BALTIMORE, MARYLAND: Levothyroxine, a widely prescribed medication for hypothyroidism, has been linked to reduced bone density and mass in older adults with normal thyroid levels, according to a recent study. Researchers from Johns Hopkins University presented their findings at the Annual Meeting of the Radiological Society of North America on November 25, 2024. The study suggests that the drug, even when appropriately prescribed, may raise concerns about osteoporosis risk in aging populations.
Key findings from the study
Study details: The research involved 81 participants aged 65 and older with typical thyroid hormone levels. Over six years, they experienced a decrease in bone mass and density while on levothyroxine.
Bone health impact: Dual-Energy X-ray Absorptiometry scans showed measurable declines in bone strength, raising concerns about long-term bone health.
Prior research: The authors previously reported similar findings, showing that levothyroxine negatively impacts leg mass in older adults, particularly when used unnecessarily.
Why is this important?
Levothyroxine is one of the most commonly prescribed drugs in the United States, especially for older adults who are more prone to thyroid disorders. Hypothyroidism, marked by fatigue, weight gain, and cognitive slowing, often leads to levothyroxine prescriptions. However, questions remain about its overprescription and potential side effects.
Expert insights
Dr. Sean Ormond, a specialist in pain management, emphasized the importance of levothyroxine in treating hypothyroidism, which can significantly improve life quality in patients. However, he acknowledged the need for cautious use in older adults to avoid side effects, including bone loss.
Similarly, Dr. Sue Clenton from the Weston Park Cancer Centre highlighted the importance of individualized treatment plans and careful monitoring. Deprescribing may be an option if patients experience adverse effects such as bone loss or rapid heart rates.
Overprescription concerns
Studies suggest that hypothyroidism is overdiagnosed, leading to unnecessary prescriptions of levothyroxine. Seasonal variations in thyroid-stimulating hormone (TSH) levels, which peak in winter and drop in summer, may not always be accounted for during diagnosis. Experts urge a more nuanced approach to treatment, especially for borderline cases.
What this means for patients
Older adults prescribed levothyroxine should consult their healthcare providers about the potential risks and benefits. Regular monitoring of bone density and thyroid function is essential to ensure the treatment remains beneficial.