thyroid gland - JASE Medical

Two Tests to Assess Thyroid Function

Nearly 5 out of every 100 Americans ages 12 years and older have hypothyroidism, and about 1 out of every 100 have hyperthyroidism. Every year about 12,000 men and 33,000 women are diagnosed with thyroid cancer, and about 900 men and 1,000 women die from the disease. Thyroid diseases can have major, lasting effects on health if left untreated. Thyroid diseases are easily detected and effectively treated with the help of thyroid function tests. The following two tests are used to assess thyroid function. If these lab results come back abnormal your care provider will order more tests, some lab, ultrasound, biopsy, and others.

The most frequently used laboratory tests to assess baseline thyroid function in the U.S. are thyroid stimulating hormone (TSH) and free thyroxine.

TSH (Thyroid stimulating hormone)

TSH is the hormone produced by the pituitary gland that stimulates the thyroid gland to produce more thyroid hormone.

A normal TSH result, which is a blood test, falls between 0.4 and 4.0 milliunits per liter (mU/L), according to the American Thyroid Association. Ranges between laboratories will vary with the upper limit generally being between 4 to 5.

Higher levels of TSH can be indicative of:

  • Hypothyroid (low thyroid)- The most common form of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune condition. Other hypothyroid conditions can be brought on by medications, thyroid cancer, and iodine deficiency to name a few.
  • Stress, such as exposure to cold, emotional stress, not sleeping well, hospitalization and any other types of stress. These all can raise cortisol levels, which in turn can cause a temporary high TSH level.

Lower Levels of TSH can be indicative of:

  • This is also known as an overactive thyroid. If a person’s thyroid gland is secreting levels of hormones that are too high, the pituitary gland produces less TSH.
  • A variety of conditions lead to hyperthyroidism, including Graves’ disease and thyroid nodules.
  • Pituitary gland tumor can stimulate the pituitary gland to release too much thyroid stimulating hormone

Thyroxine (T4)

Thyroxine, also known as T4, is the major type of hormone your thyroid releases. Too much or too little T4 can indicate thyroid disease.

Thyroxine (T4) is found in two forms:

  1. Bound T4: This form attaches to proteins, which prevents it from entering your body’s tissues.
  2. Free T4: This form “freely” enters your body’s tissues where it’s needed. The normal range for free T 4 in adults is 0.8 to 1.8 nanograms per deciliter (ng/dL)

There are a few different tests that measure T4 levels. A blood test that measures both free and bound T4 is called a total T4 test. Another test measures just free T4. Healthcare providers most often use a free T4 test to assess thyroid function because it’s more accurate than a total T4 test.

In conclusion, information from the TSH and free T4 tests help your cre provider assess if your thyroid gland is functioning properly. The thyroid gland is a complex gland, and there are many factors your care provider takes into consideration before making a diagnosis.

Next posts will delve into specific thyroid diseases and associated tests, starting with the most common form of hypothyroid- Hashimotos thyroiditis.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

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How Prepared are You for a Modern-Day Carrington Event?

(Part 1 of 2) What was the Carrington Event of 1859? Named after amateur astronomer Richard Carrington, who discovered a coronal mass ejection (CME) headed for earth in the early morning hours of September 1, 1859. On that fateful morning, telegraph communications...

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Thyroid Gland Overview

The process which the body manufactures, and processes thyroid hormones is very complex. The following is an overview of the thyroid glands anatomy, function, hormones, and nutrients needed for proper function of the thyroid gland. Given this is a very complex gland, take your time reading and going through the video links.

Next post we will delve into thyroid tests and thyroid dysfunction- specifically low and high thyroid.

Thyroid gland and its function

  • Anatomy of the thyroid gland
  • Function of the thyroid gland
  • Hormones produced by the thyroid gland
  • Nutrients needed for proper functioning of the thyroid gland

Anatomy of the thyroid gland:

Every cell in the body has thyroid hormone receptors. These receptors control transcription and effect gene expression.

