Thyroid medication?

[Kitkat]

Apologies if I'm missing this information somewhere, but I'm wondering what anyone can tell me about thyroid medication as a preventive strategy. My TSH is elevated (4.529) but I gather might be borderline in terms of whether it will require medication. Will such medication increase or decrease my risk of AD (I'm 3/4)?

[TLS]

My mother’s neurologist told me that the thyroid impacts brain function and that keeping her levels in range are important. She has been hypothyroid for over 20 years.

[Kitkat]

But I believe that some studies link thyroid medication to increased risk of dementia. Do we know, for apoe4 folks, if the medication is helpful or harmful? On X (on May 20, 2023), Dr. Dale Bredesen wrote, “Those with a history of hypothyroidism were associated with an 81% increased risk of having dementia.” And then he noted, "It’s time for more research into hormonal health, especially since those taking medication for hypothyroidism had an even bigger risk increase. https://n.neurology.org/content/99/7/e679" Is it the need for the medication that posed the bigger risk of dementia or is it the medication itself?

[TLS]

But I believe that some studies link thyroid medication to increased risk of dementia. Do we know, for apoe4 folks, if the medication is helpful or harmful? On X (on May 20, 2023), Dr. Dale Bredesen wrote, “Those with a history of hypothyroidism were associated with an 81% increased risk of having dementia.” And then he noted, "It’s time for more research into hormonal health, especially since those taking medication for hypothyroidism had an even bigger risk increase. https://n.neurology.org/content/99/7/e679" Is it the need for the medication that posed the bigger risk of dementia or is it the medication itself?

One thing you could try, as this is what I am doing personally, is have your iodine levels tested in a blood test. My levels were low so I take a kelp supplement to keep it in line. I am working with a naturopathic doctor to monitor my thyroid and iodine. This approach is working for me personally.

[Plumster]

But I believe that some studies link thyroid medication to increased risk of dementia. Do we know, for apoe4 folks, if the medication is helpful or harmful? On X (on May 20, 2023), Dr. Dale Bredesen wrote, “Those with a history of hypothyroidism were associated with an 81% increased risk of having dementia.” And then he noted, "It’s time for more research into hormonal health, especially since those taking medication for hypothyroidism had an even bigger risk increase. https://n.neurology.org/content/99/7/e679" Is it the need for the medication that posed the bigger risk of dementia or is it the medication itself?

Thank you, Kitkat, for drawing attention to this study! I've ordered a PDF and will give a summary here when I've read it. Dale Bredesen speaks of this type as Type 2 Inflammatory, when it pertains to hormones. It seems the article is saying that medication does not fully correct the insufficiency.

Here's a quote from a 2024 review article "Thyroid dysfunction and Alzheimer's disease, a vicious circle":

It can be seen that the management and treatment of patients with hyperthyroidism or hypothyroidism can partially ameliorate and alleviate symptoms, although it does not completely normalize cognitive function altogether. The incomplete recovery of cognitive function in patients after antithyroid therapy or thyroid hormone replacement may be attributed to several factors. Firstly, the multifaceted nature of the etiology of Alzheimer’s disease and the complexity of the pathology contribute to this issue (7, 8). Secondly, individual differences among patients, such as age, gender, genetics, lifestyle, the presence of underlying diseases, and even the duration of the abnormal thyroid status, also play a role. Thirdly, the limited action of thyroxine and the uncertainty of thyroxine levels in the brain., particularly the regionalized effects of thyroid hormones on brain metabolism and selective differential contributions to hippocampal circuitry and function, have been observed (79, 100). And in some studies, there was a slight improvement in serum thyroid hormone levels, but brain thyroid hormone levels were not re-established

What does one do if one is hypothyroid? The obvious ones--getting the nutrients you need, sleep, exercise, etc--but I am also thinking about photobiomodulation on the thyroid for those who are hypothyroid, at least? There are several studies out there showing benefits.

[Plumster]

But I believe that some studies link thyroid medication to increased risk of dementia. Do we know, for apoe4 folks, if the medication is helpful or harmful? On X (on May 20, 2023), Dr. Dale Bredesen wrote, “Those with a history of hypothyroidism were associated with an 81% increased risk of having dementia.” And then he noted, "It’s time for more research into hormonal health, especially since those taking medication for hypothyroidism had an even bigger risk increase. https://n.neurology.org/content/99/7/e679" Is it the need for the medication that posed the bigger risk of dementia or is it the medication itself?

The study you linked shows that increased risk of dementia was most significant in patients aged 65 or older with a history of hypothyroidism, particularly those who received medication. Hypothyroidism patients on medication had a notably higher risk of dementia, indicating that these patients likely had more severe forms of hypothyroidism or symptomatic subclinical hypothyroidism. Conversely, hyperthyroidism treatment did not show a significant effect on dementia risk. The study also found significant correlations between dementia and other conditions like hypertension, diabetes, coronary artery disease, depression, tinnitus, hearing loss, and alcohol dependence, aligning with known risk factors. The study did not identify apoe4. Bredesen recommends hypothyroid medication. He says your brain "downsizes" without it (see his book The End of Alzheimers).

A quote from the study:

This study’s main strengths include the large, population-based
sample, representing nearly all of Taiwan’s 23.5 million population,
and control for a multitude of risk factors. The limitation
of this study is that we were not able to capture the severity of the
disease nor the exact timing of the disease development due to
the limitation of the claims database, which does not contain
laboratory or image data, such as TSH levels, CSF Aβ42 or tau
protein or brain MRI images. However, by using the national
insurance claims data from the NHIRD, we minimized underreporting
of disease diagnoses and selection bias. In addition,
owing to the general limitation of observational studies, we were
not able to draw conclusions about causality but the association
between hypothyroidism and dementia.
In this large nationwide case-control study of an East Asian
population, a history of hypothyroidism was associated with
an 81% increased risk of being diagnosed with dementia in
those 65 years or older. Among those, there was a more than
3-fold increased dementia risk with thyroid conditions that
required TH replacement treatment (aOR = 3.17, p = 0.043).
Hyperthyroidism was not significantly associated with dementia.

[Kitkat]

Thank you. I like TLS's recommendation to check my iodine levels. Plumster, Bredesen's recommendation to take thyroid medicine (I've read The End of Alzheimer's) predates his more recent posting on X about the new research regarding that medicine being linked to dementia. If one is subclinical and has no symptoms, it seems that medicine may be a bad idea. I'm 56 and feel like I really still don't have an answer.

[Plumster]

Thank you. I like TLS's recommendation to check my iodine levels. Plumster, Bredesen's recommendation to take thyroid medicine (I've read The End of Alzheimer's) predates his more recent posting on X about the new research regarding that medicine being linked to dementia. If one is subclinical and has no symptoms, it seems that medicine may be a bad idea. I'm 56 and feel like I really still don't have an answer.

Kitkat,
Do you have access to the Bredesen recommendation post/video and can share it? From what I've read above, the hypothesis is that it's not the medicine causing it; it's the severity of the hypothyroidism. If you or anyone has access to this info I'd be very grateful. Thanks!

[Kitkat]

Hi Plumster! It is a post on X and that was the entirety of it.

[Plumster]

Thanks, Kitkat. For anyone interested, here is another link that Bredesen provided on X, to an article about the study:
https://scitechdaily.com/thyroid-proble ... -dementia/

Bredesen on X:

ReCODE Protocol participants know that hormones impact cognitive health. Now, mainstream practitioners may look more deeply at key hormonal parameters, as a new study linked an underactive thyroid with dementia.