SynthesisThe Journal of clinical endocrinology and metabolism2026
Treatment of Hypothyroidism That Contains Liothyronine is Associated With Reduced Risk of Dementia and Mortality.
Synthesis in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Additional treatment strategies for hypothyroidism: a network meta-analysis.Endocrine connections · 2026Pooled it
- Psychiatric morbidity following liothyronine exposure in autoimmune hypothyroidism: a Swedish nationwide cohort study.Journal of the Endocrine Society · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
introductionStandard levothyroxine (LT4) therapy may not fully address all risks associated with hypothyroidism-especially cognitive decline, dementia, and mortality-even when TSH levels are normalized. Observational studies link hypothyroidism to higher dementia rates; the role of LT4 plus T3 therapies remains uncertain.
methodsThis retrospective cohort study analyzed TriNetX data, comparing 1.26 million patients with hypothyroidism (on LT4, LT4 + T3, or desiccated thyroid extract) to 3.32 million controls. Outcomes included dementia, atrial fibrillation, and mortality over 20 years of follow-up. Propensity score matching was used to balance covariates for age, sex, and comorbidities. Adjusted hazard ratios were obtained via Cox proportional hazard modeling. A parallel systematic review and meta-analysis of 12 studies evaluated dementia risk in hypothyroidism.
resultsPatients with hypothyroidism showed a ∼1.4-fold higher risk of dementia and a >2.0-fold increase in mortality-even with normal TSH-and these risks were most pronounced when TSH levels were off-target. A parallel meta-analysis indicated a 1.4-fold heightened dementia risk. In cohorts formed by propensity score matching comparing LT4 monotherapy vs combination therapy, relative risk analysis indicated 27% and 31% lower dementia and mortality risks, respectively, with combination therapy. The adjusted Cox model (hazard ratio) showed 16% and 25% reductions in these outcomes for combination therapy patients.
conclusionDespite standard LT4 therapy, hypothyroidism remains associated with heightened risks of dementia and mortality. Adding T3 may more effectively mitigate these risks than LT4 alone, but further studies are needed to confirm the cognitive and survival benefits of T3-containing regimens.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.