[18F] With significant weight loss, dizziness, amenorrhea, and multiple systemic symptoms

Patient Description

An 18-year-old female presents with significant weight loss of approximately 49.2 pounds over the past few months, losing around 15 pounds each month. The patient reports severe dizziness, blurred vision, missed menstrual cycles for the past 3 months, extreme constipation, dry and rough skin, feeling cold, numbness and loss of feeling in her extremities, severe muscle and joint pain, hair loss, insomnia, nausea triggered by the smell of food, urinary retention, heart palpitations, tremors, a burning sensation with pressure radiating through her body, and shortness of breath. She follows a severe diet, consuming a maximum of 400 calories a day and fasting for 7 days each month, ongoing for almost 9 months. She has a history of chronic bronchitis and an autoimmune disorder affecting white blood cell production. She is allergic to penicillin and is not currently taking any medications. The patient has not sought medical or psychological help since starting this diet and fasting pattern. Immediate medical attention is strongly recommended.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, you are experiencing a range of severe symptoms that could be related to your atypical anorexia and possibly other underlying conditions. Here are some potential explanations:

  1. Severe Malnutrition: Your significant weight loss, extreme diet, and fasting are likely causing severe malnutrition. This can lead to many of the symptoms you're experiencing, including dizziness, blurred vision, hair loss, dry skin, and muscle and bone pain. Malnutrition can also affect your heart, leading to palpitations and irregular heartbeats.

  2. Electrolyte Imbalance: Severe dieting and fasting can cause imbalances in electrolytes like potassium, sodium, and calcium. This can lead to symptoms such as muscle cramps, numbness, heart palpitations, and even severe complications like cardiac arrest.

  3. Hypoglycemia: Consuming very few calories can cause low blood sugar levels, leading to dizziness, fainting, blurred vision, and shaking.

  4. Amenorrhea: The absence of your menstrual cycle for three months is likely due to the severe caloric restriction and weight loss, which can disrupt your hormonal balance.

  5. Peripheral Neuropathy: The numbness and discoloration in your hands and feet could be due to nerve damage from malnutrition or poor circulation.

  6. Autoimmune Disorder: Your autoimmune disorder and chronic bronchitis could be exacerbating your symptoms, especially given your compromised immune system.

What you can do

Given the severity of your symptoms, it is crucial to seek immediate medical attention. Here are some steps you can take:

  1. Seek Emergency Care: Go to the nearest emergency room or urgent care center immediately. Your symptoms are severe and could be life-threatening. If you are unable to get there yourself, please call 911 or have someone take you.

  2. Stop Fasting and Severe Dieting: While waiting for medical help, try to consume small, balanced meals to stabilize your blood sugar and electrolyte levels. Avoid fasting and severe caloric restriction.

  3. Stay Hydrated: Continue to drink water, but avoid overhydration, as it can further imbalance your electrolytes.

  4. Monitor Symptoms: Keep track of your symptoms, especially any changes in heart rate, breathing difficulties, or worsening pain. Share this information with the healthcare providers.

  5. Follow Up with Specialists: After receiving emergency care, follow up with specialists such as a nutritionist, endocrinologist, and mental health professional to address the underlying causes of your symptoms and develop a comprehensive treatment plan.

Remember, I am not a doctor, and this advice is based on the information you provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your health and well-being are paramount, so please take immediate action.

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4 mo ago


People Also Ask


What are the potential health risks of consuming only 400 calories a day?

Consuming only 400 calories a day can lead to severe malnutrition, which can cause muscle loss, weakened immune function, heart problems, electrolyte imbalances, and organ failure. It can also lead to psychological issues such as depression and anxiety.


How can severe malnutrition affect the body?

Severe malnutrition can lead to a weakened immune system, muscle and bone loss, organ damage, and increased risk of infections. It can also cause symptoms like dizziness, hair loss, dry skin, and heart palpitations.


What is amenorrhea and how is it related to weight loss?

Amenorrhea is the absence of menstrual periods. It can occur due to significant weight loss and caloric restriction, which disrupt hormonal balance and affect reproductive health.


Why is it important to seek immediate medical attention for these symptoms?

Immediate medical attention is crucial because the symptoms described, such as heart palpitations, severe weight loss, and electrolyte imbalances, can be life-threatening. Professional medical intervention is necessary to prevent serious complications and to begin appropriate treatment.

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