Double-edged implications of triclosan for the neuroendocrine system: evidence from the national health and nutrition examination survey (2011–2014 NHANES)

Triclosan (TCS) has raised concerns due to its widespread use and potential neuroendocrine toxicity. However, its neurological effects and the interplay between TCS-induced sex hormone disruption and neurological outcomes in adults remain largely unexplored. Herein, we analyzed data from 2717 adults in the 2011-2014 National Health and Nutrition Examination Survey, employing logistic regression, restricted cubic spline, and mediation analyses to investigate the association between TCS exposure and neurological outcomes. The results showed that higher TCS exposure (above the median) was associated with lower odds of poor cognitive performance on the digit symbol substitution test (odds ratio (OR) = 0.65, 95% confidence interval (CI) = 0.42-0.99, P = 0.046), depression (OR = 0.68, 95% CI = 0.49-0.93, P = 0.015), and serious difficulty in concentrating (OR = 0.47, 95% CI = 0.30-0.74, P = 0.001). Mediation analyses revealed that testosterone and white blood cell counts partially mediated the relationship between TCS exposure and neurological outcomes. Additionally, gender-specific and U-shaped associations were observed between TCS exposure and cognitive function, depression, and difficulty concentrating. Collectively, our findings provide the first evidence linking TCS exposure to neurological health outcomes and potential neurotoxicity via sex hormone disruption in U.S. adults. Further research is needed to elucidate the underlying mechanisms and clinical significance of these associations.