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Impact of total versus subtotal thyroidectomy on calcium metabolism and bone mineral density in premenopausal women

Published online by Cambridge University Press:  10 October 2008

F Tunca ,
Y G Senyurek ,
T Terzioglu ,
R Tanakol  and
S Tezelman
F Tunca*
Affiliation:
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
Y G Senyurek
Affiliation:
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
T Terzioglu
Affiliation:
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
R Tanakol
Affiliation:
Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey
S Tezelman
Affiliation:
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
*
Address for correspondence: Dr F Tunca, Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Capa, Topkapi 34390, Turkey. Fax: +90 212 5314054 E-mail: [email protected]
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Abstract

Objective:

This study aimed to compare the impact of total versus subtotal thyroidectomy on calcium metabolism and bone mineral density in euthyroid, premenopausal women.

Subjects:

The study included 24 premenopausal women who had undergone total (n = 10) or subtotal (n = 14) thyroidectomy and who were receiving nonsuppressive doses of thyroxine. The median post-operative period was four years. We determined, in all patients, the following parameters associated with calcium metabolism: total serum calcium, inorganic phosphate, intact parathormone, calcitonin and alkaline phosphatase. The bone mineral density of the spine and hip were measured using a Hologic QDR 4500C bone densitometer and were compared with controls matched for age and peak bone mineral density (using the t-test).

Results:

The measured calcium metabolism parameters were normal in all patients, and none had osteoporosis. There was no significant difference in the bone mineral density measurements for the spine and hip, comparing patients who had undergone total versus subtotal thyroidectomy (using the t-test).

Conclusion:

The impact of total thyroidectomy on bone mineral metabolism is not significantly different from that of subtotal thyroidectomy, in premenopausal women with normal thyroid-stimulating hormone values.

