Osteoporosis
Dr. Weyrich's Naturopathic Functional Medicine Notebook
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Etiology
According to [Starr2005, pg 77], osteoporosis can result from either hypothyroid or hyperthyroid conditions. He writes:Bones may become abnormally thickened and their infrastructure weakened due to hypothyroidism. After the patient is placed on thyroid hormones, the bones begin to remodel. Stronger, thinner bones gradually replace the weak infrastructure. The remodelling process may take as long as 6 or 12 months after an adequate dosage of thyroid hormones is given.Note that Dr. Starr [and Dr. Weyrich] use basal body temperature and the patient's symptom picture rather than TSH levels to titrate thyroid supplement dosage. This may result in TSH levels being measured that are below the "normal" range, raising concerns among some practiontioners that the patient's thyroid status has been over-corrected, and that the supposed hyperthyroid condition will aggravate osteoporosis. Dr. Starr reports that this is not the case in clinical practice, and cites additional studies that agree with this point of view [Starr2005, pg 78; Wenzel1992; Franklin1992; Muller1995].
Differential Diagnosis
ICD-9 Codes
| ICD9-Code | Description | Comments |
|---|---|---|
References
Unless specifically noted above, references used in the construction of this web page include the following:[FDM] Lecture notes from Functional Medicine University.
[SCNM] Lecture notes from Southwest College of Naturopathic Medicine.
[UT] Lecture notes from the University of Tennessee graduate programs in Chemistry and Biochemistry.
[Franklin1992] J.A. Franklin et al. Long term thyroxine treatment and bone mineral density. Lancet 340:9-13 (1992). Cited by [Starr2005].
[Gaby1994] Gaby A. Preventing and Reversing Osteoporosis: Every Women's Essential Guide. Rockland, CA: Prima Publishing (1994). [Cited by Starr2005].
[Muller1995] C.G. Muller et al. Possible limited bone loss with suppressive thyroxine therapy is unlikely to have clinical relevance. Thyroid 5(2):81-87 (1995). Cited by [Starr2005].
[Paul1988] Paul TL, et al. Long-term L-thyroxine therapy is associated with decreased hip bone density in premenopausal women. JAMA. 259(21):3137-3141 (1988). [Cited by Starr2005].
[Ross1991] Ross DS, et al. Serum osteocalcin in patients taking l-thyroxine who have subclinical hyperthryoidism. Journal of Clinical Endocrinology and Metabolism. 72(2):507-509 (1991). [Cited by Starr2005].
[Starr2005] Mark Starr. Hypothyroidism Type 2: The Epidemic. Columbia, MO: Mark Starr Trust (2005).
[Wenzel1992] K. Wenzel. Bone minerals and levothyroxine. Lancet 340:435-436 (1992). Cited by [Starr2005].
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This web page is http://www.DrWeyrich.com/disorders/osteoporosis.html - Phone Dr. Weyrich at (480) 423-6952