Tuesday, May 3, 2011

Hypothyroidism Meds Increase Fracture Risk

Quite a few women I see in my practice have some degree of hypothyroidism. Some clinical and some subclinical. Many people have relatives with some kind of thyroid concern or know someone that is struggling with weight that eventually figured out their thyroid was the culprit.

Quick primer on what hypothyroidism is: the thyroid gland (sits close to the bottom of your neck below your voice box) doesn't produce enough thyroid hormone in this health concern. The thyroid releases hormones that control metabolism. Symptoms can include: sensitivity to cold, constipation, depression, fatigue, heavier menstrual periods, thin or brittle hair, and weight gain (everyone wants something to blame for those extra pounds!). A simple blood marker called TSH (thyroid stimulating hormone) can be a quick check along with its accompanying markers called T3 and T4.

There are varying degrees of thyroid concerns and various causes but for our purposes most people are prescribed a drug called levothyroxine to replace the thyroid hormone the body is lacking.

Levothyroxine dose is linked to fracture risk in older adults, according to the results of a case-control study reported online April 28 in the BMJ. The goal of the study was to see the effect of levothyroxine dose on fracture risk in older adults. Using population-based health databases in Ontario, Canada, the investigators identified 213,511 adults 70 years or older who were prescribed levothyroxine between April 1, 2002, and March 31, 2007. Follow-up for fractures of the wrist or forearm, shoulder or upper arm, thoracic spine, lumbar spine and pelvis, hip or femur, or lower leg or ankle, continued until March 31, 2008 (mean duration of follow-up, 3.8 years).

Adhering to a very narrow range of TSH on bloodwork is important. Usually the range is from 0.5 to 5 but clinically I find the reference range is more narrow and should be around 2 or 2.5 consistently. This study just verifies how important that small little gland is..... I love how this study was done in Ontario as well!

So what can we do naturopathically for hypothyroidism? A tonne!! Of course dietary goitrogens are important to avoid: SOY is a big no-no for someone with thyroid concerns. Minerals like zinc and selenium are key cofactors in making the thyroid work efficiently. A herb called ashwaganda or withania is also fantastic at helping conversion of thyroid hormones. Ashwaganda is also a wonderful adaptogenic herb - a herb that helps your body adapt to stress - and can be used in tincture form or tea form. These are just a few things off the top of my head but important to note is that you don't want to just fool around with your thyroid and start trying things out thinking your TSH may be off. Always important to get that blood test done by either your ND or MD.

Ok now back to some online scouring of more Royal Wedding photos :)