[28F] Experiencing unexplained weight loss and a range of concerning symptoms

Patient Description

A 28-year-old female presents with a 2-year history of unexplained weight loss, inability to gain weight despite a protein-rich diet, and weakness. She is experiencing hormonal imbalances, multiple miscarriages, foamy urine, loss of appetite, faintness, nausea, and reduced sleep quality. She reports a significant weight loss from her usual range of 119-125lbs to under 90lbs. The patient also experiences random bouts of dizziness, vision blackouts, and facial spasms. She has a history of scoliosis, appendectomy, oral surgeries, abdominal surgeries including bladder tumor removal, scar tissue removal, ovarian cyst removal, and cervical cerclage operations. She has had at least four miscarriages since early 2023, with lab work indicating low progesterone levels. The patient has swelling in her legs, changes in bowel movements, severe headaches, worsening vision, confusion, speech difficulties, skin burning sensations, and lumps near her groin. She has a family history of Addison's Disease in her grandmother. She is not currently pregnant, has no known drug allergies, and is not on any prescription medications, only taking a multivitamin and occasional Aleve.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions could be contributing to your symptoms:

  • Malnutrition: This can result from not getting enough nutrients from your diet, and can cause weight loss, weakness, and faintness. However, it seems you have been trying to maintain a balanced diet, so this may not be the primary cause.

    • Treatment typically involves dietary changes and sometimes nutritional supplements.
  • Addison's Disease: This is an autoimmune condition that affects the adrenal glands, resulting in low levels of certain hormones. Symptoms can include weight loss, weakness, faintness, and changes in skin color. Given your grandmother's history with Addison's disease, this could be a possibility.

    • Treatment typically involves hormone replacement therapy.
  • Proteinuria: Foamy urine can be a sign of excess protein in your urine, which can be caused by kidney disease among other things. This could also explain your swelling and weight loss.

    • Treatment depends on the underlying cause and may involve medication to control blood pressure and reduce kidney damage.
  • Neurological conditions: Your facial twitching, faintness, and speech difficulties could be signs of a neurological condition. This could range from a vitamin B12 deficiency to a more serious condition like multiple sclerosis.

    • Treatment varies widely depending on the specific condition and may involve medication, physical therapy, and lifestyle changes.
  • Gastrointestinal issues: Your nausea and changes in bowel movements could be due to a gastrointestinal issue, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).

    • Treatment typically involves dietary changes, medication, and sometimes surgery.

What you can do

  1. Seek immediate medical attention. Your symptoms are concerning and need to be evaluated by a healthcare professional as soon as possible.
  2. Keep a symptom diary. This can help your doctor identify patterns and triggers, which can aid in diagnosis.
  3. Stay hydrated and continue to eat a balanced diet to the best of your ability. This can help manage some of your symptoms and prevent malnutrition.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, seek medical attention immediately.
  • If you notice blood in your urine or stool, seek medical attention immediately.
  • If you experience severe abdominal pain, chest pain, difficulty breathing, or severe headache, seek medical attention immediately.

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 appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of Addison's Disease?

Common symptoms of Addison's Disease include chronic fatigue, muscle weakness, loss of appetite, weight loss, low blood pressure, and skin changes such as darkening of the skin. It is caused by insufficient production of hormones by the adrenal glands.


What could cause foamy urine and how is it treated?

Foamy urine can be a sign of proteinuria, which is the presence of excess protein in the urine. This can be caused by kidney disease, high blood pressure, or diabetes. Treatment depends on the underlying cause and may involve medications to control blood pressure and reduce kidney damage.


How can hormonal imbalances affect pregnancy?

Hormonal imbalances, such as low progesterone levels, can affect pregnancy by making it difficult for the uterus to maintain a pregnancy, leading to miscarriages. Treatment may involve hormone replacement therapy to support pregnancy.


What are potential causes of unexplained weight loss despite a high-calorie diet?

Unexplained weight loss despite a high-calorie diet can be caused by conditions such as hyperthyroidism, malabsorption disorders, chronic infections, cancer, or autoimmune diseases. It is important to seek medical evaluation to determine the underlying cause.


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