Dementia, Alzheimer’s and the Endocrine System
The following article is based on “Training Manual for Dementia.” This manual and certification program were put together by a group of ladies from their work at the Alzheimer’s Association, their personal experience, various Alzheimer’s websites and books and is meant to help train caregivers, family member and anyone else regarding Dementia and Alzheimer’s disease.
You will find my comments in Red. This article is a bit long, but I felt that all the information was important.
“Overview of Dementia and Alzheimer’s Disease.”
What is Dementia?
Dementia is a general term used to describe the SYMTPOMS of memory loss and problem thinking and understanding. Dementia affects all areas of cognition (thinking and understanding): memory, organization, perception, abstraction, judgment, language, reasoning and attention. Memory is the most noticeable area affected in the early stage of dementia, but as the dementia worsens, all areas of cognition can become impaired and eventually destroyed. Note that Dementia is a SYMPTOM not a disease. Those of us who have been Hypothyroid due to being misdiagnosed, untreated, under treated or treated with T4 only meds can understand the above paragraph very well. For many this has been a daily nightmare.
Dementia itself is not the name of a disease. It is not a normal part of aging. Dementia is always caused by something. Dementia can start gradually and get progressively worse or the dementia can onset quickly. Some forms of dementia may be reversible. Some are not. The speed and severity of the dementia depends on the cause of the dementia. There are approximately 60 conditions which cause dementia:
- Alzheimer’s disease (leading cause of dementia 50-60%)***
- Vascular dementia (series of small strokes)**
- Parkinson’s disease**
- Dementia with Lewy bodies**
- Physical injury to the brain***
- Huntington’s disease
- Creutzfeldt-Jakob disease (mad cow disease)
- Frontotemporal dementia (Pick’s disease)**
- Sever liver or kidney disease
- Sever alcohol abuse
- Depression* One of the top five symptoms of Hypothyroidism***
- Medication side effects* See Link section
- Thyroid Problems* Most doctor use TSH to test and evaluate thyroid function. The TSH lab test misses 80% of those with Thyroid disease***
- Poor diet*
- Vitamin deficiencies*and***
- Certain infections*
*These conditions may be reversible or treatable.
**See definition at the end of this article.
***See studies at the end of this article.
What is Alzheimer’s disease?
Alzheimer’s is a brain disease and the leading cause of dementia.
- Alzheimer’s disease is a progressive, irreversible condition that destroys brain cells (neurons).
- The disease attacks nerve cells in all part of the brain, causing brain cells to die, shrink and disappear.
- The disease also causes deficiencies of several chemicals which are essential for the transmission of nerve messages. These chemicals would be the neurotransmitters. A small percentage of neurotransmitters are produced in the brain. A big percentage is produced in the gut, and when dealing with the gut you have to also deal with the Endocrine system.
- An autopsy will reveal that healthy brain cells were replaced by dense irregularly shaped spots or PLAQUES and also, thread-like TANGLES will have formed within and choked out the existing healthy brain cells.
Would checking all the Endocrine hormones make a difference in the diagnosis and treatment of dementia related diseases? Thyroid affects every cell in the body.
History of Alzheimer’s disease:
- The disease was named for Dr. Alois Alzheimer in 1906
- His patient was a 51-year-old woman
- She presented with symptoms of disorientation, impaired memory, troubles in reading and writing, hallucinations
- She wrote in her diary, “I have lost myself.”
- Dr. Alzheimer autopsied her brain upon death and discovered the hallmark pathology of plaques and tangles
What causes Alzheimer’s disease?
- The cause is still a mystery
- Not aluminum
What are the risk factors for Alzheimer’s disease?
- Age is the biggest risk factor, as the disease most commonly strikes those who are 65 years and older.
- It is believed that more women than men have Alzheimer’s, but this could be because women tend to live longer than men, thus more of them reach the age of greatest risk, 65 and beyond.
- It is believed that a family history of Alzheimer’s places one at a higher risk; however, there are just as many people who get Alzheimer’s with no prior family history of the disease.
- Scientists believe that genetics likely play a role in the disease, but they do not have all the answers or know all of the genes that are involved. It is possible that genes are involved and are perhaps triggered by something else that brings on the onset of the disease.
Other possible or probable risk factors or triggers:
- Race appears to be a risk factor because Blacks are getting the disease at a rate four times higher than other races, and Hispanics two times higher.
- It is theorized that exposure to toxic substances in the environment could be causing the disease.
We know that toxic substances in the environment affect the Endocrine system and can lead to hormonal imbalances.
