{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:40:16Z","timestamp":1786653616914,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Bisphosphonates (BP) used in osteoporosis management can induce an acute phase response, their short-term endocrine effects remain unclear. This study hypothesized that initial BP exposure elicits a non-thyroidal illness syndrome (NTIS)-like pattern and that thyroid autoimmunity may amplify this response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective cohort at a tertiary centre, 336 adults (93% postmenopausal women) were enrolled: 168 received first-dose BP therapy (zoledronic acid (ZA) =129; oral alendronate (ALN) = 39) and 168 matched controls (calcium\/vitamin D). FT3, FT4, TSH, and erythrocyte sedimentation rate (ESR) were measured at baseline and on days 1, 2, 3, 7, and 42 with baseline anti-TPO Ab. Linear mixed-effects models with random intercepts evaluated group \u00d7 time interactions, adjusting for age, sex, and body mass index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      BP recipients demonstrated a clear temporal pattern, FT3 declined significantly, reaching a nadir on Day 2 (mean difference \u22120.47 pg\/mL vs controls,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), FT4 fell modestly (mean difference \u22120.07 ng\/dL), and TSH was transiently suppressed before rebounding above baseline by Day 42 (mean difference +0.39 mIU\/L). ESR peaked on Day 2 and normalized by Day 7, paralleling hormonal recovery. Group \u00d7 time interactions were significant for all parameters (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Anti-TPO Ab positive individuals exhibited deeper FT3 suppression and greater TSH rebound. ALN effects were directionally similar but underpowered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>First-dose BP therapy, particularly ZA, induces a short-lived, reversible NTIS-like response amplified by thyroid autoimmunity. Early post-infusion thyroid testing may mimic hypothyroidism, re-evaluation after six to eight weeks is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_984_25","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:00:12Z","timestamp":1777568412000},"page":"187-193","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Serial Changes in Thyroid Hormones with Oral or Intravenous Bisphosphonates"],"prefix":"10.4103","volume":"30","author":[{"given":"Sandeep","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiraninder S.","family":"Brar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Manipal Hospital, Gurugram, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumar KVS","family":"Hari","sequence":"additional","affiliation":[{"name":"Magna Clinic, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayaraman","family":"Muthukrishnan","sequence":"additional","affiliation":[{"name":"Commandant 167 Military Hospital, Pathankot, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narendra","family":"Kotwal","sequence":"additional","affiliation":[{"name":"Director of Endocrinology Paras Hospital, Panchkula, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Command Hospital (AF), Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Bansal","sequence":"additional","affiliation":[{"name":"Military Hospital, Ferozepur, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prafull","family":"Sharma","sequence":"additional","affiliation":[{"name":"Army Hospital (Research and Referral), Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"R2-20260430","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1507\/endocrj.EJ11-0039","article-title":"Transient changes in thyroid functions tests after zoledronic acid infusion","volume":"58","author":"Karga","year":"2011","journal-title":"Endocr J"},{"key":"R3-20260430","doi-asserted-by":"crossref","first-page":"405","DOI":"10.4158\/EP161638.OR","article-title":"Acute-phase reactions after zoledronic acid infusion: Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy","volume":"24","author":"Crotti","year":"2018","journal-title":"Endocr Pract"},{"key":"R4-20260430","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.3389\/fcell.2020.614030","article-title":"Thyroid hormones interaction with immune response, inflammation and non-thyroidal illness syndrome","volume":"8","author":"De Luca","year":"2021","journal-title":"Front Cell Dev Biol"},{"key":"R6-20260430","doi-asserted-by":"crossref","first-page":"e2819","DOI":"10.1038\/cddis.2017.101","article-title":"Geranylgeranyl diphosphate synthase inhibition induces apoptosis that is dependent upon GGPP depletion, ERK phosphorylation and caspase activation","volume":"8","author":"Agabiti","year":"2017","journal-title":"Cell Death Dis"},{"key":"R7-20260430","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.4065\/83.9.1032","article-title":"Bisphosphonates: Mechanism of action and role in clinical practice","volume":"83","author":"Drake","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"R8-20260430","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/imm.13283","article-title":"Zoledronate promotes inflammatory cytokine expression in human CD14-positive monocytes among peripheral mononuclear cells in the presence of \u03b3\u03b4 T cells","volume":"162","author":"Takimoto","year":"2021","journal-title":"Immunology"},{"key":"R9-20260430","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/os.12338","article-title":"Multicenter study on observation of acute\u2010phase responses after infusion of zoledronic acid 5 mg in Chinese women with postmenopausal osteoporosis","volume":"9","author":"Ding","year":"2017","journal-title":"Orthop Surg"},{"key":"R10-20260430","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s12020-012-9703-2","article-title":"The incidence and prevalence of thyroid autoimmunity","volume":"42","author":"Mcleod","year":"2012","journal-title":"Endocrine"}],"container-title":["Indian Journal of Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_984_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:39:59Z","timestamp":1786649999000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_984_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijem.ijem_984_25","relation":{},"ISSN":["2230-8210","2230-9500"],"issn-type":[{"value":"2230-8210","type":"print"},{"value":"2230-9500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-11-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}