Many seniors are at high risk for fractures because they take ‘excessive’ doses of drugs used to treat thyroid problems.
Many patients with hypothyroidism are diagnosed in early or middle adulthood. Even though their treatment requirements change as they age, many patients remain on the same drug dose. This can lead to excess levels of thyroid hormone, which raises the risk of fractures, especially in older women.
Researchers examined the link between fractures and levothyroxine, a synthetic form of thyroid hormone, which is widely used to treat an underactive thyroid gland (hypothyroidism). They analysed data from over 213,511 Canadians, aged 70 years or older, in Canada who filled at least one prescription for levothyroxine between April 2002 and March 2007. During the study period, more than 22,236 (approximately 10 percent) of the patients suffered at least one fracture.
Current and recent past users (who had discontinued the drug 15 to 180 days before the start of the study) had a significantly higher fracture risk than ‘remote’ users (who had discontinued use of the drug more than 180 days before the start of the study). Among current users, those who took high or medium doses of the drug were much more likely to suffer a fracture than those who took a low dose.
These findings provide evidence that levothyroxine treatment may increase the risk of fragility fractures in older people even at conventional dosages, suggesting that closer monitoring and modification of treatment targets may be warranted in this vulnerable population. Also, treatment targets should be modified in elderly patients with thyroid problems and that regular dose monitoring of thyroid drugs is essential in older age.
Many patients with hypothyroidism are diagnosed in early or middle adulthood. Even though their treatment requirements change as they age, many patients remain on the same drug dose. This can lead to excess levels of thyroid hormone, which raises the risk of fractures, especially in older women.
Researchers examined the link between fractures and levothyroxine, a synthetic form of thyroid hormone, which is widely used to treat an underactive thyroid gland (hypothyroidism). They analysed data from over 213,511 Canadians, aged 70 years or older, in Canada who filled at least one prescription for levothyroxine between April 2002 and March 2007. During the study period, more than 22,236 (approximately 10 percent) of the patients suffered at least one fracture.
Current and recent past users (who had discontinued the drug 15 to 180 days before the start of the study) had a significantly higher fracture risk than ‘remote’ users (who had discontinued use of the drug more than 180 days before the start of the study). Among current users, those who took high or medium doses of the drug were much more likely to suffer a fracture than those who took a low dose.
These findings provide evidence that levothyroxine treatment may increase the risk of fragility fractures in older people even at conventional dosages, suggesting that closer monitoring and modification of treatment targets may be warranted in this vulnerable population. Also, treatment targets should be modified in elderly patients with thyroid problems and that regular dose monitoring of thyroid drugs is essential in older age.
Tuesday, 07 June 2011
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