EnMReviewEndocrinol Metab 2023:38:175-189https://doi.org/10.3803/EnM.2023.1701ENDOCRINOLOGYArticlePISSN2093-596X·elSSN2093-5978AND METABOLISMEvaluation and Management of Bone Health in Patientswith Thyroid Diseases:A Position Statement of the KoreanThyroid AssociationARam Hong,Ho-Cheol KangDepartment ofInternal Medicine,Chonnam National University Medical School,Gwangju,KoreaThyroid hormones play an important physiological role in maintaining adult bone structure and strength.Consequently,thyroid dys-function is related to skeletal outcomes.Overt hyperthyroidism is an established cause of high bone turnover with accelerated boneloss,leading to osteoporosis and increased fracture risk.Hyperthyroidism induced by thyroid-stimulating hormone-suppressive ther-apy in patients with differentiated thyroid cancer is a cause of secondary osteoporosis.In contrast,there is a lack of evidence on thenegative impact of hypothyroidism on bone health.Considering the clinical updates on the importance of bone health in thyroid dys-function,the Task Force from the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association recentlydeveloped a position statement on the evaluation and management of bone health of patients with thyroid diseases,particularly fo-cused on endogenous hyperthyroidism and thyroid-stimulating hormone-suppressive therapy-associated hyperthyroidism in patientswith differentiated thyroid cancer.Herein,we review the Korean Thyroid Association's position statement on the evaluation andmanagement ofbone health associated with thyroid diseases.Keywords:Hyperthyroidism;Thyroid hormones;Thyroid neoplasms;Osteoporosis;Bone densitySUMMARYuated using central bone (lumbar spine and hip)dual-energyX-ray absorptiometry(DXA)at diagnosis(A).QuantitativeL.Hypothyroidismultrasonography and peripheral bone densitometry (non-There is insuffic ient evidence that hypothyroidism increases thecentral bone;wrist,ankle,and heel)are more convenientrisk of osteoporosis and fractures.Therefore,the bone health ofthan DXA.However,the T-scores obtained using these testspatients with hypothyroidism should be evaluated and managedtend to be lower and less precise than those obtained usingaccording to general osteoporosis guidelines(E).DXA.Therefore,central bone DXA is recommended forevaluating the bone health of patients with thyroid diseasesII.HyperthyroidismE).1.0.Indications for bone health evaluation1.2.Since hyperthyroidism in premenopausal women and men1.1.The bone health of postmenopausal women should be eval-younger than 70 can lead to osteoporosis,bone health as-Received:19 March 2023,Revised:3April 2023,Accepted:5 April 2023Copyright 2023 Korean Endocrine SocietyCorresponding author:Ho-Cheol KangThis is anOpen Accessarticle distributed underthe termsof the Creative Com-mons Attribution Non-Commercial License (https://creativecommons.org/Department of Internal Medicine,Chonnam National University Medicallicenses/by-nc/4.0/)which permits unres
