[31F] Experiencing unintentional weight loss and night sweats

Patient Description

A 31-year-old female reports significant unintentional weight loss of 35 pounds over approximately 10 months, night sweats occurring twice weekly for the past 6 months, heightened anxiety, and trouble sleeping for the past year. The patient finds some relief for sleep issues using THC, as over-the-counter medications have not been effective. The patient's medical history includes endometriosis, which was treated with surgical excision and a hysterectomy with both fallopian tubes removed while retaining both ovaries. The patient experienced an adverse reaction to Zoloft and is currently taking Effexor 150 mg daily and Propranolol 20 mg as needed for panic attacks. Recent blood work indicated slightly elevated liver enzymes. No other medications or known drug allergies were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities:

  • Hyperthyroidism: This condition occurs when your thyroid gland produces too much of the hormone thyroxine. Symptoms can include unintentional weight loss, increased perspiration, difficulty sleeping, and anxiety. Elevated liver enzymes can also occur in hyperthyroidism.

    • Diagnosis typically involves blood tests to check your levels of thyroid-stimulating hormone (TSH) and thyroxine.
    • Treatment usually involves medication to reduce the production of thyroid hormones or to block their effects.
  • Anxiety disorder: Chronic anxiety can lead to physical symptoms such as weight loss, night sweats, and difficulty sleeping.

    • Diagnosis is typically made based on a thorough clinical interview and diagnostic guidelines.
    • Treatment can involve psychotherapy (cognitive-behavioral therapy or CBT is often effective), medication, or both.
  • Liver disease: Elevated liver enzymes can indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests.

    • Diagnosis typically involves further blood tests, imaging studies, and sometimes a liver biopsy.
    • Treatment depends on the specific type of liver disease.

Please note that these are just possibilities, 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 perform further tests to determine the cause of your symptoms.
  2. Continue to monitor your symptoms and take note of anything that makes them better or worse.
  3. Try to maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help manage some of your symptoms.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, seek medical attention immediately.
  • If you experience severe anxiety or panic attacks, seek immediate medical attention.
  • If you notice yellowing of your skin or the whites of your eyes, pain in your upper right abdomen, or unusually dark urine, these could be signs of a serious liver condition and you should 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 accurate information.

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11 mo ago

People Also Ask


What are the common symptoms of hyperthyroidism?

Common symptoms of hyperthyroidism include unintentional weight loss, increased appetite, rapid heartbeat, sweating, nervousness, irritability, and difficulty sleeping.


How can anxiety disorders affect physical health?

Anxiety disorders can lead to physical symptoms such as weight loss, night sweats, difficulty sleeping, increased heart rate, and gastrointestinal issues. Chronic anxiety can also weaken the immune system over time.


What might cause elevated liver enzymes in a blood test?

Elevated liver enzymes can be caused by liver inflammation or damage, which may result from conditions such as hepatitis, fatty liver disease, alcohol use, certain medications, or other liver diseases.


What are some effective treatments for sleep issues related to anxiety?

Effective treatments for sleep issues related to anxiety can include cognitive-behavioral therapy (CBT), relaxation techniques, regular exercise, and medications such as certain antidepressants or anti-anxiety drugs. It's important to consult with a healthcare provider to determine the best approach.


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