Dec 8, 2011

Challenging Dementia Behavior Can Be Caused by the Thyroid

Hashimoto’s thyroiditis, a common cause of hypothyroidism, can cause a person with dementia to feel anxiety ridden. This in turn can cause mean, unruly, or challenging behaviors.

By Bob DeMarco
Alzheimer's Reading Room

Alzheimer's care, dementia care and challenging behavior.
I receive emails every week from Alzheimer's caregivers telling me about challenging behavior problems of their loved one living with Alzheimer's.

I always make two very specific recommendations.

The first is to get a urine culture. This is not the test with the strips, this is a thorough urine analysis. This test will catch any of a number of infections. I cannot tell you how many Alzheimer's caregivers assume then can rely on their doctor to catch UTI and infections as a matter of course, and how many assume if the Alzheimer's patient is not complaining about a burning sensation while peeing there must not be anything wrong.

Infections are common in Alzheimer's patients and often go unrecognized by doctors. Unrecognized until the patient ends up in the hospital emergency room.

We have a long list of readers that have gone to the emergency room and then found out that a UTI is the cause of the illness.

The Connection Between UTI and Worsening Dementia

Second, I am also in the habit of suggesting that the caregiver request a thyroid panel as part of any blood test. I would say that when I ask an Alzheimer's caregiver if they have ever had the thyroid panel they usually respond no, or I don't know. This is common.

Hypothyroidism can be a cause of depression, dull listless behavior, and also anxiety that leads to challenging behavior.

Once again, you cannot rely on your personal care doctor to run the test on their own. In fact, they rarely do. You must request the thyroid panel. If the doctor asks why, show them this article or any of the many article on this website that discuss the thyroid.

Hashimoto’s thyroiditis, a common cause of hypothyroidism, can cause a person with dementia to feel anxiety ridden. This in turn can cause mean, unruly, or challenging behaviors. Here is my main point. Doctors often try antidepressants and antipsychotic medications to treat challenging behaviors, but they don't always check the thyroid.

Doctors that are not well schooled in dementia care don't always connect the dots. Anxiety can cause challenging behavior and the cause can be the thyroid.

Here is an article that I read recently that highlights these thyroid issues -- For Some, Psychiatric Trouble May Start in Thyroid.

A cheap generic medication, levothyroxine, is a synthetic thyroid hormone replacement and can solve the problem with the thyroid and the behavioral problem.

I just cannot understand why every Alzheimer's caregiver doesn't get a urine culture and a thyroid panel. These tests are inexpensive and are usually covered by all healthcare insurance.

I hope those of you in support groups will discuss these issues and encourage caregivers to get frequent urine cultures and thyroid panels as a matter of course.

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Original content Bob DeMarco, the Alzheimer's Reading Room

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