thyroid and bones

[Lojinks]

Hi

I'm 44, diagnosed sub clinical hypothyroid with antibodies in 2009. I take T4 and T3 combination, prescribed by an endocrinologist for hypothyroidism. I feel better than I did on T4 only but am still a bit unwell and still trying to get the dose right with my endo.

My TSH has been effectively suppressed for over a year, it stands around 0.03 (with T4 currently at 12.2 but has been as high as 21, my T3 blood test for some reason was not processed by the lab the last two times I had blood taken but was 5.5 about 6 months ago)

My question is what tests should be done to ensure my bones are not compromised and when should they be done? My endo said "at some point we will do a bone density test" I don't want to wait till my bones are crumbling!

Also, should I be taking calcium? My calcium levels were apparently fine when last tested.

NB my Vit D was deficient a while back and I take 2000 iu of that a day which has been beneficial.

thanks very much for taking the time to answer this question.

[Professor John Lazarus]

There is a concern that patients who take too much thyroxine and especially T3 are at risk of reduction in bone density. If you have been having high levels of thyroid hormone while on replacement therapy then it is reasonable to have a bone scan to check bone density. This may be repeated but not less than 2 years after the initial test

[Lojinks]

many thanks for your response Professor Lazarus.

I will request a bone density test in response to your advice.

[MamaP]

I am also interested in this question.

I hae been taking thyroxine (T4) for over 20 years after treatment for thyroid cancer and after I reached menopause my doctor reduced my meds from 200mcg to 150mcg. I didn't do well on this and after some messing around we returned to 200 mcg. Am I at risk for osteoporosis? My bones are fine (I had a dexa two years ago) and my TSH is 0.1 but am still concerned.

Thanks for any advice you can give me

[MamaP]

PS also, what is the risk of heart problems when the TSH is suppressed for many years? (I cant see where to post this)

Thank you for your help

[Lojinks]

can I add to my original question and ask what is the difference between checking for calcium levels and a bone density scan? I understand one is a blood test and one is a scan but would appreciate knowing more about why there are the two different tests, when each is appropriate and what different information doctors are getting from each of them?


thank you again, I really value this opportunity to learn more about my condition from genuine experts.