- Individuals with a previous head injury seem to have a higher likeliness of developing the disease.
We know that head injury may affect the hypothalamus causing imbalances in thyroid, cortisol, aldosterone and sex hormones.
- Statistics are showing that individuals with cardiovascular disease, diabetes, obesity and high cholesterol are all developing Alzheimer’s at a higher rate than others, building a strong case for the belief that brain health is linked to body health. It is possible that these conditions are triggering Alzheimer’s disease.
Cardiovascular disease, diabetes, obesity and high cholesterol are all symptoms of hypothyroidism.
How is Alzheimer’s disease diagnosed?
There is no single laboratory test, at this time, which confirms a person has Alzheimer’s unless the brain is autopsied at death. However, by doing a careful medical evaluation, physicians can diagnose Alzheimer’s with more the 90% accuracy. They can almost always determine that a person has dementia based on the results of family discussion and physical and mental assessments, and can offer the diagnosis of “Probable dementia of the Alzheimer’s type.”
Diagnosing Alzheimer’s requires:
- A thorough medical history and discussion with the family regarding the symptoms and behaviors their loved one is exhibiting which is causing their concern.
- A physical exam and tests performed to help identify and rule out other potential causes of dementia. This exam will normally include a general physical, blood tests and urinalysis. Through a blood test, for example, the physician can measure thyroid function. Hypothyroidism or failure to produce sufficient thyroid hormones, which is common in the elderly, can cause symptoms of dementia. Dementia may also be the results of a vitamin B-12 deficiency, a common condition in older people. Physicians may use brain scans (such as MRI) which, while they do not diagnosis Alzheimer’s, may rule out other possible causes of dementia, including brain tumors, stoke, blood accumulation on the brain surface or the conditions. In addition, brain scans can show characteristic structural brain shrinkage present in Alzheimer’s disease. Physicians may administer and EEG to measure the electrical activity in the brain. Occasionally, spinal fluid may be tested through a lumbar puncture.
- A neurological exam with neuropsychological tests to identify behavioral and mental symptoms associated with brain injury or abnormal brain function. Usually, physicians start with a brief screen tool, such as the Mini-Mental Status Examination (MMSE), to help confirm that the patient is experiencing problems with intellectual function of memory, attention, mathematical calculation and language.
- In a 20 minute window of time, PET scans can show radioactive injection to the brain that attaches to plaque.
How does Alzheimer’s progress?
- Alzheimer’s most commonly progresses slowly and gradually
- Symptoms and stages will vary from person to person
- The disease can last anywhere from 3 to 20 years with the average number of people living from 8 to 12 years after onset of symptoms.
- A person with Alzheimer’s will go backwards in time – losing abilities in the reverse order they were learned. This is sometimes referred to as retrogenesis.
- A person with Alzheimer’s will eventually revert to being an infant in an adult’s body, requiring total dependence on others for care.
- A person with dementia from Alzheimer’s will have a mixture of clarity and confusion. In the beginning, moments of confusion will gradually start to appear, affecting daily life. As the disease progresses, the confusion will increase and the clarity will decrease. This person will exhibit mysterious moments of clarity.
“If there is one thing that I want to impact to others, it is this: please remember how terrifying dementia can be. Those of us who have it are fearful every minute of every day, although we sometimes do not know it. We need a great deal of physical and emotional support to help us find and use all the brainpower that we still have.” - Bill
From the Voices of Alzheimer’s by Betsy Peterson.
Is Alzheimer’s fatal?
Alzheimer’s disease is always fatal, but more often than not, a person will die from something else first. Many seniors already have other serious health issues occurring before or simultaneously with Alzheimer’s, such as cancer, heart problems, or pneumonia and will die from one of these before the long slow insidious Alzheimer’s runs its course. If a person with the disease is physically healthy, his or her body can hang on for a long time despite the loss of mental awareness and cognitive ability. The body will eventually shut down causing death when destruction to the brain becomes great enough.
How prevalent is Alzheimer’s disease?
- 26 million people in the world currently have Alzheimer’s disease
- 5.3 million people in the US have Alzheimer’s
- 7th leading cause of death
- “Baby boomers” (born between 1946-1964) are just entering the age of greatest risk age 65
- By the year 2050, it is estimated that 11-16 million people will have Alzheimer’s
- Currently, 1 in 8 people in the age range of 65-85 years old have Alzheimer’s
- 1 in 2 people over the age of 85 have Alzheimer’s
Are there medications used to treat Alzheimer’s disease?
