Use of sensitive TSH assay to determine optimal thyroid hormone therapy and avoid osteoporosis.

Reported deleterious effects of thyroid hormone on bone mineral density have alarmed clinicians and patients alike because of the potential risks of osteoporosis and fracture. The known adverse effects of excessive thyroid hormones on bone are briefly reviewed, with distinction made between the status and potential consequences of replacement versus suppressive therapy. Employing the newer ultrasensitive TSH assay, management guidelines are offered to the clinician that should minimize risks of osteopenia in patients taking thyroid hormone.