Effects of Thyroid Stimulating Hormone on Bone Metabolism

Sun Wook Cho

doi:10.11106/ijt.2016.9.2.127

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Cho: Effects of Thyroid Stimulating Hormone on Bone Metabolism

Review Article

Int J Thyroidol 2016;9(2):127-130.

Published online: 20 November 2016

DOI: https://doi.org/10.11106/ijt.2016.9.2.127

Effects of Thyroid Stimulating Hormone on Bone Metabolism

Sun Wook Cho

Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

Correspondence: Sun Wook Cho, MD, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: 82-2-2276-2094, Fax: 82-2-762-2292, E-mail: swchomd@nmc.or.kr

Received 2 May 2014 Revised 13 July 2016 Accepted 14 July 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bone is a dynamic tissue undergoing life-long remodeling, a process of bone resorption by osteoclast and bone formation by osteoblast, regulated by diverse hormones including estrogen. Recently, several pituitary hormones have been identified as a modulator of this process. Here, we reviewed the role of thyroid stimulating hormone signaling per se in bone metabolism.

Keywords: Thyroid stimulating hormone, Bone resorption, Bone formation, Bone remodeling

References

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Fig. 1.

Hypothalamus-pituitary-thyroid-bone axis. The hypo-thalamic neurons secrete thyrotropin releasing hormone (TRH) is secreted by hypothalamic neurons and carried down to the pituitary gland where it releases thyroid stimulating hormone (TSH). TSH reaches thyroid glands and stimulates the productions of thyroxin (T4) and triiodothyronine (T3) by binding to TSH receptor (TSHR). T3 exerts its actions on bone mainly through thyroid hormone receptor α (TRα). TSH can directly act on bone by binding to TSHR. Increased levels of circulating T3 can get negative feedback loop by inhibiting TRH and TSH releases.

Table 1.

Bone phenotypes in dissociation of reciprocal relationship between thyroid hormone and TSH

Disease	Pathogenesis	T3 action	TSH action	Skeleton	References
Graves' disease	TSHR stimulating antibody	Increased	Increased	Osteoporosis and fracture	13)
Resistance to thyroid hormone (RTH)	TRβ mutation	ㆍ TRα dominant tissue → increased ㆍ TRβ dominant tissue → decreased ㆍ Supraphysiologic T4 replacement	Normal or increased	Increased bone turnover, osteoporosis, fracture	14,15)
Isolated TSH deficiency	TSHβ mutation	Decreased until T4 replacement commenced	Absent	Normal BMD	16)
rhTSH administration: thyroidectomy		Increased (supraphysiological T4 replacement)	Increase (transient)	Bone turnover markers decreased or unaffected	22,23)

BMI: body mass index, TSH: thyroid stimulating hormone

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