[35F] Experiencing significant weight loss and headaches

Patient Description

A 35-year-old female reports unintentional weight loss of 70 lbs since December 2023, accompanied by fatigue, lack of appetite, and daily headaches that can escalate to migraines with visual disturbances such as flashing lights and zigzag patterns. The headaches often start at the front of the head and can wake her up. She experiences nausea and abdominal pain, both with headaches and after eating. Since gallbladder removal, she has had diarrhea shortly after consuming certain foods like cheese and fried foods. She consumes two Red Bulls daily and notices headaches if caffeine intake is reduced. Past medical history includes a full hysterectomy in 2019, leading to sepsis, and gallbladder removal in 2023. No known allergies and not currently on any medications.

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Arora's Assessment

What might be happening

Your symptoms could be related to several potential issues:

  1. Post-Cholecystectomy Syndrome: After gallbladder removal, some people experience digestive issues like diarrhea and abdominal pain, especially after eating fatty foods. This could explain your bowel symptoms.

  2. Migraine with Aura: Your headaches, visual disturbances, and nausea are consistent with migraines, which can be triggered by stress, dietary changes, or caffeine withdrawal.

  3. Nutritional Deficiencies or Malabsorption: Significant weight loss and lack of appetite might lead to or result from nutritional deficiencies, which can also cause fatigue and headaches.

  4. Stress or Anxiety: The stress from your recent divorce might contribute to your symptoms, including appetite changes and headaches.

What you can do

Digestive Issues:

  • Avoid fatty and fried foods to see if symptoms improve.
  • Consider a low-fat diet and eat smaller, more frequent meals.
  • Stay hydrated, especially if experiencing diarrhea.

Headaches and Migraines:

  • Maintain a regular sleep schedule and manage stress.
  • Limit caffeine intake gradually to prevent withdrawal headaches.
  • Keep a headache diary to identify potential triggers.

Weight Loss and Appetite:

  • Try nutrient-dense foods in small portions.
  • Consider meal replacement shakes if eating solid food is difficult.
  • Monitor your weight and symptoms using the MDandMe journal.

General Health:

  • Schedule a follow-up with your healthcare provider to discuss these symptoms and potential nutritional deficiencies.
  • Consider seeing a dietitian for personalized dietary advice.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening headaches.
  • Persistent vomiting or inability to keep food down.
  • Signs of dehydration, such as dizziness or reduced urination.
  • Any new or concerning symptoms.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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2 mo ago

People Also Ask

What is post-cholecystectomy syndrome and how can it affect digestion?

Post-cholecystectomy syndrome refers to digestive issues that can occur after gallbladder removal, such as diarrhea and abdominal pain, especially after eating fatty foods. Managing diet by avoiding high-fat foods can help alleviate symptoms.

How can migraines with aura be managed or prevented?

Migraines with aura can be managed by identifying and avoiding triggers, maintaining a regular sleep schedule, managing stress, and gradually reducing caffeine intake. Keeping a headache diary can help identify specific triggers.

What are the potential causes of significant unintentional weight loss?

Significant unintentional weight loss can be caused by nutritional deficiencies, malabsorption, stress, or underlying medical conditions. It's important to consult a healthcare provider to determine the cause and appropriate treatment.

How does caffeine withdrawal contribute to headaches?

Caffeine withdrawal can lead to headaches because the body becomes accustomed to a certain level of caffeine. Reducing caffeine intake gradually can help prevent withdrawal symptoms, including headaches.

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