[21F] Experiencing significant unintentional weight loss and stress

Patient Description

A 21-year-old female has reported a significant unintentional weight loss of 20 pounds over 2 months, accompanied by a reduction of 4.5 inches off her waist. She is experiencing fatigue, stress related to school, work, and trauma, and a loss of appetite. The patient has been dealing with stress for approximately 3.5 years and has a diagnosis of C-PTSD. She also reports discomfort in her left eye, feeling out of focus for the past 4-5 days. During her last menstrual period, she experienced severe abdominal and vaginal pain and has noticed an increase in bowel movement frequency. She has a family history of diabetes and personal medical history of mild scoliosis, astigmatism, anxiety, major depression, and PTSD. The patient has recently discontinued medications including Sprintec, Lexapro, Abilify, Mirtazapine, Atomoxetine, and Wellbutrin around October or November 2023. She has an allergy to peaches and no new medications have been started since stopping her previous ones.

Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities to consider:

Depression and Anxiety: Both of these conditions can cause significant weight loss, especially when they're severe. They can also cause a loss of appetite and fatigue. Your history of major depression, PTSD, and anxiety, along with your recent discontinuation of antidepressants, could be contributing to these symptoms.
Stress: Chronic stress, especially when related to trauma, can also lead to weight loss, fatigue, and changes in appetite.
Hyperthyroidism: This is a condition where the thyroid gland produces too much thyroid hormone. It can cause weight loss, increased bowel movements, and eye problems. However, it typically also causes symptoms like a rapid heart rate, sweating, and tremors, which you did not report.
Diabetes: Uncontrolled diabetes can lead to weight loss and fatigue. Given your family history of diabetes, this is something to consider. However, you did not report other common symptoms of diabetes, such as increased thirst and urination.
Eating Disorders: Conditions like anorexia nervosa and bulimia nervosa can cause significant weight loss, changes in bowel habits, and fatigue. These conditions are serious and require professional help.
Eye Strain or Dry Eye: Your eye discomfort could be due to eye strain, especially if you've been spending a lot of time on screens for school or work. Dry eye can also cause discomfort and blurred vision.

Please remember that this is not an exhaustive list and other conditions could also be causing your symptoms.

What you can do

Seek professional help: Given the severity of your symptoms and their impact on your life, it's important to seek help from a healthcare provider. They can perform a thorough evaluation, order appropriate tests, and provide a definitive diagnosis.
Mental health support: If you're not currently seeing a mental health professional, consider seeking one out. They can provide support and treatment options for your depression, anxiety, and PTSD.
Healthy lifestyle: Try to maintain a balanced diet and regular physical activity, as these can help manage your weight and improve your overall health.
Eye care: If your eye discomfort continues, consider seeing an eye care professional. They can evaluate your eyes and provide treatment recommendations.

What you should look out for

Worsening symptoms: If your weight loss, fatigue, stress, loss of appetite, or eye discomfort worsens, seek medical attention immediately.
New symptoms: If you develop new symptoms, such as increased thirst and urination, rapid heart rate, sweating, tremors, or severe abdominal pain, seek medical attention.

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare provider for a formal diagnosis and treatment.

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1 yr ago

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