Keywords

ThyroidectomyBone DensityThyroxine
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 4 , April 2009 , pp. 434 - 438
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Frilling, A, Hertl, M. Endemic goiter and benign multinodular goiter. In: Doherty, GM, Skogseid, B, eds. Surgical Endocrinology. Philadelphia, Lippincott Williams & Wilkins, 2001;37–45Google Scholar
2 Delbridge, L, Guinea, AI, Reeve, TS. Total thyroidectomy for bilateral benign multinodular goiter: effect of changing practice. Arch Surg 1999;134:1389–93CrossRefGoogle ScholarPubMed
3 Pappalardo, G, Guadalaxara, A, Frattaroli, FM, Illomei, G, Falaschi, P. Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports. Eur J Surg 1998;164:501–6CrossRefGoogle ScholarPubMed
4 Reeve, TS, Delbridge, L, Brady, P, Crummer, P, Smyth, C. Secondary thyroidectomy: a twenty-year experience. World J Surg 1988;12:449–53CrossRefGoogle ScholarPubMed
5 McDermott, MT, Kidd, GS, Blue, P, Ghaed, V, Hofeldt, FD. Reduced bone mineral content in totally thyroidectomized patients: possible effect of calcitonin deficiency. J Clin Endocrinol Metab 1983;56:936–9CrossRefGoogle ScholarPubMed
6 Scheider, P, Berger, P, Kruse, K, Borner, W. Effect of calcitonin deficiency on bone density and bone turnover in totally thyroidectomized patients. J Endocrinol Invest 1991;14:935–42CrossRefGoogle Scholar
7 Capelli, C, Cottarelli, C, Cumetti, D, Agosti, B, Gandossi, E, Rizzoni, D, Agabiti, Rosei E et al. Bone density and mineral metabolism in calcitonin-deficiency patients. Minerva Endocrinol 2004;29:1–10Google Scholar
8 Sianesi, M, Cervellin, GF, Palummeri, E, De Lorenzis, GF, Ghirarduzzi, A, Chiampo, L et al. Calcitonin deficit syndrome in thyroidectomized patients. Ital J Surg Sci 1985;15:145–8Google ScholarPubMed
9 Lowery, WD, Thomas, CG Jr, Ambrey, BJ, Rosenstein, BD, Talmage, RV. The late effect of subtotal thyroidectomy and radioactive iodine therapy on calcitonin secretion and bone mineral density in women treated for Graves' disease. Surgery 1986;100:1142–9Google Scholar
10 Duncan, WE, Chang, A, Solomon, B, Wartowsky, L. Influence of clinical characteristics and parameters associated with thyroid hormone therapy on bone mineral density of women treated with thyroid hormone. Thyroid 1994;4:143–4CrossRefGoogle Scholar
11 Diamond, T, Nery, L, Hales, I. A therapeutic dilemma: suppressive doses of thyroxine significantly reduce bone mineral measurements in both premenopausal and postmenopausal women with thyroid carcinoma. J Clin Endocrinol Metab 1991;72(6):1184–8CrossRefGoogle ScholarPubMed
12 Giannini, S, Nobile, M, Sartori, L, Binotto, P, Ciuffreda, M, Gemo, G et al. Bone density and mineral metabolism in thyroidectomized patients teated with long term L-thyroxine. Clin Sci 1994;87:593–7CrossRefGoogle Scholar
13 Korsic, M, Cvijetic, S, Dekanic-Ozegovic, D, Bolanca, S, Kozic, B. Bone mineral density in patients on long term therapy with levothyroxine [in Croatian]. Lijec Vjesn 1998;120:103–5Google ScholarPubMed
14 Garton, M, Reid, I, Loveridge, N, Robins, S, Murchison, L, Bekett, G et al. Bone mineral density and metabolism in premenopausal women taking L-thyroxine therapy. Clin Endocrinol 1994;41:747–55CrossRefGoogle Scholar
15 Guo, CY, Weetman, AP, Eastell, R. Longitudinal changes of bone mineral density and bone turnover in postmenopausal women on thyroxine. Clin Endocrinol 1997;46:301–7CrossRefGoogle ScholarPubMed
16 Kung, AW, Lorentz, T, Tam, SC. Thyroxine suppressive therapy decreases bone mineral density in post-menopausal women. Clin Endocrinol 1993;39:535–40CrossRefGoogle ScholarPubMed
17 Mirzaei, S, Krotla, G, Knoll, P, Koriska, K, Kohn, H. Possible effect of calcitonin deficiency on bone mass after subtotal thyroidectomy [in German]. Acta Med Austrica 1999;26:29–31Google Scholar
18 Hurley, DL, Tiegs, RD, Wahner, HW, Heath, H 3rd. Axial and apendicular bone mineral density in patients with long term deficiency or excess of calcitonin. N Engl J Med 1987;317:537–41CrossRefGoogle ScholarPubMed
19 Lakatos, P, Tarjan, G, Merei, J, Foldes, J, Hollo, I. Androgens and bone mineral content in patients with subtotal thyroidectomy for benign nodular disease. Acta Med Hng 1989;46:297–305Google ScholarPubMed
20 Marcocci, C, Golia, F, Bruno-Bossio, G, Vignali, E, Pichera, A. Carefully monitored levothyroxine suppressive therapy is not associated with bone loss in premenopausal women. J Clin Endocrinol Metab 2004;78:818–22Google Scholar
21 Greenspan, SL, Greenspan, FS, Resnick, NM, Block, JE, Friedlander, AL, Genant, HK. Skeletal integrity in premenopausal and postmenopausal women receiving long-term L-thyroxine therapy. Am J Med 1991;91:5–14CrossRefGoogle ScholarPubMed
22 Sijanovic, S, Karner, I. Bone loss in premenopausal women on long-term suppressive therapy with thyroid hormone. Medscape Womens Health ejournal 2001;6:3Google ScholarPubMed
23 Chen, CH, Chen, JF, Yang, BY, Liu, RT, Tung, SC, Chien, WY et al. Bone mineral density in women receiving thyroxine suppressive therapy for differentiated thyroid carcinoma. J Formos Med Assoc 2004;103:442–7Google ScholarPubMed
24 Baran, DT. Hyperthyroidism, thyroid hormone replacement and osteoporosis. In: Favus, MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 3rd edn. Philadelphia: Lippincott Raven, 1996:286–8Google Scholar
25 Franklyn, JA, Betteridge, J, Daykin, J, Holder, R, Oates, GD, Parle, JV et al. Long-term thyroxine treatment and bone mineral density. Lancet 1992;340:9–13CrossRefGoogle ScholarPubMed
26 Gonzales, DC, Mautalen, CA, Correa, PH, el Tamer, E, el Tamer, S. Bone mass in totally thyroidectomized patients. Role of calcitonin deficiency and exogenous thyroid treatment. Acta Endocrinol 1991;124:521–5Google Scholar
27 Quan, ML, Pasieka, JL, Rorstad, O. Bone mineral density in well-differentiated thyroid cancer patients treated with suppressive thyroxine: a systematic overview of the literature. J Surg Oncol 2002;79:62–9CrossRefGoogle ScholarPubMed
28 Sugino, K, Kure, Y, Suzuki, A, Sekino, H, Iwasaki, H, Goto, H et al. Bone metabolism in thyroidectomized patients – evaluation of bone mineral content by quantitative CT [in Japanese]. Nippon Geka Gakkai Zasshi 1990;91:500–7Google ScholarPubMed
29 Becker, KL, Snider, RH, Moore, CF, Monoghan, KG, Silva, OL. Calcitonin in extrathyroidal tissues of man. Acta Endocrinol 1979;92:746–51Google ScholarPubMed
30 Hirsch, PF, Lester, GE, Talmage, RV. Calcitonin an enigmatic hormone: does it have a function? J Musculoskelet Neuronal Interact 2001;1:299–305Google ScholarPubMed
31 Silva, O, Wisneski, LA, Cyrus, J, Snider, RH, Moore, CF, Becker, KL. Calcitonin thyroidectomized patients. Am J Med Sci 1978;275:159–64CrossRefGoogle ScholarPubMed
32 Lopez Alvarez, MB, Hawkins, F, Rigopoulou, D, Martinez, G, Jodar, E, Estenoz, J et al. The risk factors and bone mineral density in women on long-term levothyroxine treatment. Med Clin 1999;30:85–9Google Scholar
33 Nguyen, TT, Heath, H 3rd, Bryant, SC, O'Fallon, WM, Melton, LJ 3rd. Fractures after thyroidectomy in men: a population-based cohort study. J Bone Miner Res 1997;12:1092–9CrossRefGoogle Scholar
34 Pouillés, JM, Trémollieres, FA, Ribot, C. Osteoporosis in otherwise healthy perimenopausal and early postmenopausal women: physical and biochemical characteristics. Osteoporosis Int 2006;17:1954–9CrossRefGoogle ScholarPubMed