The thyroid gland is one of the largest endocrine glands and consists of two connected lobes. It is found in the neck, below the thyroid cartilage which forms the laryngeal prominence, or “Adam’s apple”. It is a butterfly-shaped organ and is composed of two cone-like lobes or wings, lobus dexter (right lobe) and lobus sinister (left lobe), connected via the isthmus. The thyroid is one of the larger endocrine glands, weighing 2-3 grams in neonates and 18-60 grams in adults, and is increased in pregnancy. The thyroid gland is covered by a thin fibrous sheath, composed of an internal and external layer. The thyroid tissue itself consists of a lot of small individual lobules joined together by thin sheaths of connective tissue. These lobules contain a great number of small vesicles, called follicles, which store thyroid hormones in the form of little droplets. These spherical follicles selectively absorb iodine from the blood for production of thyroid hormones and for storage of iodine in thyroglobulin (a protein present in the thyroid gland, from which thyroid hormones are synthesized). Thyroglobulin is also called colloid. Twenty-five percent of the body’s iodide ions are in the thyroid gland. Inside the follicles, in a region called the follicular lumen, colloid serves as a reservoir of materials for thyroid hormone production and, to a lesser extent, acts as a reservoir for the hormones themselves. The follicles are surrounded by a single layer of thyroid epithelial cells, which secrete T3 and T4. T3, also called triiodothyronine and T4, also called thyroxin are thyroid hormones.

Function of the thyroid gland

The thyroid plays an important role in regulating the body’s metabolism and calcium balance.  T4 and T3 hormones stimulate every tissue in the body to produce proteins and increase the amount of oxygen used by cells. The harder the cells work, the harder the organs work. The calcitonin hormone calcitonin works together with the parathyroid hormone to regulate calcium levels in the body. Some of the organ systems thyroid hormones regulate are:

  • Respiratory system– regulation of respiratory rate and ventilatory response to hypercapnia and hypoxia
  • Renal (kidney)– glomerular filtration rate and blood flow to the kidneys
  • Cardiovascular– regulates heart rate, force of cardiac contractions, stroke volume, cardiac output, catecholamine receptors
  • Metabolism- regulates glucose absorption in the gastrointestinal track, regulates insulin receptors
  • Growth and tissue development– regulates growth and maturation of bones and teeth, also regulates growth and maturation of epidermis, hair follicles and nails. Regulates force and rate of skeletal muscle contractions.
  • Nervous system-thyroid hormones are critical for neuronal development, Enhances memory and alertness.

 

Hormones produced by the thyroid gland

Check out this video on thyroid gland synthesis

What are the thyroid hormones and what substances do they contain? The thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) are made of an amino acid, tyrosine, and an iodine molecule. For the hormone to be synthesized it must complete the following steps:

  1. Tyrosine, an amino acid that is provided by thyroid epithelial cells and secreted into the lumen of the follicle by a large glycoprotein scaffold called thyroglobulin. Thyroglobulin, as noted above is also called colloid.
  2. Iodine (or more accurately iodide) is taken up from blood by

thyroid epithelial cells which has an outer plasma membrane called a sodium-iodide symporter, or more commonly known as an “iodine trap”. Once inside the cell, iodide is transported into the lumen of the follicle along with thyroglobulin.

 

3. The thyroid hormone requires an enzyme called thyroid peroxidase to join the tyrosine with the iodine. The tyrosine will receive either one or two iodine. The term T1 represents one tyrosine and one iodine molecule. T2 represents one tyrosine and two iodine molecules.                                   

4. These, meaning T1 and T2, further combine through the enzyme thyroid peroxidase (TPO) to make the final thyroid hormones: T1+T2=T3 and T2+T2=T4. The byproduct from both reactions is hydrogen peroxide.

5. The thyroid hormone is bound to thyroglobulin and is liberated by hydrolytic enzymes that digest thyroglobulin.

6. The thyroid hormone diffuses out of the lysosomes and into the blood where they bind to carrier proteins and are transported to target cells in the body.

