Bone mineral density in well-differentiated thyroid cancer patients treated with suppressive thyroxine: a systematic overview of the literature.

BACKGROUND: The effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by suppressive thyroxine therapy in patients with well-differentiated thyroid cancer (WDTC) remains unclear. An overview of the current literature was undertaken to evaluate studies to date. METHODS: A systematic medline search yielded a total of 11 studies appropriate for review which included premenopausal women, postmenopausal women, and men on suppressive thyroxine post thyroidectomy for WDTC. Main outcome measures were bone mineral density and bone turnover markers. CONCLUSIONS: Although studies were limited by small numbers and varying degrees of control for confounding variables, results suggested no significant change in bone mineral density for premenopausal women or men. Findings for postmenopausal women remain unclear with two of the best controlled studies reporting opposing results. Further studies for this population are recommended to help guide clinical practice.