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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Long Term Usage Of Levothyroxine Cause Osteoporosis?

Hi. My 7 year old daughter takes Levothyroxine 75mg/day for Hashimoto s Hypothyroidism. Her numbers have leveled out and at her next bloodwork in October we re going to test for other autoimmune issues. A friend said long term use of a synthetic thyroid medicine is linked to osteoporosis. They suggested Armor, which is desiccated pig thymus, but has fewer side effects and generally better all around because it s natural and not synthetic. What should my concerns be about both of the medicines?
Tue, 27 Sep 2016
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General & Family Physician,  's  Response
Levothyroxine is the treatment of choice for hypothyroidism. You need to take levothyroxine for life-long. Any interruption in treatment will cause symptoms of hypothyroidism.
Long term use in high dose causes reduced bone mineral density (osteoporosis), especially in post-menopausal women. But this side effect is seen in those who are taking high dose. So monitoring of treatment is essential. Serum TSH should be measured to monitor for adequate replacement. TSH can take up to 4 months to normalize. TSH is measured 6–8 weeks after initiation of levothyroxine and then annually once you are on a stable dose of levothyroxine.
Advice
1.     Continue with 75 mcg of levothyroxine
2.     Do not use any other supplement such as Armor
3.     Measure your serum TSH after 6 weeks; take the report to your doctor. Doctor will titrate the dose of levothyroxine as per serum TSH level
4.     Regularly check your blood pressure and pulse rate
5.     Avoid smoking, coffee and alcohol
6.     Eat high protein and calcium rich diet such as milk, cheese, meat, fruits, and dry fruits
Thanks
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Does Long Term Usage Of Levothyroxine Cause Osteoporosis?

Levothyroxine is the treatment of choice for hypothyroidism. You need to take levothyroxine for life-long. Any interruption in treatment will cause symptoms of hypothyroidism. Long term use in high dose causes reduced bone mineral density (osteoporosis), especially in post-menopausal women. But this side effect is seen in those who are taking high dose. So monitoring of treatment is essential. Serum TSH should be measured to monitor for adequate replacement. TSH can take up to 4 months to normalize. TSH is measured 6–8 weeks after initiation of levothyroxine and then annually once you are on a stable dose of levothyroxine. Advice 1. Continue with 75 mcg of levothyroxine 2. Do not use any other supplement such as Armor 3. Measure your serum TSH after 6 weeks; take the report to your doctor. Doctor will titrate the dose of levothyroxine as per serum TSH level 4. Regularly check your blood pressure and pulse rate 5. Avoid smoking, coffee and alcohol 6. Eat high protein and calcium rich diet such as milk, cheese, meat, fruits, and dry fruits Thanks