Like many physical disorders, the clinical signs associated with metabolic diseases affecting thyroid, adrenal, and pancreatic function are reflective of nonspecific changes in behavior. Additionally, patients who have underlying disorders associated with fear, anxiety, stress, conflict, and/or panic may be under treatment with medications that alter basal thyroid, glucose, and cortisol levels. Through reinforcement and punishment of behaviors associated with clinical signs caused by organic or iatrogenic endocrine disease, behaviors can be perpetuated and become persistent patterns. Screening all patients presenting with a primary behavior complaint or those with behavioral clinical signs of endocrine diseases is essential. Alleviating stress immediately while working up or treating metabolic disease reduces suffering and may stave off the adoption of behavior patterns more permanently.