Effect of propranolol treatment on bone mass, bone mineral content, bone remodelling, parathyroid function and vitamin D metabolism in hyperthyroidism

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Abstract
The effect of propranolol 160-640 mg/day for 3 mo. on the accelerated loss of bone matrix and mineral in hyperthyroidism was studied in 17 patients. A rise in serum thyroxine (P < 0.01) during the first 3 wk was followed by a fall (P < 0.02). Serum triiodothyronine declined during the study (P < 0.02). The enhanced bone mineral mobilization and collagen turnover continued during treatment and the bone mineral content decreased 3.2% (P < 0.01). The secondary adaptive changes in serum parathyroid hormone and vitmain D metabolites and in renal phosphate handling stayed unchanged. Iliac crest bone biopsies after tetracycline double labeling showed initially a high bone turnover (P < 0.01) with a reduced amount of cortical and trabecular bone (P < 0.05). Following treatment bone formation rate decreased at both cellular and tissue level (P < 0.01). No significant changes were observed in the amount of cortical and trabecular bone. Propranolol, in contrast to antithyroid medication, lacks any curative effect on the accelerated bone loss in hyperthyroidism.