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Hormones and Bone Tissue01:17

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Functions of Thyroid Hormones01:18

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Skeleton and Calcium Homeostasis01:21

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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Synthesis and Functions of Calcitonin00:51

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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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In Vivo Inhibition of MicroRNA to Decrease Tumor Growth in Mice
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TSH suppressive therapy and bone.

Alessandro Brancatella1, Claudio Marcocci2

  • 1Endocrine Unit 1, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Endocrine Connections
|June 23, 2020
PubMed
Summary
This summary is machine-generated.

Thyroid-stimulating hormone (TSH) suppressive therapy is safe for premenopausal women and men but may harm postmenopausal women

Keywords:
bone mineral densitydifferentiated thyroid cancerfractureslevothyroxinethyroid cancertrabecular bone score

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Oncology

Background:

  • Thyroid hormones influence bone turnover via osteoclastic resorption.
  • Thyroid-stimulating hormone (TSH) suppressive therapy is a standard treatment for differentiated thyroid cancer (DTC).
  • Potential skeletal risks of long-term TSH suppressive therapy have been investigated.

Purpose of the Study:

  • To review the impact of TSH suppressive therapy on bone health in patients with DTC.
  • To evaluate the differential effects on bone in premenopausal versus postmenopausal women.
  • To inform clinical guidelines regarding bone health monitoring and management.

Main Methods:

  • Review of existing studies and meta-analyses on TSH suppressive therapy and bone health.
  • Analysis of data on bone mineral density (BMD), bone architecture (QCT, TBS), and fracture risk.
  • Consideration of experimental data on TSH receptor function in bone cells.

Main Results:

  • Chronic TSH suppressive therapy is generally safe for premenopausal women and men.
  • Postmenopausal women on TSH suppressive therapy show decreased BMD, poorer bone architecture, and potential increased fracture risk.
  • The role of TSH levels versus thyroid hormone levels in bone loss remains debated.

Conclusions:

  • TSH suppressive therapy requires careful risk-benefit assessment, especially in postmenopausal women.
  • Bone health evaluation (BMD/TBS) is recommended for postmenopausal women on long-term therapy.
  • Antiresorptive therapy may be considered for selected patients at high risk of bone loss or fracture.