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Thyroid Hormones and Osteoporosis-Reply

Leonard Wartofsky, MD
Arch Intern Med. 1996;156(3):341. doi:10.1001/archinte.1996.00440030149020.
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The comments of Liel are both interesting and welcome. Restoration of thyrotoxicosis to the euthyroid state serves to reduce bone resorption and to improve bone mineral density and markers of aberrant bone metabolism toward normal.1-5 In addition to estrogen therapy as a means to reduce bone resorption, one should keep in mind the potential benefits of treatment with the bisphosphonate pamidronate disodium, which have been indicated by the findings in at least one published study.6 Studies of the oral bisphosphonate, alendronate, are currently in progress, the preliminary findings of which are also promising.7 Given that thyroxine therapy, as replacement or in a mildly suppressive dosage, is not associated with bone mineral loss,8 such therapeutic adjuncts might be indicated only in patients who are taking higher suppressive dosages of thyroxine therapy, such as those with recurrent thyroid cancer, or in the unusual case, such as the one


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