A new study has raised concerns about levothyroxine, a medication commonly prescribed to treat hypothyroidism, potentially causing bone loss in older adults. This drug is used by about 23 million Americans, making it the second-most-prescribed medication among older U.S. adults. However, researchers have discovered that long-term use of levothyroxine may increase the risk of osteoporosis, a condition where bones become weak and more likely to break.
What is Levothyroxine and Hypothyroidism?
Levothyroxine is primarily used to treat hypothyroidism, a condition where the thyroid gland does not produce enough of the hormone thyroxine. This deficiency can lead to symptoms like fatigue, weight gain, and hair loss. Although hypothyroidism can lead to severe health complications if untreated, the thyroid hormone must be carefully balanced. Excess thyroid hormone, or hyperthyroidism, can cause symptoms like heart palpitations, anxiety, and an increased risk of bone fractures.
Concerns About Bone Health in Older Adults
The study, led by Dr. Elena Ghotbi from Johns Hopkins School of Medicine, found that taking levothyroxine may contribute to bone loss in older adults, a factor that could increase the risk of osteoporosis. The condition is particularly concerning for postmenopausal women, who are already more likely to experience bone density loss as part of aging. In osteoporosis, bones become fragile and break easily, even from minor movements like coughing or sneezing.
Study Findings: Levothyroxine and Bone Density
The research team, including radiologists and endocrinologists, investigated how levothyroxine affects bone density over time. The study used data from the Baltimore Longitudinal Study of Aging (BLSA), focusing on adults over 65 with normal thyroid hormone levels. They compared 81 participants who took levothyroxine with 364 participants who did not take thyroid medication. After six years, those taking levothyroxine showed more significant bone loss than those who did not take the medication.
Aging and Bone Loss: A Natural Process
As people age, some bone loss is natural. This is particularly true for women after menopause, when estrogen levels drop, contributing to a decrease in bone density. While bone loss can happen slowly, conditions like osteoporosis make bones much more fragile and prone to fractures. Dr. Ghotbi emphasized the importance of understanding the potential impact of medications like levothyroxine, which could speed up this process.
Medical Recommendations and Considerations
Doctors advise that older adults taking levothyroxine should regularly monitor their thyroid function and discuss the medication with their healthcare providers. Dr. Jennifer Mammen, co-senior author of the study, recommended a thorough evaluation of the risks and benefits of levothyroxine use, especially for those without clear thyroid problems. It’s important to ensure that the medication is necessary and being used appropriately.
The Bottom Line for Levothyroxine Users
While the study’s findings may sound concerning, Dr. Ghotbi clarified that those taking levothyroxine to treat genuine hypothyroidism should not be alarmed. However, for older adults who do not have a clear diagnosis of hypothyroidism, the use of levothyroxine should be carefully considered. There is ongoing debate about the proper threshold for treatment in this population, and individuals should seek medical advice tailored to their specific health needs.
In summary, while levothyroxine is crucial for managing hypothyroidism, its potential impact on bone health, especially in older adults, requires careful monitoring. Regular check-ups and discussions with healthcare providers are essential to ensure the best outcomes for patients.
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