[35F] Experiencing generalized swelling and fatigue

Patient Description

A 35-year-old female is experiencing generalized swelling throughout her body, including hands, feet, legs, buttocks, and neck, which has been present for almost four days. The swelling is described as painful and cold, but not red, warm, or itchy. The patient's hands and feet are particularly affected, and warmth seems to alleviate the cold sensation. The patient also reports significant fatigue and difficulty staying awake, as well as recent weight gain. She has a 20-year history of hypothyroidism and is currently taking Levoxyl 200 mcg daily, along with magnesium (500mg once daily) and vitamin D (50mcg once daily) supplements. No new medications or supplements have been started recently, and there are no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Hypothyroidism: You've mentioned that you have a history of hypothyroidism. This condition can cause fatigue, cold intolerance, and weight gain, which are symptoms you've been experiencing. However, generalized swelling (edema) is less common in hypothyroidism.

    • Treatment typically involves taking a synthetic thyroid hormone, like the Levoxyl you're currently taking. Your doctor may need to adjust your dosage if your symptoms are due to hypothyroidism.
  • Hypoalbuminemia: This is a condition characterized by low levels of albumin, a protein in your blood. It can cause generalized swelling, fatigue, and weight gain. Hypoalbuminemia can be caused by liver disease, kidney disease, malnutrition, and certain other conditions.

    • Treatment involves addressing the underlying cause and may include dietary changes or medication.
  • Heart Failure: This condition, in which the heart can't pump blood as well as it should, can cause swelling, fatigue, and weight gain. However, you've not reported other common symptoms of heart failure, such as shortness of breath and chest pain.

    • Treatment typically involves lifestyle changes, medication, and sometimes surgery.

What you can do

Given the severity and duration of your symptoms, you should seek medical attention as soon as possible. Your doctor can provide a formal assessment and order relevant tests if necessary.

What you should look out for

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

  • Chest pain
  • Shortness of breath
  • Confusion or difficulty thinking clearly
  • Fainting or loss of consciousness

Please remember that while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


Can hypothyroidism cause generalized swelling throughout the body?

Hypothyroidism can cause symptoms like fatigue, cold intolerance, and weight gain, but generalized swelling (edema) is less common. If swelling occurs, it may indicate that the thyroid hormone dosage needs adjustment or there might be another underlying issue.


What are the symptoms and causes of hypoalbuminemia?

Hypoalbuminemia is characterized by low levels of albumin in the blood, leading to symptoms like generalized swelling, fatigue, and weight gain. It can be caused by liver disease, kidney disease, malnutrition, or other conditions. Treatment involves addressing the underlying cause.


How can heart failure lead to swelling and fatigue?

Heart failure can cause swelling (edema) because the heart is unable to pump blood effectively, leading to fluid buildup in the body. It also causes fatigue due to reduced blood flow and oxygen delivery to tissues. Treatment typically involves lifestyle changes, medication, and sometimes surgery.


What should I do if I experience severe symptoms like chest pain or shortness of breath?

If you experience severe symptoms such as chest pain, shortness of breath, confusion, or fainting, seek medical attention immediately. These could be signs of a serious condition that requires urgent care.


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