Thyroid disease and bone health

If your thyroid hormone levels stay too high for too long, you may be more likely to develop low bone density and osteoporosis. This is particularly likely if you are a post-menopausal woman and research has shown a potential increased risk of breaking your hip.

Hyperthyroidism can also be associated with muscle weakness and loss of lean body mass, which can be quite severe in some cases. This can then lead to an increased risk of falling and subsequent broken bones.

If I have hyperthyroidism should I have a bone density scan?

A bone density scan provides information about the strength of your bones and helps your doctor determine whether or not you have a high risk of breaking bones. It is important to discuss your individual risks for osteoporosis with your doctor. Hyperthyroidism is one of a number of conditions that can cause a reduction in bone density. Once your thyroid problem is controlled, bone density usually recovers. Your doctor will assess your need for a bone density scan based on your risk factors and refer you for a scan if necessary.

Hypothyroidism and osteoporosis

Hypothyroidism itself is not a risk factor for osteoporosis as it does not lead to bone loss. However, if you have hypothyroidism and are on too much replacement therapy to treat the condition then this may result in bone loss.

To prevent this, the thyroxine replacement (levothyroxine) must be carefully monitored to ensure levels do not become too high. This seems to be particularly important if you are elderly as research is indicating an increased risk of hip fracture in those over 70 who are taking high doses of levothyroxine.

I have had thyroid problems. What else can I do to prevent osteoporosis and fractures?

Factors which can help to maintain healthy bones include a well-balanced diet with adequate calcium rich foods; safe sunlight exposure to get adequate vitamin D; regular weight bearing exercise; avoiding smoking and keeping alcohol.

Content reviewed: April 2017

(Updated December 2021)