Presented at the 22nd Annual Meeting of the European Thyroid Association, Vienna August 27–September 1, 1994, and at the 68th Annual Meeting of the American Thyroid Association, Chicago September 27–October 1, 1994.
Skeletal Integrity in Men Chronically Treated with Suppressive Doses of L-Thyroxine†
Article first published online: 1 JAN 1997
Copyright © 1997 ASBMR
Journal of Bone and Mineral Research
Volume 12, Issue 1, pages 72–77, January 1997
How to Cite
Marcocci, C., Golia, F., Vignali, E. and Pinchera, A. (1997), Skeletal Integrity in Men Chronically Treated with Suppressive Doses of L-Thyroxine. J Bone Miner Res, 12: 72–77. doi: 10.1359/jbmr.1918.104.22.168
- Issue published online: 4 DEC 2009
- Article first published online: 1 JAN 1997
- Manuscript Accepted: 30 AUG 1996
- Manuscript Revised: 7 AUG 1996
- Manuscript Received: 1 MAY 1996
We measured bone mineral density (BMD) (lumbar spine, femoral neck, Ward's triangle, and trochanter) in 34 men given suppressive doses of levothyroxine (L-T4) for a mean of 10.2 years. Indications for treatment were nontoxic goiter (n = 5) or thyroidectomy for differentiated thyroid cancer (n = 6) or nontoxic goiter (n = 3). Patients were followed at our institution and treated with the minimal amount of L-T4 able to suppress thyroid-stimulating hormone (TSH). At the time of evaluation, free T3 was normal in all cases, whereas free T4 was increased in 14 men (41.2%). The mean daily dose of L-T4 was 172 ± 6 μg, and the cumulative dose of LT4 was 673 ± 71 mg. We found no significant difference between patients and age- and weight-matched controls in BMD (g/cm2) at any site of measurement (lumbar spine 1.144 ± 0.12 vs. 1.168 ± 0.15; femoral neck 0.979 ± 0.13 vs. 1.001 ± 0.13; Ward's triangle 0.854 ± 0.17 vs. 0.887 ± 0.15; and trocanther 0.852 ± 0.13 vs. 0.861 ± 0.13). BMD was not correlated with the duration of therapy, cumulative or mean daily dose of L-T4, serum levels of free T4, free T3, osteocalcin, and bone alkaline phosphatase. Serum calcium and osteocalcin were slightly but significantly elevated in patients compared with controls, whereas there was no difference in intact parathyroid hormone, bone alkaline phosphatase, and sex hormone-binding globulin (marker of thyroid hormone action). Our data suggest that L-T4 suppressive therapy, if carefully carried out and monitored, using the smallest dose necessary to suppress TSH secretion, has no significant effects on bone metabolism and bone mass in men.