While the research is contradictory and sometimes confusing, the predominance of the evidence points toward the conclusion that non-suppressive thyroid replacement does not substantially increase the risk of osteoporosis. The key risk factors seems to be age and menopausal status.
It does not seem logical for doctors to refuse to treat to lower-normal TSH level, or to provide supplemental but not excessive T3 treatment - both therapies which may help resolve major hypothyroidism symptoms for some patients - solely on the basis of concerns over osteoporosis. This is particularly true for patients who are pre-menopausal.
There are some specific things you can do to reduce your risk of osteoporosis:
- Younger thyroid patients should pay particular attention to building bone during the period before age 30. Weight bearing exercise, sufficient calcium intake, and sufficient Vitamin D levels are the best ways to build bone when younger, and should continue as a way to maintain bone.
- Consider having a bone density test at 40, and every several years thereafter. This is particularly important for thyroid patients.
- Hormone replacement therapy, calcium supplementation, and drugs such as Fosamax, can also be discussed with the doctor for use in slowing loss in bone density or as preventatives.