title: The skeletal consequences of thyrotoxicosis.
abstract: Euthyroid status is essential for normal skeletal development and the maintenance of adult bone structure and strength. Established thyrotoxicosis has long been recognised as a cause of high bone turnover osteoporosis and fracture but more recent studies have suggested that subclinical hyperthyroidism and long-term suppressive doses of thyroxine (T4) may also result in decreased bone mineral density (BMD) and an increased risk of fragility fracture, particularly in postmenopausal women. Furthermore, large population studies of euthyroid individuals have demonstrated that a hypothalamic-pituitary-thyroid axis set point at the upper end of the normal reference range is associated with reduced BMD and increased fracture susceptibility. Despite these findings, the cellular and molecular mechanisms of thyroid hormone action in bone remain controversial and incompletely understood. In this review, we discuss the role of thyroid hormones in bone and the skeletal consequences of hyperthyroidism.
authors.affiliation: Molecular Endocrinology Group, Department of Medicine, Imperial College London, Hammersmith Campus, Room 7N2b, Commonwealth Building, Du Cane Road, London W12 0NN, UK.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Nicholls
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Brassill
authors.forename: Graham R
authors.initials: GR
authors.lastname: Williams
authors.forename: J H Duncan
authors.initials: JH
authors.lastname: Bassett
mesh_terms: D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050723:Fractures, Bone / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D008954:Models, Biological; D010024:Osteoporosis / Q000150:complications* / Q000503:physiopathology; D013961:Thyroid Gland / Q000378:metabolism / Q000502:physiology; D013971:Thyrotoxicosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D013974:Thyroxine / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D013974:Thyroxine