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PECULIARITIES OF TREATMENT FOR BONE DISEASES IN WOMEN OF DIFFERENT AGE WITH DIFFUSE TOXIC GOITER

Аuthors: L. V. Gerasimenko, V. V. Khaziev

Pages: 237–245

Abstract

         

Introduction. Graves' disease in 60% of cases is followed by osteopenic bone disorders. Women are affected more than men. Moreover, bone disorders most often occur in women under the age of menopause. In Ukraine medical treatment (thyreostatic) or surgical treatment is most often used for treatment of Graves' disease.

Purpose. To determine the most effective methods of treatment for diffuse toxic goiter with correction of osteopenic complications in the women of different age – reproductive and menopausal.

Materials and methods. The patients with thypoid disorders were investigated – 36 of reproductive age and 29 menopausal, as well as healthy individuals (12 and 5, correspondingly). The examination included: ultrasound determination of the thyroid gland volume, mineral bone tissue density evaluation by dual-energy X-ray absorptiometry with reference criteria T- and Z-score calculation, and measurement of thyroid hormones and TSH with thyroid hormone immunoassay methods. Then, the patients were prescribed different treatments. All patients were administered Vitamin D3 and Calcium supplements for prevention. After that, two different age groups were given "Alpha-D3-Тeva" – medication for reproductive age; "Bonviva" (bisphosphonates group), "Bivalos" (Strontium ranelate) – for menopausal age. The preparations were taken for 12 months with a break for one month every 3 months of intake.

Results. Two other different age groups were treated surgically. It has been demonstrated that the surgical method of treatment of diffuse toxic goiter combined with anti-osteopenia medications leads to a more effective increase of the bone tissue mineral density values than medication method in attainment of euthyroid condition at the background of anti-osteopenia medications in both age groups of patients.

Keywords: reproductive age, menopause, osteopenia, osteoporosis, thyroid hormones, bone tissue density, medication treatment, surgical treatment.

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