In other words,

T1+T2=T3+ hydrogen peroxide, and

T2+T2=T4+ hydrogen peroxide

Note:

T3 is up to four times more biologically active than T4. Only twenty percent of the body’s T3 is made by the combination of the T1 and T2 molecules. The additional eighty percent is made by T4 losing an iodine molecule in a process carried out in the organs such as the liver.

How is thyroid hormone regulated?

Hormonal output from the thyroid is regulated by thyroid-stimulating hormone (TSH) produced by the anterior pituitary, which itself is regulated by thyrotropin-releasing hormone (TRH) produced by the hypothalamus in a negative feedback loop.

This is described as follows:

HYPOTHALMUS-Signaled by low thyroid hormones the hypothalamus releases TRH (thyrotropin releasing hormone) which stimulates the pituitary gland, *Illustration depicts both high and low thyroid hormone events.

 ANTERIOR PITUITARY GLAND– Releases TSH (thyroid stimulating hormone) into the bloodstream, which reaches the thyroid gland

 THYROID GLAND –TSH (Thyroid stimulating hormone) causes thyroid gland to release thyroid hormones (T4 and T3 )

When enough T4 and T3 are in the bloodstream it signals the hypothalamus to stop releasing TRH (thyrotropin releasing hormone)

Nutrients needed by the thyroid gland

For the thyroid gland to function properly it requires a supply of nutrients

Selenium– Selenium content in the thyroid is higher than any part of the body. It is  a naturally occurring  trace mineral found in our foods and soil. One of the challenges with obtaining selenium from our food sources is that the levels can vary dramatically. Brazil nuts are known to be a rich source of selenium, but their selenium content varies according to the region they are grown in. 

Selenium is converted into three types of selenoproteins or seleno-enzymes, both terms are interchangeable.  The three types of selenoproteins are:

  1. GPx (glutathione peroxidase) are antioxidants and best known of the selenoproteins
  2. TRx- (thioredoxin reductases) are involved in cell growth and structure
  3. Dis (iodothyronine deiodinases) are involved in the conversion of T4 to T3 and other metabolic functions.

A selenium deficiency along with an iodine deficiency is implicated in goiters.

Iodine- Iodine is an essential element that is also needed from our environment. It is one of the building blocks of the thyroid molecule. For the body to be able to utilize iodine, it must be converted to iodide. This is accomplished through the thyroid peroxidase (TPO) reaction. Once this occurs, the free iodine joins with tyrosine to make the thyroid molecule, with hydrogen peroxide as the byproduct.

The group of molecules called the halogens; fluorine, bromine and chlorine mimic iodine and attach to tyrosine thereby rendering the tyrosine molecule useless. This means that your body is not getting the T4 or T3 it needs.  Sources of iodine include kelp, sea vegetables, cow’s milk, eggs, tuna, and navy beans. There are several over the counter iodine supplements. Caution should be exercised when using supplemental iodine. When there is an excess of iodine along with a deficiency of selenium, an autoimmune condition called Hashimotos thyroiditis may occur.

Tyrosine– Tyrosine is a nonessential amino acid the body makes from another amino acid called phenylalanine. It combines with iodine to form thyroid hormones. Tyrosine is also the precursor to neurotransmitters dopamine, epinephrine and norepinephrine. It is rare to have a deficiency in tyrosine and supplements are usually not recommended. Dietary sources of tyrosine are chicken, turkey, fish, peanuts, almonds, avocados, bananas, milk, cheese, yogurt, cottage cheese, lima beans, pumpkin seeds, and sesame seeds.

Zinc– Zinc is required to transform the inactive thyroid hormone T4 into the active form T3.  It plays an important role in immune function, wound healing, blood clotting, reproduction, growth and smell. Zinc supplementation should be approached carefully. If too much zinc is taken, a copper and iron deficiency can result. Also, taking too much zinc intake can contribute to hyperthyroidism and copper deficiency. Foods rich in zinc are raw pumpkin seeds, oysters, wheat germ, and lamb.

