Alzheimer's Disease- Why So Hard to Diagnose?

Alzheimer's disease (AD) should be simple to diagnose, right? How hard can it be for a doctor to decide if memory loss is a normal part of aging, or if it is severe enough to "count" as Alzheimer's? Well, if diseases only occurred one at a time, it might be simple. Unfortunately, as old Texas doc's say, when you itch, it's possible you've got ticks AND fleas. I find in family medicine, it's rare we see any disease state by itself, and Alzheimer's is no exception.

Many different issues can affect memory. Depression and/or anxiety very frequently preoccupy the brain so much that short term memory loss can be a predominant issue. Low thyroid levels can decrease memory. B12 deficiency is another cause. The list of medications that can affect memory seems to be growing each year as well.

When my mother first noticed significant memory issues at the age of 61, she was convinced she had Alzheimer's. I literally laughed when she told me her concerns...We had no family history of early or even late onset dementia. She had recently started a medication known for impairing memory (Digoxin.) As her medical workup progressed, I was relieved to find out she had not only that medication as a possible cause, but literally every cause I listed above- B12 deficiency, hypothyroidism and depression. I felt confident that as we addressed each of these problems, her memory would improve. In many cases, that would have been true, but unfortunately for Mom, she did indeed have underlying Alzheimer's, which took roughly another two years to fully decipher.

If you are concerned about memory loss, please make an appointment with your family physician to address your concerns. Head to the Alzheimer's Association website and review the 10 Warning Signs of Alzheimer's. Until those biomarkers for AD become more refined, physicians will not have a quick or simple answer, but a thorough history and exam, combined with possible neuropsychiatric testing, will take us a long way in the right direction.

BOTTOM LINE: Memory loss can have many different causes, and these causes can and frequently do overlap.

My Metabolism STINKS!

Do you feel like no matter what you do, you simply cannot lose weight? Many people ask there doctors what is wrong with their metabolism. Physicians run many thyroid function tests trying to find an answer for their patients, but the majority of the time, those tests are normal. In addition, even if your thyroid is sluggish, starting on thyroid medication does not guarantee that the pounds will melt off!

There are certainly other factors that go into your metabolism. Co-factors such as vitamin B12 and adrenally produced steroids play a role as well. However, most of the time, our science is not advanced enough to detect subtle changes. We cannot give people thyroid medications to "speed things up" unless they are truly low thyroid, because excess thyroid causes medical problems such as irregular heart rhythms, osteoporosis, and anxiety.

So what can you do? There are only two behavioral modifications that YOU can do to help speed up your metabolism. Ready? Here they are:
1. NO SKIPPED MEALS, especially BREAKFAST (because you have already "fasted" while you slept.)
2. DAILY AEROBIC ACTIVITY (walking, biking, hiking, dancing- anything that raises your heart rate)

Additionally, realize that it has been proven that when we record or recall our food intake and exercise, people always UNDERestimate what we eat, and OVERestimate our exercise. Recognize that you (like all of us) have that bias! If you are frustrated with your metabolism, try a different approach. Obviously, what you are doing now is not working, right? So talk with your doctor, your registered dietician, and/or your personal trainer and find ways to step it up a notch!

BOTTOM LINE: Naturally speed up your metabolism by making sure you don't skip meals and you DO increase your daily exercise!