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July 04, 2023 8 min read

Have you ever wondered if your thyroid condition could be causing bone loss? Well, you're not alone! Many individuals with hypothyroidism experience this concern despite taking levothyroxine, a medication commonly prescribed to manage their thyroid levels. It's like standing in a crowd, surrounded by others who share this puzzling phenomenon. But fear not! This article will unravel why some of us still experience bone loss despite our best efforts with levothyroxine. Moreover, we'll provide insights and practical steps you can take to address this issue and protect your precious bones.

Can hypothyroidism cause bone loss?

The complexities of the thyroid and its effects on bone health are truly fascinating, yet our understanding is far from complete. Trying to pinpoint the exact ways thyroid hormones interact with our bone structures on a cellular and molecular level can be quite challenging. Nonetheless, the influence of thyroid health on bone health is undeniable.

Thyroid hormones are pretty amazing. They help in the healthy growth of our bones and keep them functioning well in adults. But, like all good things, there's a catch. If these hormones are not working properly, they might actually harm our bones.

For instance, unchecked severe hyperthyroidism, a condition where the thyroid produces too much thyroid hormone, could reduce bone mass and elevate the risk of osteoporosis, a disorder that weakens bones and makes them vulnerable to fractures.

Subclinical hyperthyroidism, a less obvious type of this disease defined by lower than normal levels of a hormone known as thyroid stimulating hormone (TSH) or thyrotropin, while other hormones remain within the normal range, often sneaks under the radar without displaying any symptoms. It's usually detected by chance during routine check-ups. Yet, recent studies indicate it might be quietly harming bone health by reducing bone mineral density (BMD) and increasing fracture risk, with postmenopausal women being the most affected.

Frequently, subclinical hyperthyroidism can arise from the overuse of thyroid medication like levothyroxine, commonly prescribed for benign thyroid lumps or thyroid cancer. Being on a hefty dose for extended periods might cause a decrease in BMD and a hike in fracture risk, more so in postmenopausal women.

At the other end of the scale, we find hypothyroidism, when the thyroid fails to produce enough hormones. This thyroid disease tends to slow down bone turnover, reducing the activities that break down and regenerate bones. This typically results in increased bone mineralization, essentially making bones thicker. However, the correlation between BMD levels in adults and hypothyroidism is still not fully established.

Taking all this into account, it's clear that a delicate balance of thyroid activity is crucial for optimal bone health. Being either too generous or stingy with thyroid medications can tip that balance, potentially leading to bone loss and a higher risk of fracture.

Levothyroxine, what is it exactly?

Levothyroxine, also known as L-thyroxine, is a type of medication primarily used to tackle hypothyroidism, a condition where your thyroid doesn't produce enough hormones required for your body's normal functioning. It is essentially a man-made version of thyroxine (T4), one of the hormones naturally produced by the thyroid gland.

Recognized as a cornerstone in thyroid hormone treatment, levothyroxine steps in to supplement or replace the thyroxine that your body is falling short on. This allows those living with hypothyroidism to effectively control their symptoms, thereby improving their overall health and quality of life, whether their condition is caused by an autoimmune thyroid disease like Hashimoto's thyroiditis, surgical removal of the thyroid, or other causes. However, it should be noted that this medication is typically not a cure but a lifelong therapy to manage the levels of thyroid hormone in the body.

While regulating thyroid hormone levels seems elementary, it presents its own set of complexities, particularly when entwined with risk factors such as bone health. Just like Goldilocks preferred her porridge, the dosage of levothyroxine should be just right - not too low nor too high.

Taking into account what has been explained earlier, having too much of this thyroid medication, levothyroxine, in your system can have undesirable effects. The excess thyroid hormone can speed up bone turnover, a process where old bone tissue is replaced with new. This accelerated pace can lead to a reduction in bone density, making you more susceptible to experiencing bone fractures.

What can you do if you're taking too much levothyroxine?

If you suspect you might be taking too much levothyroxine, don't panic. It's important to address this situation promptly, as overuse presents a significant risk factor for your overall well-being. Here's what you can do:

Firstly, do not make any adjustments to your dosage, stop, or switch the medication on your own. Levothyroxine plays an essential role in your body's metabolism.

Instead, get in touch with your healthcare provider as soon as you can. Discuss the symptoms you are experiencing. Aside from bone loss, the symptoms of taking too much levothyroxine can resemble those of hyperthyroidism and can include insomnia, heart palpitations, increased hunger, excessive sweating, and more.

Your healthcare provider might adjust your dosage or suggest a schedule change for your medication. In some instances, they might even switch you to a different medication. Regular blood tests to check your hormone level are also likely to ensure optimal thyroid function and reduce the risk factor associated with overuse.

Remember, open and regular communication with your healthcare provider is crucial. This way, they can closely monitor your hormone levels and ensure that you are on the safest and most effective dosage of levothyroxine for you. No two individuals are the same, and treatment plans should be personalized to best fit your health needs and lifestyle. Remember, taking care of your thyroid means taking care of your overall health.

Why do I continue to experience bone loss even after adjusting my levothyroxine dosage?

Experiencing bone loss despite adjusting your levothyroxine dosage can feel puzzling. The connection between thyroid hormone therapy and bone health is intricate, and while this medication does have an impact on your bones, it might not be the only contributing influence. Aside from having too much thyroid medication in your body, here are some reasons you might continue to experience bone loss despite dosage adjustments

1. Multiple factors impacting bone health

Remember, bone loss can be influenced by aspects outside your thyroid hormone replacement. Factors like age, gender, diet, physical activity levels, genetics, and other co-existing health conditions can all affect your bone density.

