[33F] Experiencing a constellation of chronic and acute symptoms

Patient Description

A 33-year-old female presents with a complex medical history, including full body swelling and sudden weight gain within the past year, constipation despite laxatives for a month, chronic back and joint pain with varying intensity, and urinary retention described as frequent urges with minimal output for a month. She also reports long-standing symptoms such as hair thinning with concurrent body hair growth, a persistent bumpy rash on her back, and swollen lymph nodes with breast pain. The patient has a history of hypertension, tachycardia palpitations, MTHFR mutation, Hemochromatosis carrier status, protein S deficiency, and was diagnosed with narcolepsy in 2015, manifesting as excessive daytime sleepiness, sleep attacks, sleep paralysis, nightmares, and difficulty maintaining wakefulness. She is currently taking dextroamphetamine. No recent travel or new environmental exposures were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possible conditions that could be causing your symptoms:

  • Hypothyroidism: This condition occurs when your thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, constipation, dry skin, weight gain, joint pain, and hair loss.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.

    • Treatment often involves a team approach, including your doctor, a physical therapist, and possibly other health professionals.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest.

    • Treatment focuses on symptom relief.
  • Narcolepsy: This is a chronic sleep disorder that causes overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances.

    • Treatment often involves medications that can help manage symptoms.

Please note that these are only possible diagnoses and you should consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may be able to provide a diagnosis or refer you to a specialist for further testing.
  2. Keep a symptom diary. Write down when your symptoms occur, what you're doing at the time, and any potential triggers you notice. This can be helpful information for your healthcare provider.
  3. Try to maintain a healthy lifestyle. Eat a balanced diet, get regular exercise, and try to get enough sleep each night. This can help manage some of your symptoms.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Severe pain that doesn't improve with rest or over-the-counter pain relievers
  • Difficulty breathing
  • Chest pain
  • Confusion or difficulty staying awake
  • Any other symptoms that are severe or concerning to you

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare provider for a formal diagnosis and treatment.

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People Also Ask


What could be causing my full body swelling and sudden weight gain?

Full body swelling and sudden weight gain can be caused by several conditions, including hypothyroidism, which is when the thyroid gland doesn't produce enough hormones. It can also be related to fluid retention or other metabolic issues. It's important to consult a healthcare provider for a proper diagnosis.


Why am I experiencing constipation despite taking laxatives?

Constipation despite taking laxatives can occur due to underlying conditions such as hypothyroidism, which slows down metabolism and digestive processes. It could also be related to dietary factors, dehydration, or other gastrointestinal issues. A healthcare provider can help determine the cause and appropriate treatment.


What might be the reason for my chronic back and joint pain?

Chronic back and joint pain can be associated with conditions like fibromyalgia, which causes widespread musculoskeletal pain, or other inflammatory or autoimmune disorders. It's important to work with a healthcare provider to identify the cause and develop a treatment plan.


How can I manage my narcolepsy symptoms effectively?

Managing narcolepsy often involves a combination of medications, such as stimulants to help maintain wakefulness, and lifestyle changes, including scheduled naps and good sleep hygiene. It's crucial to work with a healthcare provider to tailor a treatment plan that suits your specific needs.


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