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J Affect Disord. 2012 Jan;136(1-2):e89-e94. doi: 10.1016/j.jad.2011.06.011. Epub 2011 Jul 14.

Long-term treatment with supraphysiological doses of thyroid hormone in affective disorders - effects on bone mineral density.

Author information

1
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
2
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany; Berlin School of Mind and Brain, Berlin, Germany.
3
Department of Medical Statistics, Informatics and Documentation, University Hospital of Friedrich-Schiller University Jena, Jena, Germany.
4
Department of Psychiatry and Psychotherapy, Schloßparkklinik, Berlin, Germany.
5
Nervenärztlich Psychotherapeutische Praxisgemeinschaft, Tegeler Weg 4; 10589 Berlin, Germany.
6
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Electronic address: Michael.Bauer@uniklinikum-dresden.de.

Abstract

BACKGROUND:

To investigate the long-term effects of supraphysiological, TSH suppressive doses of levothyroxine (TSDL) on bone mineral density (BMD) in patients with affective disorders during an average treatment duration of 69 months.

METHODS:

In 22 patients, BMD of the spine (lumbar vertebrae L1-4) and femur (femoral neck) was measured by dual energy X-ray absorptiometry (DXA). Forty (40) measurements from the prior study and 48 new follow-up measurements were included. BMD was expressed as Z-scores as a population standard reference. We used a linear mixed model to investigate the duration of TSDL as an explanatory factor for change in BMD compared to an age and gender matched reference population.

RESULTS:

We found no significant differences in bone loss between the study and the reference population. The estimated non-significant decrease in Z-score compared to the reference population found was: a) lumbar spine (L1-4): -0.00069/month (p=0.9759) b) neck region of femur: -0.01405/month (p=0.4436). We did not find the factors age, thyroxine-dose or postmenopausal state as predictors for a decline in BMD.

LIMITATIONS:

Small sample size, no bone density assessment prior to treatment with TSDL, no patient control group with mood disorders who did not receive TSDL, variable bone density follow-up intervals.

CONCLUSION:

This study did not demonstrate evidence that long-term treatment of affectively ill patients with TSDL accelerates loss of BMD compared to an age- and gender-matched reference population.

PMID:
21757236
DOI:
10.1016/j.jad.2011.06.011
[Indexed for MEDLINE]

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