Understanding the Connection Between Hypothyroidism and Osteoporosis

Hypothyroidism is when you don’t have enough thyroid hormone in your blood. It stems from having an underactive thyroid gland. The thyroid gland is a butterfly-shaped gland found on the lower part of your neck. It helps regulate many of your body’s vital systems and organs.

At this time, there is no clear evidence that hypothyroidism on its own contributes to osteoporosis. According to the American Thyroid Association, there are two main ways thyroid hormones can affect your bones and cause bone loss:

• having too much thyroid hormone as a result of an overactive thyroid (hyperthyroidism)
• taking too much medication for hypothyroidism, which can cause too much thyroid hormone to circulate in the blood

Risk factors for hypothyroidism

Certain factors may increase your risk of developing hypothyroidism. These factors include:

• being over age 60
• being a woman
• having a history of medical issues affecting the thyroid, such as:
  • goiter
  • thyroid surgery
  • previous radiation treatment on or near your thyroid
• having a family history of thyroid conditions
• having recently been pregnant
• having certain health conditions, such as:
  • diabetes
  • anemia
  • lupus
  • arthritis
  • Celiac disease
  • Sjögren’s syndrome

Risk factors for osteoporosis

Osteoporosis is more likely to happen as you age and is most common after post-menopause due to a drop in estrogen.

Taking certain medications, such as anti-epileptic medications and a type of corticosteroid known as glucocorticoids, can also increase your risk of osteoporosis.

Some medical conditions may increase your risk of developing osteoporosis, too. These conditions include:

• a family history of osteoporosis
• renal failure
• Cushing disease
• anorexia
• nutritional malabsorption
• low body weight
• early menopause

In addition, some lifestyle factors, such as smoking and having a sedentary lifestyle, can affect your risk.

For some people, the symptoms of hypothyroidism may be obvious, while for others, symptoms may be more subtle. Symptoms tend to increase with time and may vary among people.

Some of the most common hypothyroidism symptoms include:

• gaining weight
• trouble losing weight
• exhaustion
• difficulty tolerating cold temperatures
• low mood or depression
• pain in your muscles and joints
• thinning hair
• dry skin
• changes in menstruation, heavy periods, trouble getting pregnant
• lowered heart rate

If you are taking medication for hypothyroidism, you’ll have blood tests to be sure the medication is working correctly. These tests usually happen 6–8 weeks after you begin the medication.

If your doctor finds that you develop hyperthyroidism symptoms as a result of taking this medication, they will adjust the dose.

After these tests, you will continue to be monitored for signs of hyperthyroidism, usually once or twice per year. This will help reduce your risk of developing hyperthyroidism as a result of taking too medication for hypothyroidism, and as a result, help reduce your risk of osteoporosis.

If you do develop hyperthyroidism as a result of your medication, your doctor will discuss next steps with you. They can also suggest tips to protect and strengthen your bones in order to prevent osteoporosis.

Note that when osteoporosis is diagnosed and treated promptly, outcomes are often good. This is why it’s important for a doctor to carefully monitor your medication for hypothyroidism and assess your risk of osteoporosis.

In order to provide a hypothyroidism diagnosis, a doctor will discuss your symptoms, take a medical and family history, do a physical exam to look for signs of the condition, and have you undergo bloodwork.

The following blood tests are used to look for hypothyroidism:

Thyroid-stimulating hormone (TSH) test

The TSH test measures how much thyroxine (T4) hormone is present. TSH is produced by the pituitary gland, which is located at the base of your brain. It’s responsible for regulating how much hormone is released by the thyroid.

Thyroxine (T4) test

The T4 test measures thyroxine, which helps your body with growth and metabolism.

What does this diagnosis mean for osteoporosis?

If you are diagnosed with hypothyroidism, you will likely be put on medication to help your body make more thyroid hormone. Your risk of osteoporosis only increases if you take too much thyroid medication.

If you are taking thyroid medication, a doctor will carefully monitor your medication and conduct routine bloodwork to make sure it is the right dose for you. Though, you may already suspect that your thyroid levels are not in balance since you may be having symptoms such as fatigue, racing heart, or others.

What are other side effects of hypothyroid medication?

Too much medication for hypothyroidism also has the potential to cause unpleasant side effects, including anxiety, trouble sleeping, and a racing heartbeat.

If you are experiencing any of these side effects, contact your doctor to adjust your medication.

What medication is used to treat hypothyroidism?

Hypothyroidism is often treated with a medication called Synthroid. The generic name for Synthroid is levothyroxine.

What does thyroid hormone do?

Thyroid hormone helps regulate how energy is used in your body, keeps your metabolism running smoothly, and contributes to the functioning of your heart, muscles, and brain.

Having high levels of thyroid hormone in your body — whether from hyperthyroidism or taking too much thyroid medication — can speed up bone turnover rates, which can cause bone loss, decreased bone density, and bone fractures.

If you have a thyroid condition and are taking thyroid medication, discuss your risk of osteoporosis with your doctor.

In addition, be sure to work with your doctor to determine the right dose of medication for you and notify them if you begin to experience symptoms of too much thyroid hormone, such as a racing heart and trouble sleeping.

By identifying too much thyroid hormone and adjusting your medication, you and your doctor can help reduce your risk of osteoporosis.