Iron (Ferritin) – Iron requires a high stomach acid for transport into the cells. Many people take iron tablets, and their iron levels stay the same due to low stomach acid.   Having low iron levels decreases deiodinase activity. It slows down the conversion of T4 to T3.  Insufficient iron levels may affect thyroid hormone synthesis by reducing the activity of the enzyme thyroid peroxidase (TPO) which is dependent on iron.  Thyroid peroxidase (TPO) brings about the chemical reactions of adding iodine to tyrosine (amino acid), which then produces T4 and T3. Insufficient iron levels alter and reduce the conversion of T4 to T3. Low iron levels can also increase circulating concentrations of TSH (thyroid stimulating hormone).

Apple cider vinegar or Betaine, a supplement which enhances stomach acidity, promotes protein breakdown and iron absorption.  The most bioavailable form of iron is called heme and is found in liver and meats

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

How Prepared are You for a Modern-Day Carrington Event?

How Prepared are You for a Modern-Day Carrington Event?

(Part 1 of 2) What was the Carrington Event of 1859? Named after amateur astronomer Richard Carrington, who discovered a coronal mass ejection (CME) headed for earth in the early morning hours of September 1, 1859. On that fateful morning, telegraph communications...

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How do Antibiotics Work?

Part 1

A brief history of antibiotics- or what do bread mold, arsenic, and soil all have in common?

Throughout history populations used plants, soils and foods to treat infections. Many of our modern-day antibiotics originated from these. Only recently- the past 100 years or so has the active compounds been isolated and purified for commercial use, saving millions of lives globally. We know antibiotics work, but how do they do their job? 

 In this 4-part series we will explore:

Part 1

  • A brief history of antibiotics
  • How antibiotics work- what mechanisms are at play when we take them

Part 2

  • The role of biofilms in bacteria and why these present a challenge to our modern-day arsenal of antibiotics
  • Antibiotic resistance challenges

Part 3

  • When antibiotics are needed and when they aren’t appropriate
  • Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

Part 4

  • A review of each of the antibiotics found in the Jase Case and their use.

A brief history of antibiotics

  • As far back as 350 A.D., tetracycline, a widely used antibiotic were found in bone fragments in ancient Sudanese Nubia. It is believed that stored contaminated grains back then helped cultivate a strain of tetracycline from Streptomycetes. By the late 40s tetracycline was purified and marketed commercially. This antibiotic covers a wide variety of infections, from acne to certain types of pneumonia, and some infections spread by mice and ticks.
  • In ancient Egypt, China, Serbia, Greece and Rome moldy bread was used topically to treat infections. This was documented by John Parkison in his book “Theatrum Botanicum” which was published in 1640.
  • Heavy metals, such as arsenic, bismuth and mercury were used to treat syphilis and gonorrhea with some success.  Salvarsan, an arsenic based chemical was discovered in 1909 by Paul Ehrlich. who is considered the father of microbial therapy. 
  • In 1928 Alexander Fleming discovered mold growing on a petri dish that had staphylococcus bacteria in it. The mold prohibited the growth of the staph. He described the mold as a type of self-defense chemical that killed bacteria. He named it penicillin. It wasn’t until 1940 that penicillin was first used- to treat streptococcal meningitis. 
  • Early 1930s- sulfa based drugs were discovered and produced by the Massengill Company in pill and tablet form. However, the company decided to mass produce an elixir without animal testing made from diethylene glycol (known today as antifreeze) which resulted in what was called the Sulfanilamide Disaster of 1937. More than 100 people died after ingesting this poison. This led to the Food Drug and Cosmetic Act in 1938 and the Drugs and Cosmetics Act of India, where controls are now in place on the manufacture and sale of drugs. 
  • In the mid-1950s synthetic antibiotics were introduced (such as quinolones)

How antibiotics work- what mechanisms are at play when we take them

Before we dive into how antibiotics work it must be stated that they do not work on viruses such as colds, flu, covid, viral pneumonia, RSV, measles, etc. Sometimes there is confusion when an antibiotic is given when the patient has a virus. The virus can lower the bodys immune defenses, in turn making it susceptible to opportunistic bacteria. At that point an antibiotic may be indicated. 