- Medications currently used are: Aricept, Exelon, Razadyne (reminyl) and Namenda.
- None of these medications will stop or reverse the disease.
- Because it is difficult to determine their effectiveness due to the gradual progression of the disease many doctors do not see the benefit of prescribing these medications.
What is happening with research and finding a cure for Alzheimer’s?
- Although there is no cure at this time, the combined efforts of the federal government, led by the National Institutes of Health (NIH), the scientific community, the pharmaceutical industry and the Alzheimer’s association -- phenomenal progress in the diagnosis and treatment of Alzheimer’s disease has been achieved in the last 20 years.
- On January 4, 2011, President Obama signed into law the National Alzheimer’s Project Act (NAPA) which formed an historic council to create and maintain a national plan to overcome Alzheimer’s disease and address the many challenges facing those with AD and their families.
- Research evidence is linking heart health with brain health – what is good for your heart is good for your head.
- Research evidence is linking Alzheimer’s with high blood pressure, diabetes and obesity.
- Research evidence is showing nutrition and exercise may help prevent or delay Alzheimer’s.
- Research evidence is showing that brain games and challenging the brain to learn new thing may help to prevent or delay Alzheimer’s.
- Advanced imaging technologies, including PET, MRI, SPECT and others, are improving early detection of Alzheimer’s. Accurate, early diagnosis would help treat people earlier and speed up testing of new drugs in treatment trials.
- Research is investigating the possibility that protein patterns found in spinal fluid may detect Alzheimer’s.
- Numerous treatment medications are currently being tested in clinical trials.
- A potential vaccine has worked in mice to reduce and reverse buildup of plaques, and though complications have occurred in human trials, research continues along this line.
- One small study showed benefit from intravenous immunoglobulin therapy (IVIG), which is used to treat various autoimmune, infectious and idiopathic disease.
- Several studies suggest caffeine from coffee may reduce the risk of Alzheimer’s (5-6 cups per day).
- Some research suggests coconut oil has the ability to reverse symptoms and halt progression of Alzheimer’s.
- Some studies suggest Gingko Biloba has the ability to improve memory.
- Some studies suggest that Vitamin E has the ability to improve memory.
- Some studies suggest that anti inflammatory drugs such as Ibuprofen can prevent Alzheimer’s disease
- Some studies suggest that diets high in curry (curcumin) can prevent slow or halt Alzheimer’s disease. Curry is a dietary staple in India, a country where the rate of Alzheimer’s disease is among the worlds lowest. Curry is a powerful antioxidant and anti-inflammatory
- Some studies suggest that certain foods will enhance one’s brain power: blueberries, walnuts, almonds, fish, tomatoes, broccoli and sage
Other Conditions/Diseases which cause Dementia.
Seniors may have dementia from varying conditions, although the most common cause will be Alzheimer’s disease. The following information will help to understand some of the other conditions:
Vascular Dementia is an umbrella term that describes impairments in cognitive function caused by problems in blood vessels that feed the brain. In some cases, a blood vessel may be completely blocked, causing a stroke. Not all strokes cause vascular dementia. It depends on the severity of the stroke, where the stroke occurred and the portion of the brain that is affected. Vascular dementia can occur when blood vessels in the brain narrow, reducing the amount of blood flow to those section of the brain. The prevalence of vascular dementia ranges from 1 to 4 percent in people over the age of 65. Because few treatments are available for vascular dementia, prevention is crucial.
Frontotemporal dementia, also known as Pick’s Disease (frontotemporal lobar degeneration) is an umbrella term for a diverse group of uncommon disorders that primarily affect the frontal and temporal lobes of the brain – the areas generally associated with personality, behavior and language. In frontotemporal dementia, portions of these lobes atrophy, or shrink. Signs and symptoms vary, depending on the portion of the brain affected. Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally blunted, while others lose the ability to use and understand language. Frontotemporal dementia is often misdiagnosed as a psychiatric problem or as Alzheimer’s, however frontotemporal dementia tends to occur at a younger age than does Alzheimer’s, typically between the ages of 40 and 70.
Lewy body dementia shares characteristics with both Alzheimer’s and Parkinson’s. Like Alzheimer’s, it causes confusion. Like Parkinson’s, it can result in rigid muscles, slowed movement and tremor. But the most striking symptom of Lewy body dementia may be its visual hallucinations, which can be one of the first signs of the disorder. Hallucinations may range from abstract shapes or colors to conversations with deceased loved ones. In Lewy body dementia, abnormal round structures – call Lewy bodies_ develop in regions of the brain involved in thinking and movement. While the risk increases with age, Lewy body dementia is estimated to affect less than 1 percent of the population over the age of 65.
