Authors: Mazokopakis, Elias E.¹; Starakis, Ioannis K.²; Papadomanolaki, Maria G.³; Batistakis, Antony G.⁴; Papadakis, John A.⁵

Source: Current Medical Research and Opinion, Volume 22, Number 7, July 2006 , pp. 1369-1373(5)

Publisher: Informa Healthcare

Abstract:

Objective: We studied the effect of levothyroxine (L-T₄) suppressive therapy on bone mineral density (BMD) in pre-menopausal women with total thyroidectomy and radioactive iodine (¹³¹I) ablation therapy post-operatively for differentiated thyroid cancer (DTC).

Patients and methods: We prospectively studied 26 athyroid pre-menopausal women (median age 39 years, range 28-48 years) receiving suppressive L-T₄ therapy postoperatively for 48 months. BMD was measured by dual energy X-ray absorptiometry (DEXA) at the femoral neck, femoral trochanter and Ward's triangle, before (basal) and during (12th and 48th month) the follow-up period. None of the women gave a medical history that could possibly affect bone metabolism. Patients were free of thyroid cancer in clinical and laboratory examinations at the time of the study. Paired t-test was used for comparisons among BMD measurements during the suppressive therapy.

Results: There were statistically significant decreases of BMD at all measured regions during (12th and 48th month) L-T₄ suppressive therapy. The overall decreases in BMD at the femoral neck, femoral trochanter and Ward's triangle were 7.5%, 10.9% and 3.4%, respectively, at the end of the follow-up period. The coefficient of variation (CV) of all BMD measurements was around 10%, showing a rather homogenous group of patients. Our patients had a statistically significant decrease in their body mass index (BMI) and weight at the end of the follow-up period. However, there was no significant correlation between the decrease in BMI and BMD. Patients did not experience significant adverse effects from L-T₄ suppressive therapy during the study.

Conclusion: L-T₄ suppressive therapy for at least 1 year in pre-menopausal women with DTC causes a reduction in BMD of the femoral neck, femoral trochanter and Ward's triangle.

Keywords: BONE MINERAL DENSITY; LEVOTHYROXINE; PRE-MENOPAUSAL WOMEN; SUPPRESSIVE THERAPY

Document Type: Case report

DOI: http://dx.doi.org/10.1185/030079906X115612

Affiliations: 1: Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece; Department of Internal Medicine, Naval Hospital of Crete, Chania, Greece 2: Department of Internal Medicine, Patras University Hospital, Rion, Patras, Greece 3: Department of Sciences, Technical University of Crete, Chania, Greece 4: Department of Internal Medicine, Naval Hospital of Crete, Chania, Greece 5: Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece

Publication date: 2006-07-01

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