Many antibiotics work by attacking the cell wall of bacteria. Specifically, the drugs prevent the bacteria from synthesizing a molecule in the cell wall called peptidoglycan, which provides the wall with the strength it needs to survive in the human body,

Examples are penicillin, Ceftin,vancomycin

Protein synthesis is a multistep process where DNA is first transcribed into a molecule of single-stranded messenger RNA (mRNA). Then, ribosomes translate it with the help of transfer RNA (tRNA) into long strings of amino acids, which become proteins. Protein synthesis inhibitors prevent proteins from being made by acting as inhibitors of translation or transcription. By blocking either of these processes, many types of antibiotics kill or impair the growth of bacteria by preventing them from making proteins.

Examples: tetracycline, erythromycin, streptomycin, gentamycin

Antimicrobial drugs that can target the microbial cell membrane to alter its functionality. Membrane lysis, or rupture, is a cell death pathway in bacteria frequently caused by cell wall-targeting antibiotics.

Examples are polymyxin and gramicidin

  • Antibiotics that interfere with the development of DNA or break DNA strands through enzyme inhibitors 

Examples: rifamycins and fluoroquinolones, metronidazole

Antimetabolites are medications that interfere with the synthesis of DNA. Some antimetabolites are used in chemotherapy to kill cancer cells, while others are used as antibiotics since they inhibit bacterial folate synthesis

Examples: levofloxacin, norfloxacin, and ciprofloxacin

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

How Prepared are You for a Modern-Day Carrington Event?

How Prepared are You for a Modern-Day Carrington Event?

(Part 1 of 2) What was the Carrington Event of 1859? Named after amateur astronomer Richard Carrington, who discovered a coronal mass ejection (CME) headed for earth in the early morning hours of September 1, 1859. On that fateful morning, telegraph communications...

Practice Gratitude – Improve Health

“I awoke this morning with devout thanksgiving for my friends, the old and the new.”

Ralph Waldo Emerson

Gratitude- The state of being grateful. Thankfulness Thanksgiving. Embracing and being grateful for what we have (the gift) and for the source (the giver) of it. The gift can come from another, a higher power or nature. 

The world is in upheaval. There are challenges facing all of us as we bid 2022 goodbye and welcome 2023 with a little trepidation. We are entering uncharted territory in world history. The good news is that we are not alone. How we enter this new year depends a lot on our attitude and ability to remain flexible to our changing landscape. In other words, our attitude can make or break us. Let’s take the higher road and focus on solutions.

Robert Emmons, professor of psychology at the University of California, Davis, is one of the world’s leading experts on the science of gratitude, conducted a series of tests to determine if acknowledging and expressing gratitude had any lasting health effects. After conducting several studies ranging from weekly to daily gratitude journaling, he concluded that daily expressions of gratitude had lasting positive outcomes physically, emotionally, and mentally. In other words, daily expressions of gratitude set the stage for continued habits of positive emotions and resilience. 

Practicing gratitude, either in written or spoken form activates the parasympathetic nervous system, which is known as the calming part of the nervous system. This in turn lowers cortisol levels and promotes feelings of wellbeing. 

Health benefits of practicing gratitude

  • Reduces stress- Stress hormones such as cortisol 23% lower
  • Lowers inflammation with reduced stress comes reduced inflammation
  • Improved heart health- lower blood pressure
  • Alleviates anxiety
  • Promotes social wellness
  • More likely to choose healthy habits such as diet and exercise
  • Better sleep quality
  • Higher sense of self worth
  • Improved immune function

Is gratefulness a personality trait or can it be learned?

