[30F] With headaches, hair loss, easy bruising, and unexplained weight loss

Patient Description

A 30-year-old female presents with several concerning symptoms. The primary issue is a dull, pulsing headache in the temples, lasting for several hours and occurring daily for the past week, rated as 4 out of 10 in severity and relieved by ibuprofen. Additionally, the patient has been experiencing diffuse hair loss for about a month, losing a handful of hair every few days, resulting in noticeable thinning. The patient has also noticed easy bruising on the legs for the past two weeks, with small pinpoint bruises that start dark purple and fade to yellow. The patient takes iron tablets for anemia and has not had any recent injuries. There is also numbness and tingling in the hands, starting from the armpits, occurring randomly for the past week, lasting a few minutes, and mildly painful. The patient reports a 40-pound unintentional weight loss over the past five months. The patient denies fever, night sweats, sudden vision loss, or double vision. The patient is awaiting results for a possible autoimmune condition and has an elevated SED rate and high white count diagnosed four months ago. Current medications include Paxil (40mg daily), Verapamil (240mg daily), Vyvanse (40mg daily), a multivitamin (PureGenomics daily), iron tablets (60mg daily), vitamin C (2,000mg daily), vitamin D (1,500IU daily), and fish oil (2,400mg daily). No known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, several potential conditions could explain your symptoms:

  • Temporal Arteritis (Giant Cell Arteritis): This condition involves inflammation of the blood vessels, particularly in the temples, and can cause headaches, jaw pain, and vision problems. It is more common in people over 50, but it can occur in younger individuals.

    • Treatment: Typically involves corticosteroids to reduce inflammation. Prompt treatment is crucial to prevent complications such as vision loss.

  • Autoimmune Disorders: Given your elevated SED rate and high white count, an autoimmune condition could be causing your symptoms. Conditions like lupus or rheumatoid arthritis can cause systemic symptoms including headaches, hair loss, and unexplained weight loss.

    • Treatment: Depends on the specific autoimmune disorder but often involves immunosuppressive medications.

  • Nutritional Deficiencies: Despite taking supplements, deficiencies in certain vitamins and minerals (e.g., B12, iron) can cause symptoms like hair loss, bruising, and numbness.

    • Treatment: Addressing the specific deficiencies through diet or supplementation.

  • Medication Side Effects: Some of your medications, such as Paxil and Vyvanse, can have side effects that might contribute to your symptoms.

    • Treatment: Reviewing and possibly adjusting your medications with your healthcare provider.

What you can do

While waiting for a formal diagnosis from your healthcare provider, you can try the following to manage your symptoms:

  1. Maintain a Balanced Diet: Ensure you are getting adequate nutrition to support overall health.
  2. Monitor Symptoms: Keep a diary of your symptoms, noting their frequency, duration, and any potential triggers. This can help your healthcare provider in making a diagnosis.
  3. Stay Hydrated: Drink plenty of water to help manage headaches and overall well-being.
  4. Rest and Relaxation: Stress can exacerbate symptoms, so try to incorporate relaxation techniques such as deep breathing, meditation, or gentle exercise.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden vision loss or double vision
  • Severe or worsening headaches
  • Significant changes in your symptoms
  • New or worsening jaw pain, especially while chewing
  • Any signs of infection, such as fever or chills

Remember, it is essential to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. Your symptoms are complex and may require a thorough evaluation by a specialist.

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5 mo ago

People Also Ask

What could be causing my daily headaches and how can they be treated?

Your daily headaches could be due to conditions like temporal arteritis or an autoimmune disorder. Treatment often involves medications like corticosteroids to reduce inflammation. It's important to consult with your healthcare provider for a proper diagnosis and treatment plan.

Why am I experiencing hair loss and what can I do about it?

Hair loss can be caused by autoimmune disorders, nutritional deficiencies, or other underlying health issues. Ensuring adequate nutrition and addressing any deficiencies with your healthcare provider can help manage this symptom.

What might be the reason for my easy bruising and how should I address it?

Easy bruising might be related to nutritional deficiencies, such as low levels of certain vitamins or minerals, or an underlying health condition. It's important to discuss this with your healthcare provider to determine the cause and appropriate treatment.

Could my medications be contributing to my symptoms and should they be adjusted?

Some medications, like Paxil and Vyvanse, can have side effects that may contribute to your symptoms. It's advisable to review your medications with your healthcare provider to see if adjustments are needed.

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