[22F] Experiencing significant fatigue and hair loss

Patient Description

A 22-year-old female reports experiencing severe fatigue that has progressively worsened over the past 6 years, making it difficult to perform daily activities and leading to increased sleep, especially after work or exercise. Additionally, she has significant hair loss at the crown and forehead, which began 8 months ago. The hair loss is characterized by a thin, brittle texture, and the affected area is expanding despite attempts to manage it. The patient has an irregular menstrual cycle, which has been a long-standing issue, and an allergy to Lidocaine. She has been on Lexapro (20 mg daily) for about a year and takes vitamins. There is no known family history of autoimmune diseases, and she does not use recreational drugs, alcohol, or tobacco. No other medical history or medication allergies were reported.

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Arora's Assessment

What might be happening

Based on your symptoms of fatigue, hair loss, and weight changes, there are a few possible conditions that could be causing these symptoms:

  • Hypothyroidism: This is a condition where your thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, hair loss, weight gain, and irregular menstrual cycles. However, you mentioned that you don't have cold intolerance or constipation, which are also common symptoms of hypothyroidism.

    • Typical treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine, which restores adequate hormone levels and reverses the symptoms of hypothyroidism.
  • Iron Deficiency Anemia: This is a common type of anemia that occurs if you don't have enough iron in your body. Your bone marrow needs iron to produce hemoglobin, a protein in red blood cells that enables them to carry oxygen around the body. If your body doesn't have enough hemoglobin, you can feel very tired. Other symptoms can include hair loss and irregular menstrual cycles.

    • Treatment for iron deficiency anemia includes taking iron supplements and changes to your diet to include more iron-rich foods.
  • Chronic Fatigue Syndrome: This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. Other symptoms can include sleep problems, difficulty concentrating, and dizziness.

    • There's no single treatment for chronic fatigue syndrome. Instead, treatment focuses on symptom relief.

What you can do

  1. Consult a doctor: It's important to consult a healthcare professional who can provide a formal diagnosis and appropriate treatment. They may order tests such as a blood test to check your thyroid hormone levels or your iron levels.

  2. Monitor your symptoms: Keep track of your symptoms and any potential triggers. This can help your doctor understand your condition better.

  3. Maintain a balanced diet: Eating a balanced diet can help ensure you get enough nutrients and can help manage your symptoms. If you have iron deficiency anemia, eating iron-rich foods can help.

  4. Regular exercise: While strenuous activity can worsen your fatigue, regular gentle exercise can help manage your symptoms.

What you should look out for

  • If your symptoms worsen or if you develop new symptoms, you should seek medical attention.
  • If you experience severe fatigue that prevents you from doing your daily activities, you should seek medical attention.
  • If you notice any other changes in your body, such as a lump or swelling, you should seek medical attention.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, hair loss, dry skin, cold intolerance, constipation, and irregular menstrual cycles. However, symptoms can vary from person to person.


How can iron deficiency anemia affect menstrual cycles?

Iron deficiency anemia can lead to heavier or more prolonged menstrual periods, as well as irregular cycles. This is because iron is crucial for producing hemoglobin, and low levels can affect the menstrual cycle.


What lifestyle changes can help manage chronic fatigue syndrome?

Lifestyle changes that can help manage chronic fatigue syndrome include maintaining a balanced diet, engaging in regular gentle exercise, managing stress, and ensuring good sleep hygiene. It's important to pace activities to avoid overexertion.


What should I do if I experience severe fatigue that affects my daily activities?

If you experience severe fatigue that affects your daily activities, it's important to consult a healthcare professional for a proper diagnosis and treatment plan. They may conduct tests to determine the underlying cause of your fatigue.

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