[30F] With chronic fatigue, abdominal pain, and skin changes

Patient Description

A 30-year-old female presents with chronic fatigue persisting for several months, which worsens despite a full night's rest. She reports constant dull abdominal pain with intermittent intense cramping, erratic sleep due to pain, and significant weight loss of 17 pounds over three months without trying. Additionally, she experiences muscle soreness and spasms, joint popping in knees and elbows, and persistent ankle swelling. Skin changes include unexplainable bruising, tenderness, dark spots, and sore or pimple-like lesions. The patient also reports significant hair loss and brittle, yellow nails. She experiences little to no appetite with occasional insatiable hunger and constant thirst. Menstrual cycles are irregular with missed periods. She has a history of allergies to pollen, dust, dander, bug bites, and grass, currently managed with Allegra. No known family history of autoimmune diseases or thyroid disorders. No recent travel or known medication allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing. Please remember that these are not diagnoses, and it's important to consult with a healthcare professional for a formal evaluation.

  1. Autoimmune Disorder: Your symptoms, including fatigue, joint pain, skin changes, and hair loss, could suggest an autoimmune disorder such as lupus or rheumatoid arthritis. These conditions occur when the immune system mistakenly attacks healthy tissues, leading to inflammation and a variety of symptoms. Blood tests and imaging studies are often used to diagnose these conditions.

  2. Thyroid Dysfunction: The combination of fatigue, weight loss, hair loss, and changes in your menstrual cycle could indicate a thyroid disorder, such as hyperthyroidism. This condition occurs when the thyroid gland produces too much hormone, affecting metabolism and energy levels. Blood tests to measure thyroid hormone levels can help diagnose this condition.

  3. Nutritional Deficiencies: Your symptoms could also be related to nutritional deficiencies, such as iron deficiency anemia or vitamin D deficiency. These deficiencies can cause fatigue, hair loss, and changes in skin and nails. Blood tests can help identify any deficiencies.

What you can do

Fatigue and Weight Loss:

  • Schedule an appointment with your healthcare provider to discuss your symptoms and potential underlying causes. They may recommend blood tests to check for autoimmune markers, thyroid function, and nutritional deficiencies.
  • Ensure you're eating a balanced diet rich in fruits, vegetables, lean proteins, and whole grains to support overall health.
  • Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

Joint Pain and Swelling:

  • Consider gentle exercises, such as stretching or yoga, to maintain joint flexibility and reduce stiffness.
  • Apply ice packs to swollen areas to help reduce inflammation.
  • Over-the-counter pain relievers, such as ibuprofen, may help alleviate discomfort, but consult your doctor before starting any new medication.

Skin and Hair Changes:

  • Use gentle, fragrance-free skincare products to avoid further irritation.
  • Consider using a moisturizing shampoo and conditioner to help with hair breakage.
  • Protect your skin from sun exposure by wearing sunscreen and protective clothing.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe or worsening joint pain and swelling
  • Significant changes in weight or appetite
  • New or worsening skin rashes or lesions
  • Persistent or severe fatigue that affects your daily life

Please remember that this information is not a substitute for professional medical advice. It's important to consult with a healthcare provider for a thorough evaluation and appropriate treatment.

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1 mo ago

People Also Ask


What are common symptoms of an autoimmune disorder like lupus or rheumatoid arthritis?

Common symptoms of autoimmune disorders like lupus or rheumatoid arthritis include chronic fatigue, joint pain and swelling, skin rashes, hair loss, and sometimes fever. These conditions can vary widely in symptoms and severity.


How can thyroid dysfunction affect weight and energy levels?

Thyroid dysfunction, particularly hyperthyroidism, can lead to symptoms such as unexplained weight loss, increased appetite, fatigue, and changes in menstrual cycles. It affects metabolism and energy levels due to the overproduction of thyroid hormones.


What are the signs of nutritional deficiencies such as iron or vitamin D deficiency?

Signs of nutritional deficiencies like iron deficiency anemia or vitamin D deficiency include fatigue, hair loss, brittle nails, pale skin, and sometimes muscle weakness or bone pain. Blood tests can help diagnose these deficiencies.


What lifestyle changes can help manage joint pain and swelling?

Lifestyle changes to manage joint pain and swelling include engaging in gentle exercises like yoga or stretching, applying ice packs to reduce inflammation, and using over-the-counter pain relievers as advised by a healthcare provider. Maintaining a healthy diet and weight can also help alleviate symptoms.


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