[34F] Experiencing rapid weight gain and easy bruising

Patient Description

A 34-year-old female has reported a rapid weight gain of 60 pounds over a 7-month period without any changes in medication, diet, or exercise habits. The weight gain is primarily in the abdominal area, and she has also noticed easy bruising and hair loss. Despite having a family history of thyroid problems and diabetes, her tests for these conditions have been negative. She has a past medical history of depression, anxiety, ADHD, and bipolar 2, diagnosed at age 19 and age 30 respectively. She is not currently taking any medications, and there have been no changes in her menstrual cycle or bowel movements. No substance use has been reported.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions could be contributing to your symptoms:

  • Hypothyroidism: This condition occurs when your thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, cold intolerance, weight gain, and hair loss. However, you mentioned that your thyroid tests came back negative.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine.
  • Cushing's syndrome: This condition occurs when your body is exposed to high levels of the hormone cortisol for a long time. Symptoms can include weight gain (especially in the abdomen), easy bruising, and hair loss.

    • Treatment usually involves lowering cortisol levels through surgery, radiation, or medication.
  • Polycystic ovary syndrome (PCOS): This hormonal disorder common among women of reproductive age can lead to excessive weight gain and hair loss. However, you mentioned that your menstrual cycle has not changed, which is a common symptom of PCOS.

    • Treatment may involve lifestyle modifications and medication to manage symptoms and prevent complications.
  • Side effects of medication: Some medications can cause weight gain and other side effects. The medications you're taking (Venlafaxine, Lomotrigine, Adderall) are not commonly associated with weight gain, but everyone's body reacts differently to medication.

What you can do

  1. Consult with your healthcare provider: They can provide a formal assessment and order relevant tests if necessary.
  2. Monitor your symptoms: Keep track of any changes in your symptoms or any new symptoms. This information can be helpful for your healthcare provider.
  3. Maintain a healthy lifestyle: Regular exercise and a balanced diet can help manage weight and improve overall health.

What you should look out for

  • Rapid or continued weight gain
  • Changes in menstrual cycle
  • Increased fatigue or cold intolerance
  • New or worsening symptoms

Please remember that 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, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of Cushing's syndrome?

Common symptoms of Cushing's syndrome include rapid weight gain, particularly around the abdomen and face, easy bruising, thinning skin, fatigue, muscle weakness, and hair loss. It can also cause high blood pressure and changes in mood or mental health.


Can stress or mental health conditions contribute to weight gain?

Yes, stress and mental health conditions like depression and anxiety can contribute to weight gain. Stress can lead to increased levels of cortisol, which may cause weight gain, especially in the abdominal area. Additionally, some people may experience changes in appetite or physical activity levels due to mental health conditions.


How can I differentiate between weight gain due to hormonal issues and lifestyle factors?

Weight gain due to hormonal issues often comes with other symptoms such as changes in hair growth, skin texture, or menstrual cycle irregularities. Lifestyle-related weight gain is usually associated with changes in diet or physical activity. A healthcare provider can help determine the cause through a detailed medical history and appropriate tests.


What tests are typically conducted to diagnose Cushing's syndrome?

To diagnose Cushing's syndrome, doctors may conduct a series of tests, including a 24-hour urinary free cortisol test, a late-night salivary cortisol test, or a low-dose dexamethasone suppression test. Imaging tests like CT or MRI scans may also be used to identify any tumors affecting cortisol production.


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