[22F] Experiencing unexplained weight gain, fatigue, and nausea

Patient Description

A 22-year-old female has been experiencing a gradual weight gain totaling 35 lbs over the last 8.5 months, despite efforts to eat healthier and exercise. She also reports daily nausea occurring around 2pm, which she rates as mild in severity, and fatigue, including waking up in the middle of the night with sweating. Additionally, she has noticed hair thinning around her hairline in the past few months. The patient has a history of asthma diagnosed in early childhood but is not on any prescription medications, only taking vitamins. She has a hormonal IUD in place and has not observed changes in her skin or menstrual cycle. She also reports increased frequency of urination. No known allergies or adverse reactions to medications have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Hypothyroidism: This is a condition where the thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, weight gain, and hair thinning.
- Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine, which restores adequate hormone levels, reversing the symptoms of hypothyroidism.
Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Symptoms can include weight gain, fatigue, and thinning hair. However, you did not mention irregular periods, which is a common symptom.
- Treatment of PCOS may involve lifestyle modifications and medication to manage individual symptoms.
Cushing's Syndrome: This is a condition that occurs from exposure to high cortisol levels for a long time. Symptoms can include weight gain, fatigue, and thinning hair. However, you did not report some of the common symptoms such as a rounded face, pink or purple stretch marks, and increased body hair.
- Treatment depends on the cause. It may involve reducing corticosteroid use, surgery, radiation, or medications.

Please note that these are possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Schedule an appointment with your healthcare provider. They can order tests to confirm a diagnosis and discuss treatment options.
Keep a symptom diary. This can help your healthcare provider understand your symptoms better.
Continue to maintain a healthy lifestyle. This includes eating a balanced diet, regular exercise, and getting enough sleep.

What you should look out for

If your symptoms worsen or if you develop new symptoms, seek medical attention immediately.
If you experience severe abdominal pain, vomiting, or fainting, these could be signs of a more serious condition and you should seek immediate 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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11 mo ago

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