While there are certain personalities that are naturally geared to be more grateful, gratitude can be developed into lifelong habits. Dr. Emmons believes you can cultivate gratitude. In this excellent video, he explains how to become more grateful.  (He has a whole series on gratitude on You Tube worth watching)  

How to practice gratitude

Practicing gratitude not only elevates another person but also elevates you. Dr Emmons work revealed daily and consistent focus on gratitude and being thankful had lasting benefits

The following are a few tips to get started:

    • Journal- Keep a daily journal of 5 things you are grateful for, commit to doing this daily for one month
  • Write letters to loved ones and those you appreciate. Let them know how you feel. It always feels good to get something in the mail that isn’t an advertisement or bill! This could be in combination with other forms of gratitude.
  • Tell 5 people something about them you are grateful for 
  • Text 5 people something positive. Let them know you are thinking about them
  • Start a couple’s journal. Leave it out on coffee table. Write something positive in it daily to each other. 
  • Take time out each day to meditate or pray. Focus on what is good in your life, and work towards solutions to challenges in your life.

Gratitude Quotes- to inspire you!

  1. “This is a wonderful day. I have never seen this one before.” Maya Angelou
  2. “When we focus on our gratitude, the tide of disappointment goes out and the tide of love rushes in.” Kristin Armstrong
  3. “When eating fruit, remember the one who planted the tree.” Vietnamese proverb
  4. “When I started counting my blessings, my whole life turned around.” Willie Nelson
  5. “Enjoy the little things, for one day you may look back and realize they were the big things.” Roert Brault
  6. “‘Enough’ is a feast.” Buddhist Proverb
  7. “He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has.” Epictetus
  8. “Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude.” A.A. Milne
  9. “We must find time to stop and thank the people who make a difference in our lives.” John F. Kennedy
  10. “Gratitude is the ability to experience life as a gift. It liberates us from the prison of self-preoccupation.” John Ortberg
  11. “O Lord that lends me life, lend me a heart replete with thankfulness.” William Shakespeare
  12. “We can only be said to be alive in those moments when our hearts are conscious of our treasures.” Thornton Wilder

 

 

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

How Prepared are You for a Modern-Day Carrington Event?

How Prepared are You for a Modern-Day Carrington Event?

(Part 1 of 2) What was the Carrington Event of 1859? Named after amateur astronomer Richard Carrington, who discovered a coronal mass ejection (CME) headed for earth in the early morning hours of September 1, 1859. On that fateful morning, telegraph communications...

A Dementia Diagnosis Can Be Challenging

Rule out other causes of decline first

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common type of dementia. It takes a toll on families and especially caregivers. Holidays and get togethers can be challenging for both families and the patient.

Some symptoms of early onset of dementia are:

  • Confusion
  • Loss of coordination-tripping, unable to hold items
  • Memory loss especially short term
  • Inability to reason complex situations
  • Emotional lability- anger, sadness, depression.

As dementia progresses symptoms become more pronounced, and leads to physical inability to take care of self independently

Risk factors for dementia

  • Genetics
  • Age- older adults are more at risk for a dementia diagnosis
  • Alcohol abuse
  • Smoking
  • Social isolation

Types of dementia

Alzheimer’s dementia

  • Twice as many women as men are diagnosed with Alzheimer’s dementia
  • Most are over 65 years.

Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.

Symptoms are mild to start and progress over time. Early symptoms are forgetfulness- of names or items such as keys are, unable to recall family or friends names along with forgetting special dates or appointments

As disease progresses changes in mood, depth perception and inability to organize thoughts and cognition are apparent. In later stages of Alzheimer’s the person experiences hallucinations, delusions and is physically incapable of performing basic hygiene.

