Older people with thyroid disease are at a higher risk of developing dementia

People who needed thyroid hormone replacement for a thyroid condition had an even higher risk of developing dementia, revealed to findings published in the journal Neurology.

The effects of dementia on the elderly may begin earlier than previously known. Now, a recent study shows that older adults with hypothyroidism, also known as underactive thyroid, are at increased risk of developing dementia.

People who needed thyroid hormone replacement for a thyroid condition had an even higher risk of developing dementia, revealed to findings published in the journal Neurology.

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones. It slows down the metabolism. Symptoms include fatigue, weight gain, and sensitivity to cold.

“In some cases, thyroid disorders are associated with dementia symptoms that are reversible with treatment,” said Chien-Hsiang Weng of Brown University in the US.

“Although more studies are needed to confirm these findings, people should consider thyroid problems as a risk factor for dementia and treatments that can prevent or reverse irreversible cognitive decline,” Weng added.

For the study, researchers looked at the health records of 7,843 people newly diagnosed with dementia in Taiwan and compared them to the same number of people without dementia. Their average age is 75.

The researchers looked at those who had a history of hypothyroidism or hyperthyroidism. Hyperthyroidism, also known as overactive thyroid, is when the thyroid produces too much hormone. It can increase metabolism. Symptoms include unintended weight loss, rapid or irregular heartbeat, and anxiety or nervousness.

A total of 102 had hypothyroidism and 133 had hyperthyroidism.

Researchers found no link between hyperthyroidism and dementia.

However, the team found that people over 65 with hypothyroidism were 80 percent more likely to develop dementia than people the same age without thyroid problems. For those under 65, having a history of hypothyroidism was not associated with dementia risk.

When the researchers looked only at people who took medication for hypothyroidism, they were three times more likely to develop dementia than those who didn’t take the medication. “One explanation for this is that these individuals are more likely to experience more symptoms from hypothyroidism that require treatment,” Weng said.

Weng noted that the observational study did not prove hypothyroidism was a cause of dementia, only an association.

A limitation of the study was that the researchers were unable to include information about how severe hypothyroidism was for the participants.

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The Thyroid, the forgotten gland?

The thyroid gland is important in all metabolic functions in the body and its importance is often underappreciated.

The thyroid gland is a butterfly-shaped gland in the front of the neck that covers the voice box (larynx) and trachea (trachea). This gland is important in all metabolic functions in the body and its importance is often underestimated. The thyroid gland produces several hormones: triiodothyronine, thyroxine, and calcitonin. Iodine and tyrosine are needed to produce these hormones. The secretion of these hormones is influenced by the thyroid and controlled by thyroid-stimulating hormone (TSH) produced in the pituitary gland in the brain, which is controlled by thyrotropin-releasing hormone (TRH) produced by the hypothalamus. Thyroid hormones provide negative feedback to TSH and TRH: when thyroid hormones are high, TSH production is suppressed and vice versa. TRH is secreted at increased rates in situations such as cold exposure to stimulating thermogenesis (the generation of heat).

Calcitonin helps regulate blood calcium levels If blood calcium levels are high, calcitonin reduces the release of calcium from bone by reducing the activity of bone cells (osteoclasts) that break down bone.

The main function or effect of these thyroid hormones in the body can be summarized as follows:

Development
Thyroid hormones are required for normal growth and growth rate in young adults. A lack of thyroid hormones in a pregnant woman can harm fetal brain maturation and the first few years after birth. A baby born without thyroid-producing hormones can develop severe pathology and this condition is called cretinism.

Metabolism
Thyroid hormones increase the basal metabolic rate. Appetite, bowel movement, and absorption of substances are affected by it. Lowers cholesterol by increasing the secretion of cholesterol in the bile. Therefore, if the thyroid is dysfunctional, the patient’s cholesterol may increase.

Cardiovascular
The speed of the heartbeat and the strength of heart contractions are also affected by thyroid hormones. Hence the consumption and intake of oxygen and the rate of respiration are affected.

Endocrine gland
Sleep and thinking patterns, sexual function (libido), and a normal menstrual cycle depend on the normal functioning of thyroid hormones.

Thyroid dysfunctions include hyperthyroidism and hypothyroidism:

Hyperthyroidism is an overproduction of thyroid hormones, resulting in an overactive gland. It can cause weight loss, increased appetite, insomnia, heat intolerance, palpitations, anxiety, and heart rhythm disorders (atrial fibrillation), and hair loss. Causes of hyperthyroidism include Graves’ disease, a toxic multinodular goiter (enlargement of the thyroid gland with nodules), thyroid adenoma (growth), swelling or adenoma in the pituitary gland, the latter causing excessive TSH secretion.

Graves’ disease is an autoimmune disease that results in the overproduction of thyroid hormones (with all the associated symptoms) and possible eye and skin problems. Antibodies are produced against the TSH receptor.

Long-term management of hyperthyroidism may include drugs that suppress thyroid hormones, alternatively, radio-active iodine to destroy the thyroid or removal of the thyroid (thyroidectomy) may be considered. Radioactive iodine and thyroidectomy can cause a permanent deficiency of thyroid hormones and require chronic thyroid medication instead.

Hypothyroidism is a term that refers to an underactive thyroid gland. Iodine deficiency is a common cause of hypothyroidism. Hashimoto’s thyroiditis (auto-immune disease) is a cause of the underproduction of thyroid hormones. Common symptoms of hypothyroidism are weight gain, fatigue, hair loss, cold intolerance, and constipation. In some cases, it can cause myxedema (swelling of the skin and tissues) and, in severe cases, myxedema coma.

Hypothyroidism can be treated by replacing thyroid hormones. The cause of hypothyroidism should be established and if possible corrected (iodine deficiency). In some cases, it is transient, sometimes seen in the postpartum period (postpartum thyroiditis) or with sub-acute thyroiditis.

Other pathology related to the thyroid gland:

Thyroid nodules are often found in the thyroid gland, but only about 5% are cancerous (malignant). Ultrasound can determine whether a nodule is malignant or not, followed by micro needling to examine whether the cells are normal or cancerous. Most thyroid cancers are well contained and can be cured by removing the gland, in a minority of cases, thyroid cancer is invasive and spreads to other organs (anaplastic thyroid cancer) and then has a poor prognosis.

Goiter is a term used to refer to an enlarged thyroid gland. Goiters can be caused by iodine deficiency, Graves’ disease, Hashimoto’s thyroiditis, and inflammatory or invasive diseases such as sarcoidosis and amyloidosis. Identify and treat the underlying cause of goiter; In some cases, surgical removal of the thyroid gland is necessary.

As part of your annual checkup, remind your general practitioner to check your thyroid gland for any nodules or enlargement. Recommend including a thyroid profile blood group (or at least testing your TSH) when other routine tests for cholesterol, blood glucose, and prostate-specific antigen (men) are done. A healthy thyroid is essential for a healthy life!

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