2. Lingering effects of high dosage

The effects of previous high-thyroxine dosages don't immediately undo themselves once your dosage has been adjusted. Bone remodeling, or the replacement of old and damaged bone tissue, is a gradual process that can take months or even years to accomplish.

3. Impact of other medications

It's also essential to factor in any other medications you might be taking. Certain drugs, such as corticosteroids, some anti-seizure medications, and certain kinds of cancer chemotherapy, can influence bone health. So, ensure your healthcare provider knows about any other medications you're on.

4. Possible underlying conditions

Persistent bone loss, even with an adjusted levothyroxine dosage, might indicate that your body isn't responding to the thyroid hormone therapy as expected. Alternatively, there could be other underlying health issues at play, such as as-yet-undetected autoimmune disorders.

5. Levothyroxine absorption

While calcium supplements can be excellent for your bone health, they do have something of a double-edged sword effect when it comes to thyroid hormone therapy. Interestingly, calcium can interfere with the absorption of levothyroxine.

This is especially important to keep in mind if you're on levothyroxine. The timing of when you take these supplements matters a great deal. It's usually recommended to take your levothyroxine on an empty stomach, well before any meals or other medications, to ensure optimal absorption.

If you're taking calcium supplements or any other medication which might interfere with levothyroxine absorption, do discuss this with your healthcare provider. They can help tailor a schedule for you that optimizes the effectiveness of all the medications and supplements you're taking while still safeguarding your bone health.

Just as with some medications and supplements, certain foods can also affect the way your body absorbs levothyroxine. For instance, food rich in fiber or those that contain soy might lower the absorption of this thyroid hormone.

Coffee and espresso have also been shown to reduce levothyroxine absorption if they are taken too close to your medication time.

Foods like walnuts, grapefruit, and cottonseed meal are also known to interfere with levothyroxine absorption.

Moreover, the recommendation to take levothyroxine on an empty stomach is due to these possible interactions with food. Ideally, it should be taken at least 30-60 minutes before breakfast or at least three to four hours after the last meal of the day.

6. Impaired T4 to T3 conversion

Levothyroxine replaces thyroxine, commonly known as T4, an important thyroid hormone that our bodies naturally produce. Under normal circumstances, your body converts this T4 into triiodothyronine, or T3, which is the active form of the hormone that your body can use.

However, sometimes, a hurdle might surface in your body's conversion process from T4 to T3. If your body can't efficiently convert T4 into T3, you might find yourself with a surplus of T4 but deficient in T3. This means that despite having adequate levels of levothyroxine (T4) in your body, you could still experience symptoms of hypothyroidism because of the lack of T3 or even hyperthyroidism symptoms because of the excess amount of T4.

Impaired conversion can occur due to various reasons, such as stress, nutrient deficiencies, certain medications, and some medical conditions. If you're experiencing persistent symptoms even with medication, your healthcare provider might consider checking your T3 levels or may even consider adding a thyroid hormone replacement that consists of T3.

A potential remedy might be taking liothyronine. This medication is a synthetic form of T3, which directly supplements the active thyroid hormone your body might be lacking.

However, another route some patients and their healthcare providers consider is natural desiccated thyroid (NDT). NDT, derived from dried pig thyroid glands, contains both T4 and T3 hormones. This blend aligns more closely with the natural balance of thyroid hormones in your body.

NDT has garnered quite a bit of attention and is often preferred by some patients and practitioners for its 'natural' connotation and perceived efficacy. NDT is available in both medication and supplement forms. The most popular brands of NDT in the US are Armour Thyroid and NP Thyroid. However, you can also buy desiccated thyroid online in supplement form, such as VitaliThy. This NDT supplement is free from lactose, gluten, eggs, fish, and shellfish, as well as artificial color and flavor. Thus, it's safe for anyone with certain dietary restrictions.

Conclusion: Bone loss is a side effect of levothyroxine

While levothyroxine has long been a trusted treatment for hypothyroidism, it isn't free from potential complexities. The interactions of this medication with our bone health depict an intricate game of balance. Too little may render us deprived of an essential hormone, while too much can push us toward bone loss and fractures. Adjusting the dosage might seem like a simple solution, but it's not always an immediate or adequate remedy.

Beyond that, various factors such as age, diet, other medications, underlying conditions, and even how we consume our levothyroxine can all have a rollicking impact on our bone health. Not forgetting the possible hurdle in the conversion of T4 to T3, which might leave us experiencing an array of symptoms despite having the 'right amount' of levothyroxine, according to numbers.

The key to properly managing thyroid health and its influence on our bones lies in acquiring a solid understanding of these complexities and avidly communicating with healthcare providers. Regular check-ups and open discussions about symptoms, medication intake, diet, and lifestyle can help tailor a treatment plan that best fits an individual's health needs.

Considering therapies beyond levothyroxine might also be beneficial, with Natural Desiccated Thyroid (NDT) comprising both T4 and T3 hormones being a promising alternative. Its close alignment with our body's natural hormone levels, coupled with its 'natural' appeal, makes it a worthy option to explore. One great option if you want to make the switch is VitaliThy, a natural desiccated thyroid you can buy online.

Ultimately, when it comes to hypothyroidism and bone health, the journey might be complex, but with the right knowledge, communication, attention to individual needs, and considering alternatives like NDT, maintaining a healthy balance is more than achievable. Regaining control over your thyroid health can be the first step towards supporting and strengthening the health of your bones.

Wojciech Majda
Wojciech Majda

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