Thyroid Hormones & Tx of Osteoporosis

primary effects of thryoid hormones are to increase metabolism such as

cell metabolism

BMR

body temp

CO, respiration

growth & development

sxs of hyperthyroidism

nervous, low body weight, tachycardia, heat intolerance, muscle wasting

sxs of hypothyroidism

lethargic, weight gain, bradycardia, cold intolerance, weakness due to lack of muscle metabolism

tx of hyperthyroidism

antithyroid agents (propylthiouracil, methimazole), iodide (high doses), radioactive iodine (chemical removal of thyroid), surgical removal of thyroid

surgical removal or chemical oblation of thyroid gland results in

hypothyroidism

tx for hypothyroidism

replacement therapy (levothyroxine: T4, liotrix: T3 & T4)

rehab concerns for thyroid hormones is to

monitor pt response, too much replacement therapy mimics hyperthyroidism, too little mimics hypothyroidism

bisphosphonates (alendronate, pamidronate (“-dronate”)) in tx for osteoporosis MOA

adhere to calcium in bone; prevent osteoclast activity

bisphosphonates are often 1st choice for postmenopausal osteoporosis, but can cause

esophageal damage (pts must remain upright for 30 min after taking)

& bone lesions in jaw or femur

other anti-osteoporosis options include parathyroid hormone analogs (teriparatide, abaloparatide) which are made in the C-glands in thyroid, break down bones to bring more calcium into blood stream; however

small doses in burst may have opposite affect

other anti-osteoporosis options include denosumab which is an

antibody that inhibits osteoclast formation

other anti-osteoporosis options include Romosozumab MOA

antibody that inhibits sclerostin activity in osteocytes

other anti-osteoporosis options include hormonal therapies such as

estrogen, SERMs

other anti-osteoporosis options include calcitonin which acts like

the endogenous form of this hormone to ↑ calcium content in bone

what enhances calcium absorption from GI tract?

vitamin D