Mild cognitive impairment is a transition stage between the cognitive decline of normal aging and the more serious problems caused by Alzheimer's disease. The disorder can affect many areas of thought and action - such as language, attention, reasoning, judgment, reading and writing. However, the most common variety of mild cognitive impairment causes memory problems. According to the American College of Physicians, mild cognitive impairment affects about 20 percent of the population over 70. Many people with mild cognitive impairment eventually develop Alzheimer's disease, although some remain stable and others even return to normal.
Parkinson’s disease is a progressive disorder of the nervous system that affects movement. It develops gradually, often starting with a barely noticeable tremor in just one hand. While a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes a slowing or freezing of movement. Friends and family may notice that the sufferer’s face shows little or no expression and his/her arms don't swing when walking. Speech often becomes soft and mumbling. Parkinson's symptoms tend to worsen as the disease progresses. In the later stages of Parkinson's disease, some people develop problems with memory and mental clarity. While there is no cure for Parkinson's disease, many different types of medicines can treat its symptoms. In some cases, the doctor may suggest surgery.
Encephalitis: Although the term "encephalitis" literally means "inflammation of the brain," it usually refers to brain inflammation resulting from a viral infection. The severe and potentially life-threatening form of this disease is rare. Experts suspect that the actual incidence of encephalitis is probably much higher - but because most people have such mild signs or symptoms, many cases go unrecognized. Encephalitis occurs in two forms - a primary form and a secondary form. Primary encephalitis involves direct viral infection of the brain and spinal cord. In secondary encephalitis, a viral infection first occurs elsewhere in the body and then travels to the brain. Seeing a doctor and receiving timely treatment is important because the course of the encephalitis is unpredictable. Some patients may have symptoms of a cold or stomach infection before encephalitis symptoms begin. When a case of encephalitis is not very severe, the symptoms may be similar to those of other illnesses, including: Fever that is not very high, mild headache, low energy and a poor appetite, clumsiness, unsteady gait, confusion, disorientation, drowsiness, irritability or poor temper control, light sensitivity, stiff neck and back (occasionally) and vomiting.
Stroke occurs when blood flow to a part of the brain is interrupted or severely reduced. This deprives part of the brain of oxygen and nutrients, which can destroy brain cells and result in some degree of permanent disability. Stroke symptoms may include trouble walking and speaking, as well as paralysis or numbness on one side of the body. Prompt treatment is essential. The longer a stroke goes untreated, the greater the risk of permanent disability.
Transient ischemic attack: The term "mini-stroke" is a misnomer that typically refers to a transient ischemic attack (TIA) - a temporary interruption of blood flow to part of the brain. The symptoms of a TIA are similar to those of a stroke but resolve quickly - within several minutes to several hours. A TIA doesn't destroy brain cells or cause permanent disability, however, TIAs may recur. Each TIA increases the risk of a subsequent stroke.
Studies and information: While there is some good information in these studies, the use of TSH and T4 without simultaneous testing of FT4 and FT3 does not provide adequate information about thyroid function. This needs to be kept in mind when reviewing this information.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021928/ - The role of B12 and Thyroid in Dementia
http://archinte.jamanetwork.com/article.aspx?articleid=414403 – Thyroid function and the risk of Alzheimer’s
http://www.ncbi.nlm.nih.gov/pubmed/19276542 - Thyroid function and Alzheimer’s
http://www.ncbi.nlm.nih.gov/pubmed/6822088 - T3 and the Brain
http://www.hindawi.com/journals/jtr/2012/590648/ - Thyroid and Depression
http://thejns.org/doi/abs/10.3171/2013.1.JNS121696 - T3 and Brain surgery
The above link does not contain a complete list of medication that will interfere with the Endocrine system.
While it is true that dementia has many different causes, many can be avoided.
As dementia and Alzheimer’s progress the patient may have fits of rage and inappropriate behavior. This would point to not only low thyroid hormones, but also low cortisol and low aldosterone.
My research shows there are many unanswered questions about the role of endocrine health in Dementia and Alzheimer’s disease. I believe that this would be a ground-breaking area of research for Endocrine Awareness Center for Health.
What if doctors were taught to include extensive endocrine and other testing when addressing Dementia and Alzheimer’s disease, how would that change the face of these diseases? How many people would be well or cured if proper thyroid, hormone and vitamin testing were done?