Patients and methods - We analysed cerebrospinal fluid (CSF) albumin a
nd immunoglobulin G (IgG) concentrations and psychometric performance
in subclinical (n=6) and overt hypothyroidism (n=9) before and after 6
months with L-thyroxine. Results - In overt hypothyroidism, CSF album
in and IgG concentrations were increased before therapy [mean(SD): 328
(156) mg/l and 69(27) mg/l], but within the reference interval [198(48
) mg/l and 39(11) mg/l], P<0.05, after therapy. In contrast, in subcli
nical hypothyroidism CSF protein concentrations were within the refere
nce intervals before and after therapy. Psychometric testing indicated
an improvement in performance in both groups. Conclusion - The increa
se in CSF proteins in overt hypothyroidism does not appear to be relat
ed to thyroid autoimmune disease per se, since we found no increase in
CSF proteins in individuals with subclinical hypothyroidism and prese
nce of thyroid antibodies. The increase might rather be caused by a bl
ood-brain barrier dysfunction related to low thyroid hormone concentra
tions.