabolism would result in an increase in bone mineralization. At the moment, there are no clear data that demonstrate any relationship between BMD in adults and hypothyroidism. Despite these clinical evidences, the cellular and molecular actions of thyroid hormones on bone structures are not complete clear. View Full-Text
Keywords: thyroid dysfunctions; subclinical hypothyroidism; subclinical hyperthyroidism; osteoporosis; bone mass density thyroid dysfunctions; subclinical hypothyroidism; subclinical hyperthyroidism; osteoporosis; bone mass density
MDPI and ACS Style

Delitala, A.P.; Scuteri, A.; Doria, C. Thyroid Hormone Diseases and Osteoporosis. J. Clin. Med. 2020, 9, 1034.

AMA Style

Delitala AP, Scuteri A, Doria C. Thyroid Hormone Diseases and Osteoporosis. Journal of Clinical Medicine. 2020; 9(4):1034.

Chicago/Turabian Style

Delitala, Alessandro P., Angelo Scuteri, and Carlo Doria. 2020. "Thyroid Hormone Diseases and Osteoporosis" Journal of Clinical Medicine 9, no. 4: 1034.

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