الفهرس 
Abstract
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Hypothyroidism is mostly insidious in onset, making its recognition difficult. Symptoms of hypothyroidism include fatigue, lethargy, weight gain despite poor appetite, cold intolerance, hoarseness of voice, constipation, weakness, myalgias, arthralgias, paresthesia, dry skin, and hair loss (2).
Osteoporosis is characterized by low bone mass, microarchitectural disruption, and skeletal fragility, resulting in decreased bone strength and an increased risk of fracture. Decreased bone strength is related to many factors other than bone mineral density (BMD),including rates of bone formation and resorption (turnover), bone geometry (size and shape of bone), and microarchitecture (96).
The World Health Organization (WHO) has defined diagnostic thresholds for low bone mass and osteoporosis based upon BMD measurements compared with a young adult reference population (T-score)(97).
Most postmenopausal women with osteoporosis have bone loss related to estrogen deficiency and/or age. Early diagnosis and quantification of bone loss and fracture risk are important because of the availability of therapies that can slow or even reverse the progression of osteoporosis (94).
This is a clinical trial study during which 80 postmenopausal females were enrolled. The female cohort were divided into two equal group.
The first group = 40 females (Hypothyroid group) received the intervention which is Levothyroxine sodium anhydrous (Eltroxin™) and Vit-D and calcium replacement according to NOF (National osteoporosis foundation), The second group = 40 females received Vit-D and calcium replacement (euthyroid group) (186).
This study revealed that vitamin D is lower in the hypothyroid group than in the control group. Vitamin D insufficiency and deficiency are more frequent in patients in the hypothyroid group than in the control group.
Our study shows that the percent of change in TSH, total calcium level and VIT D level was significantly higher in the Hypothyroid group than in the Control group and p-value was significant at 0.001 this is due to the thyroid hormone replacement as the level of vitamins has negative correlation with the level of TSH in case of hypothyroid patient.
Regarding DEXA scan measurement parameters, FraxTM major fracture measurement was significantly higher in the hypothyroid group than in the Control group which indicates that treatment of hypothyroidism in postmenopausal females with evidence of osteoporosis has a positive correlation with bone health on the long run.
Our study shows that among hypothyroid postmenopausal females, there is significant increase in total serum Calcium, Ionized serum calcium and Vit. D levels after replacement compared to their levels before therapy, while there are no significant differences in serum phosphorus level or PTH level before and after therapy.
Our study reveals that among hypothyroid females, there is significant decrease in DEXA scan of FraxTM major osteoporotic after VIT.D therapy compared to its value before VIT.D therapy, while there are no significant differences in DEXA scan of AP spine, left femur score, Left radius T score or FraxTM hip fracture before and after replacement therapy.
Among the Control group our study shows, there are significant increases in Ionized serum calcium and Vit.D levels after Control while PTH level significantly decreased after treatment, However, there are no significant differences in Total serum Calcium level or Serum phosphorus level before and after treatment of control group.
our study shows that among the Control group, there are significant decreases in DEXA scan of AP spine, Left radius T-score and Frax hip fracture after Control. while there are no significant differences in DEXA scan of Left femur score or Frax major osteoporotic before and after Control so these results statistically significant however with the use of FRAX score it’s negligible.