Patients 65 years of age and older who receive thyroid hormone therapy and have low levels of the hormone thyrotropin are at increased risk of developing dementia and other cognitive problems.
A study published in JAMA Internal Medicine shows that patients with thyrotoxicosis (excess thyroid hormones) were more likely to develop cognitive disorders, writes Medscape.
The study also found that women are more likely to have low thyrotropin (thyroid-stimulating hormone/TSH) levels than men and are also more likely to be overmedicated.
Jennifer Mammen, MD, assistant professor of medicine at the Johns Hopkins University School of Asthma and Allergy Center, and her colleagues analyzed the electronic medical records of patients age 65 and older who received primary care in the Johns Hopkins Community Physician Network since 2014.
None of them had a history of low TSH (thyroid-stimulating hormone) or cognitive impairment within 6 months of their first visit to the doctor.
More than 65,000 patients participated in the study. Just over half (56%) were female, nearly 70% were white, 19.3% were black, 4.6% were Asian, and 0.4% were American Indian. During the study period, nearly 25,000 low TSH measurements were recorded in 2,710 patients.
During the observation period, 7.2% of patients received a new diagnosis of cognitive disorder. In 77% of cases it was dementia.
Mammen says that primary care physicians should carefully consider whether thyroid hormone therapy is needed in elderly patients. If so, they are advised to be very careful to avoid overtreatment.
Jean Chen, MD, partner at Texas Diabetes & Endocrinology, also emphasizes caution when prescribing thyroid hormone therapy for older patients.
“All health care providers should be aware that people 65 and older do not need aggressive thyroid hormone treatment. We are increasingly finding complications from overtreatment rather than benefit in this patient category.” she says.
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Iryna Batiuk, UP. Life