[32F] Experiencing fatigue, weight gain, joint pain, and hair loss

Patient Description

A 32-year-old female presents with a one-year history of significant weight gain (20lbs), particularly in the face, arms, and belly, without changes in dietary habits. She also reports persistent, achy joint pain rated 7/10 in severity, affecting multiple joints, including elbows, wrists, hands, knees, fingers, and ankles, which is somewhat alleviated by hot showers or sleep. Additionally, she has been experiencing hair loss for six months, with a handful of hair falling out upon contact. Menstrual cycle changes, cold intolerance, constipation, skin dryness, muscle weakness, and unilateral facial and forehead acne have also been noted. The patient has sharp, throbbing foot pain, rated 8/10, located in the ball of the foot and under the toes, persisting for three months. She takes Synthroid 200mcg daily and a multivitamin. There is a family history of hyperthyroidism, hypothyroidism, and rheumatoid arthritis. The patient has not been diagnosed with fibromyalgia, which is present in her family history.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, here are a few possibilities:

  • Hypothyroidism: This is a condition where your thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, weight gain, joint pain, hair loss, cold intolerance, constipation, dry skin, and muscle weakness. Given your family history of hypothyroidism and the fact that you're currently taking Synthroid (a medication used to treat hypothyroidism), this could be a possibility. However, your dosage may need to be adjusted if you're still experiencing symptoms.

    • Treatment typically involves taking a daily hormone replacement medication, like the Synthroid you're currently taking. Your doctor may need to adjust your dosage based on your symptoms and blood test results.
  • Rheumatoid Arthritis: This is an autoimmune disorder that primarily affects the joints, causing pain, swelling, and stiffness. It can also cause fatigue and weight gain. Given your family history of rheumatoid arthritis and your symptoms of joint pain and fatigue, this could be a possibility.

    • Treatment typically involves medications to reduce inflammation and slow the disease's progression, physical therapy, and sometimes surgery.
  • Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Symptoms can include irregular periods, weight gain, acne, and hair loss. Given your symptoms and the changes in your menstrual cycle, this could be a possibility.

    • Treatment typically involves lifestyle changes like diet and exercise, medications to manage symptoms, and sometimes surgery.

Please note that these are just possibilities based on the symptoms you've provided. It's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your primary care physician to discuss your symptoms. They may want to adjust your Synthroid dosage or investigate other potential causes of your symptoms.
  2. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This can be helpful information to share with your doctor.
  3. Try to maintain a balanced diet and regular exercise routine. These can help manage symptoms of many conditions, including hypothyroidism and PCOS.
  4. Consider seeing a rheumatologist if your joint pain continues. They specialize in conditions affecting the joints and can provide a more detailed assessment.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe pain
  • Difficulty breathing
  • Chest pain
  • Sudden or severe swelling in your legs
  • Any other severe or concerning symptoms

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, joint pain, hair loss, cold intolerance, constipation, dry skin, and muscle weakness. It occurs when the thyroid gland doesn't produce enough hormones.


How is rheumatoid arthritis diagnosed and treated?

Rheumatoid arthritis is diagnosed through a combination of physical exams, blood tests for specific markers, and imaging tests like X-rays. Treatment typically involves medications to reduce inflammation and slow disease progression, physical therapy, and sometimes surgery.


What lifestyle changes can help manage Polycystic Ovary Syndrome (PCOS)?

Lifestyle changes that can help manage PCOS include maintaining a healthy weight through diet and exercise, managing stress, and possibly taking medications to regulate menstrual cycles and reduce symptoms like acne and hair loss.


What could be causing sharp, throbbing foot pain?

Sharp, throbbing foot pain could be caused by conditions such as plantar fasciitis, metatarsalgia, or nerve issues. It's important to consult a healthcare provider for an accurate diagnosis and appropriate treatment.


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