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What Causes Sudden Weight Loss With Hypothyroidism, Dementia And Hypertension?
Question: Yes, I am a retired R.N. from SFGH in SF. My mom is in a LTC facility and has been checked for swallowing issues, and has a history of cancer 20 years ago, she is 99! She has recently experienced a weight loss issue and today a lot of labs are being done to check her general health. Her appetite is good for chocolate, tasty Italian foods and now I find out that they are considering more meds like appetitie enhancers, that I frankly think are not @ the root of the problem. What do you think the standard of care should define as a starting point for uncovering the problems? (They are possibly considering such chemicals as Megesterol, Remeron and others that work re: "side effects") I am open to everything but since she has lost approx. 20 lbs in the last 2 months or so I wonder if there is more natural alternatives? I am also mother's DPOA for health care and have worked as her advocate since her dementia, age-related has increased. I know that XXXXXXX care is predicated on "doing less" so as to not do harm with all the interactions of various medications and in the past Kaiser has put my mom on sulfa that made her INR spike double! She also had had a recent fx of her large toe of right foot and a hx of a clavicle fx last year due probably to fragility and her severe osteoporosis. She has also recently had to go to the ER for obstipation after I told them she was developing a high impaction, (I've helped her with her bowel regimen and now things are proceeding nicely with lactulose.) I guess I feel that most seniors do well as a MD lecturer from Reno said the 5 fives are OK. Temp,hydration, nutrition, bowel function and sleep. (Besides spiritual health)
Just about me, I am 67, in good health and worked mainly in psychiatry for 41 years, in ED with crisis patients and in psych where many patients were elderly and at risk for dual dx. I enjoyed it thoroughly. I continue to keep up with stuff and am considering more volunteerism through Catholic charities, venues while working with my mother 99 and auntie who is 96 and at a different facility in XXXXXXX Thanks
Just about me, I am 67, in good health and worked mainly in psychiatry for 41 years, in ED with crisis patients and in psych where many patients were elderly and at risk for dual dx. I enjoyed it thoroughly. I continue to keep up with stuff and am considering more volunteerism through Catholic charities, venues while working with my mother 99 and auntie who is 96 and at a different facility in XXXXXXX Thanks
Brief Answer:
Weight loss in elderly is multifactorial.
Detailed Answer:
Hello,
I am Dr Prakash H M and I would like to help you in finding suitable answers to the questions you asked.
You first query is about identifying the starting point for uncovering the problem –
Normally any new patients, I would look into their
1. Drug history (as elderly always have multiple/too many and sometimes unnecessary drugs)
2. Medical history
3. Present complaints.
I always find the first two usually contributing to the present complaints.
Your mother has been admitted to an LTC facility with swallowing issues and also she is getting multiple laboratory tests done. If the laboratory reports were there it would have been more beneficial. From drug treatment i would assume, she is under treatment for dementia, hypertension / heart disease, osteoporosis and low thyroid levels.
20 pounds in 2 months is considerably high and I can probably highlight a few causes that could be probable singly or all together. Most of the times weight loss is multifactorial
1. Dementia can lead to weight loss directly by affecting eating behaviors and also altering metabolism
2. Synthyroid levels – probably needs to be adjusted.
3. Her diet – If nutritional imbalance is present, reduced muscle mass due to reduced intake of protein could lead to decreased physical activity and weight loss.
4. Any recent acute illness
5. Bowel regimen – Has lactulose led to more fluid loss and reduced nutritional absorption
Unless a cause is identified, adding of additional drugs like Mirtazapine which promotes weight gain and Megestrol probably needs to be discussed again.
If you find any abnormal laboratory values in thyroid profile, Complete blood hemogram (specifically anemia or raised ESR) or low protein, appropriate therapy needs to be given.
If laboratory values are normal I would suggest the following possible remedies -
1. Offering nutritious comfort foods – chicken soup, mashed eggs
2. Offer nutrient dense beverage like milk shakes, or smoothies
3. Encourage companionship during feeding
4. Increase or maximize caloric intake during favorite meal of the day
5. Offer several small meals in a day.
6. Avoid any sort of distractions during meals.
7. Improved physical activity
8. Keep food always visible during the day, even during walking, finger foods can be used.
You can further discuss with your doctor.
Hope I have answered your query. If you have any further questions I will be happy to help
Dr. Prakash H M
Weight loss in elderly is multifactorial.
Detailed Answer:
Hello,
I am Dr Prakash H M and I would like to help you in finding suitable answers to the questions you asked.
You first query is about identifying the starting point for uncovering the problem –
Normally any new patients, I would look into their
1. Drug history (as elderly always have multiple/too many and sometimes unnecessary drugs)
2. Medical history
3. Present complaints.
I always find the first two usually contributing to the present complaints.
Your mother has been admitted to an LTC facility with swallowing issues and also she is getting multiple laboratory tests done. If the laboratory reports were there it would have been more beneficial. From drug treatment i would assume, she is under treatment for dementia, hypertension / heart disease, osteoporosis and low thyroid levels.
20 pounds in 2 months is considerably high and I can probably highlight a few causes that could be probable singly or all together. Most of the times weight loss is multifactorial
1. Dementia can lead to weight loss directly by affecting eating behaviors and also altering metabolism
2. Synthyroid levels – probably needs to be adjusted.
3. Her diet – If nutritional imbalance is present, reduced muscle mass due to reduced intake of protein could lead to decreased physical activity and weight loss.
4. Any recent acute illness
5. Bowel regimen – Has lactulose led to more fluid loss and reduced nutritional absorption
Unless a cause is identified, adding of additional drugs like Mirtazapine which promotes weight gain and Megestrol probably needs to be discussed again.
If you find any abnormal laboratory values in thyroid profile, Complete blood hemogram (specifically anemia or raised ESR) or low protein, appropriate therapy needs to be given.
If laboratory values are normal I would suggest the following possible remedies -
1. Offering nutritious comfort foods – chicken soup, mashed eggs
2. Offer nutrient dense beverage like milk shakes, or smoothies
3. Encourage companionship during feeding
4. Increase or maximize caloric intake during favorite meal of the day
5. Offer several small meals in a day.
6. Avoid any sort of distractions during meals.
7. Improved physical activity
8. Keep food always visible during the day, even during walking, finger foods can be used.
You can further discuss with your doctor.
Hope I have answered your query. If you have any further questions I will be happy to help
Dr. Prakash H M
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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