[28F] Experiencing significant weight loss and multiple symptoms

Patient Description

A 28-year-old female presents with a significant weight loss of over 50 pounds in the past 18 months, with no intentional changes to diet or exercise and a poor appetite. She is experiencing migraines with a severity of 7/10, characterized by distorted vision, sensitivity to light, and occasionally aura, which started a few months ago. The migraines are felt at the bottom back of her head, extending through her neck. Additionally, she reports an achy neck pain, rated 5/10 in severity, that worsens at night and has been present for six months. She also describes pressure-like pain on the top left side of her breast, rated 3/10 in severity. Swollen lymph nodes are also noted. No recent neck injuries or pregnancies were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are a few possibilities that could explain your symptoms:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is often associated with tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. However, it doesn't typically cause weight loss.

    • Treatment often involves a combination of medications, exercise, stress management and healthy lifestyle habits.
  • Thyroid disorders: Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can cause a variety of symptoms including weight changes, neck pain, and migraines. Hyperthyroidism can cause weight loss, while hypothyroidism can cause weight gain.

    • Treatment typically involves medication to regulate your thyroid hormone levels.
  • Chronic Fatigue Syndrome (CFS): This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest. This condition is also associated with headaches, joint pain, and tender lymph nodes.

    • Treatment typically involves a combination of medications, exercise, psychological therapy, and healthy lifestyle habits.
  • Breast conditions: There are many conditions that can cause breast pain, including hormonal changes, injury, infection, and benign or malignant tumors. It's important to have any new breast pain evaluated by a healthcare provider.

    • Treatment depends on the underlying cause.

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

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to run some tests to help determine the cause of your symptoms.
  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can help your healthcare provider identify patterns and make a diagnosis.
  3. Try to maintain a healthy lifestyle. Eat a balanced diet, get regular exercise, and ensure you're getting enough sleep. These can all help boost your overall health and may help alleviate some of your symptoms.

What you should look out for

Seek immediate medical attention if you experience:

  • Sudden, severe pain
  • Difficulty breathing or shortness of breath
  • A sudden, severe headache
  • Changes in vision or speech
  • Fainting or loss of consciousness

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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10 mo ago

People Also Ask


What could cause unintentional weight loss and poor appetite in a young adult?

Unintentional weight loss and poor appetite can be caused by various conditions, including hyperthyroidism, chronic infections, cancer, gastrointestinal disorders, and psychological conditions such as depression or anxiety. It's important to consult a healthcare provider for a thorough evaluation.


How are migraines with aura different from regular migraines?

Migraines with aura are characterized by sensory disturbances that occur before the headache phase, such as visual changes, tingling sensations, or speech difficulties. These auras typically last less than an hour and are followed by the headache phase. Regular migraines may not have these preceding symptoms.


What are common causes of neck pain that worsens at night?

Common causes of neck pain that worsens at night include poor sleeping posture, stress, muscle strain, or conditions like cervical spondylosis. It's important to evaluate sleeping habits and consult a healthcare provider if the pain persists.


When should swollen lymph nodes be a cause for concern?

Swollen lymph nodes can be a cause for concern if they are persistently enlarged, hard, fixed in place, or accompanied by symptoms like fever, night sweats, or unexplained weight loss. These could indicate an infection or, in rare cases, a more serious condition like lymphoma, and should be evaluated by a healthcare provider.


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