Frontotemporal

Frontotemporal dementia (FTD), also called Picks disease is one of the less common types of dementia. It covers a range of different conditions that can affect personality, behavior, and language. FTD is mostly diagnosed in people under 65. Average onset is between 40 and 60 years, however it can occur as early as 20 years old.

Dementia with Lewy bodies

Dementia with Lewy bodies (DLB) is caused by Lewy body disease. In this disease, tiny

clumps of proteins – known as Lewy bodies – appear in the nerve cells of the brain, and progresses to decline in reasoning, independent function. and cognition. It can be hard to diagnose because it presents similar to many psychiatric symptoms

Vascular Dementia

 This type of dementia- which is sometimes called “Post Stroke Dementia” is different from Alzheimer’s or Lewy Body Dementia. Vascular Dementia is brain damage caused by bleeding or harm in the brain-such as a stroke. Symptoms that identify Vascular Dementia are observed immediately following a stroke and can include:

  • Changes in personality,
  • Depending on the area of the brain that has been affected- thinking short attention span
  • Difficulty reasoning organizing and analyzing thoughts

Correct diagnosis of dementia can be challenging

Many medical conditions, physical and emotional factors, along with medications can mimic dementia.

Medical conditions that can present as dementia like symptoms:

  • Liver and kidney disease– accumulation of toxic metabolic waste products in the blood can cause confusion and inability to form cohesive thoughts.
  • Infections– notably urinary tract infections can cause confusion and personality changes.This is more common in older population, symptoms of urinary tract infection sometimes present with different symptoms than younger population. Other infections should also be ruled out, such as syphilis or Lyme disease.
  • Cancer-especially brain cancer- by tumor pressing on the brain- or an immune response in which antibodies against the brain are formed, producing a “paraneoplastic syndrome”.
  • Endocrine dysregulation– such as thyroid gland (hypo or hyperthyroid) or diabetes- both of these conditions can alter mood, ability to coordinate and concentrate.
  • Head trauma– concussion
  • Depression– which can alter and slow thought processes and cause inability to make decisions along with irritability and mood changes.

Physical conditions that can present as dementia like symptoms

  • Poor vision– resulting in tripping, falling and bumping into furniture, walls, stairs, etc
  • Hearing lossA Lancet Commission report on hearing loss showed a link between hearing loss and cognitive decline, leading to a diagnosis of dementia.
  • Lack of sleep– inability to concentrate or pay attention can mimic dementia, however research points to altered sleep patterns , even one nights sleep disruption has been shown to increase the beta amyloid plaque – the protein that causes dementia in the brain.

Medications that can mimic dementia

Some medications can take a long time before symptoms set in, so if you notice any cognitive changes even without a change in medication- either over the counter or prescription review with your care provider your concerns.

  • Anticholinergic medications-such as tolterodine or oxybutynin, often used to treat urinary incontinence, Benadryl used for allergies and for sleep,
  • Tricyclic antidepressants such as amitriptyline for example
  • Antipsychotics such as Seroquil
  • Benzodiazepines such as Valium, Xanax, and Librium
  • Sleep aids such as Sonata and Ambien
  • Corticosteroids such as Prednisone
  • Narcotic pain relievers- such as morphine
  • Anti-Parkinson drugs such as trihexyphenidyl (Artrane)

It is important to make sure all other causes of confusion, memory loss, poor coordination, mood changes and other dementia mimicking signs have been considered before a diagnosis of dementia is made. Many medical conditions, physical conditions and drugs mimic the symptoms of dementia, take the time to review them and discuss with your care provider.

If a definite diagnosis of dementia has been made there are many resources available. One is the Alzheimers.org online support group and help with finding local resources to help with caring for your loved one.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

How Prepared are You for a Modern-Day Carrington Event?

How Prepared are You for a Modern-Day Carrington Event?

(Part 1 of 2) What was the Carrington Event of 1859? Named after amateur astronomer Richard Carrington, who discovered a coronal mass ejection (CME) headed for earth in the early morning hours of September 1, 1859. On that fateful morning, telegraph communications...