Why do people suffering from this thyroid condition often develop bone problems later in life? 

Highlights:  

1. Thyroid disorders and osteoporosis often affect older patients, especially postmenopausal women. 

2. Hypothyroidism can increase the risk of osteoporosis due to slowed bone tissue renewal and increased intake of thyroid hormones. 

3. Treating hypothyroidism and osteoporosis requires an individualized approach and continuous monitoring to prevent a decline in bone density.  

Osteoporosis is a condition characterized by low bone density and is often the cause of fractures and breaks as people age. This is especially true for women after menopause, and the risk increases even more with advancing age. Over 70% of people over the age of 80 have osteoporosis – that’s more than 200 million people worldwide. 

Hypothyroidism is a reduced function of the thyroid gland – a chronic condition in which the thyroid does not produce enough thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). These hormones regulate many vital processes in the body, including metabolism, thermoregulation, heart function, and even mental health. When their levels are low, the entire body functions in “slow mode,” which manifests through symptoms like chronic fatigue, weight gain, and others. The condition can be caused by autoimmune disorders such as Hashimoto’s thyroiditis, surgical removal of the gland, iodine deficiency, or as a side effect of certain medications.  

People suffering from hypothyroidism and other thyroid disorders are more predisposed to developing osteoporosis. In pronounced hypothyroidism, low bone remodeling is observed, meaning that the process of renewing bone tissue slows down. As a result, although bone density may not decrease immediately, the bones become more fragile and less resistant to stress. Some studies also suggest that disturbances in lipid

Metabolism in hypothyroidism – including elevated triglyceride levels – can indirectly negatively affect bone density. 

Taking excessive amounts of medication for hypothyroidism can also lead to osteoporosis. According to the American Thyroid Association, there are two ways in which thyroid hormones can affect the bones and cause loss of bone mass: 

• too much thyroid hormone due to hyperthyroidism  

• an excessive dose of medication used to treat hypothyroidism, leading to elevated hormone levels in the blood.  

Who Is at Risk of Hypothyroidism or Osteoporosis? 

Risk factors for hypothyroidism include: 

• Age – the likelihood of thyroid disorders increases with age 

•  Female gender – women are more prone to thyroid problems than men 

• Previous medical history related to the thyroid (goiter, surgery, radiation) 

• Family history of thyroid disorders 

• Recent pregnancy 

• Conditions such as diabetes, anemia, lupus, arthritis, celiac disease, Sjögren’s syndrome 

Risk factors for developing osteoporosis include: 

• Advanced age, especially after menopause 

Menopause alone increases the risk of osteoporosis due to the drastically reduced levels of estrogen – a hormone that helps maintain bone density. When combined with hypothyroidism, the risk is doubled. 

• Use of certain medications (anti-epileptic drugs and glucocorticoids) 

• Conditions such as chronic kidney disease, Cushing’s disease, anorexia, nutrient malabsorption, low body weight, early menopause 

• Lifestyle factors (smoking, lack of physical activity)  

What Are the Symptoms of Hypothyroidism? 

The symptoms can be varied and often develop slowly, which makes early recognition difficult. One of the most common signs is weight gain, as metabolism slows down. 

Another typical symptom is constant fatigue and exhaustion that does not improve even with prolonged rest. Many people also experience cold intolerance – a feeling of being cold, which is due to impaired thermoregulation in the body caused by low levels of thyroid hormones. 

Other common symptoms include depressive states, slowed heart rate (bradycardia), muscle and joint pain, dry skin, and thinning hair. Women often report irregular or heavy menstrual periods, and in more severe cases, infertility may also occur. 

To make an accurate diagnosis, in addition to symptom assessment and an examination by an endocrinologist, the most important part of the diagnostic process is laboratory testing of the hormones TSH (thyroid-stimulating hormone) and free T4 (thyroxine). Elevated TSH levels combined with low T4 levels confirm the diagnosis of hypothyroidism. 

What Is the Treatment for People with Hypothyroidism and Osteoporosis? 

The treatment of patients suffering simultaneously from hypothyroidism and osteoporosis requires a precise and individualized approach. For hypothyroidism, the main therapy involves taking levothyroxine – a synthetic form of the hormone thyroxine (T4), which compensates for the deficiency of natural thyroid hormones. Treatment usually starts with a low dose that is gradually adjusted according to the individual needs of the patient and the results of regular blood tests measuring TSH and free T4 levels. 

In addition to this, various non-hormonal products can be added to support thyroid function. One such example is Sarita+, specially formulated to alleviate symptoms of hypothyroidism such as fatigue, depressive states, weight gain, and lack of energy. The formula of Sarita+ supports the normal function of the thyroid gland and helps restore hormonal balance, while also promoting better metabolism and an overall sense of vitality. 

On the other hand, the treatment of osteoporosis includes a combination of medications, dietary supplements, and a diet rich in calcium and vitamin D, along with physical activity. Bisphosphonates are often prescribed – medications that slow down bone breakdown. In some cases, hormone therapy or new biological medications are used to stimulate the formation of new bone tissue. 

Timely diagnosis through tests like bone densitometry (DXA scan), which measures bone density, is also crucial. The combined management of both conditions through collaborative efforts between an endocrinologist and a rheumatologist/orthopedic specialist significantly improves the prognosis and quality of life for patients.  

What Does the Diagnosis Mean for the Risk of Osteoporosis? 

Receiving a diagnosis of a thyroid disorder, especially when it involves hormone replacement therapy, is crucial for assessing the risk of osteoporosis. Studies show that prolonged use of levothyroxine, particularly in higher doses, can accelerate bone loss and increase the frequency of fractures in older patients. Even when laboratory values remain within the “normal” range, bone density may gradually decrease. 

To prevent such consequences, it is important for patients to undergo regular screenings not only for hormone levels but also for bone mineral density through specialized tests such as a DXA scan. This allows for the early detection of reduced bone mass and the implementation of preventive measures, such as adjusting treatment and including medications to support bone health.  

In conclusion: 

The link between hypothyroidism and osteoporosis is real and significant, especially for postmenopausal women, where hormonal imbalance and age-related changes amplify the negative impact on bone density. Slowed metabolism, low bone regeneration, and potential overdosing of thyroid hormones make patients more vulnerable to fractures and bone complications. Timely diagnosis, proper therapy, and combining it with appropriate dietary supplements and physical activity are of utmost importance. Prevention through regular check-ups and a comprehensive treatment approach can not only reduce the risk of osteoporosis but also significantly improve the quality  

Sources:  

https://www.niams.nih.gov/health-topics/osteoporosis#:~:text=Osteoporosis%20in%20Men-,Osteoporosis%20is%20a%20bone%20disease%20that%20develops%20when%20bone%20mineral,Pregnancy%2C%20Breastfeeding%2C%20and%20Bone%20Health

https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism

https://pmc.ncbi.nlm.nih.gov/articles/PMC7230461

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