Endogenous and Exogenous Thyrotoxicosis and Risk of Incident Cognitive Disorders in Older Adults

In this cohort study among 65,931 patients aged 65 years and older, a low thyrotropin level from either endogenous or exogenous thyrotoxicosis was associated with increased risk of incident cognitive disorder (adjusted hazard ratio, 1.39; 95% CI, 1.18-1.64; P<0.001).

SPS commentary:

A related commentary praises the study for providing a better understanding of the association between excess thyroid hormone levels and cognition, particularly regarding exogenous thyrotoxicosis in older adults, and underscoring the critical need to reduce thyroid hormone overtreatment and misuse in the population. It highlights the use of levothyroxine as a risk factor, particularly as increased use is observed with increasing age.

It concludes that the increasing awareness of the risks associated with levothyroxine usage should promote more cautious prescribing practices, for instance, avoiding the use of levothyroxine for mild subclinical hypothyroidism in older adults.

JAMA Internal Medicine

Resource links:

Commentary