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Cerebrospinal fluid (CSF) levels of rT3 were evaluated in 21 euthyroid patients with overt Alzheimer's disease (AD) and 18 matched healthy controls. The assessment also included trans-thyretin and total T3 and T4 CSF concentrations. Despite normal circulating thyroid hormone levels, AD subjects showed significantly increased rT3 levels and an increased rT3 to T4 ratio in the face of unchanged CSF total T4 and transthyretin levels. These results suggest an abnormal intracerebral thyroid hormone metabolism and possibly the occurrence of brain hypothyroidism, either as a secondary consequence of the ongoing process or as a cofactor in the progression of the disease.

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