[35F] With sudden onset of feet and ankle swelling

Patient Description

A 35-year-old female presents with sudden onset of swelling in her feet and ankles for the past three days. The swelling is described as soft and leaves an indentation when pressed. The patient is a teacher and walks a lot. The swelling improves with elevation. There are no changes in skin color or temperature, and no recent injuries or trauma to the area. The patient denies shortness of breath and chest pain. She uses a nicotine vape and has no history of heart, kidney, or liver problems. The patient has hypothyroidism, diagnosed in 2015, and is allergic to morphine. She is not currently taking any medications or supplements, and there have been no recent changes to her diet or salt intake.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for the swelling in your feet and ankles:

  • Edema: This is a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body. It can be caused by prolonged standing or walking, especially in your case as a teacher. Edema can also be related to other conditions such as hypothyroidism, which you have a history of.

    • Treatment: Elevating your feet, reducing salt intake, and wearing compression stockings can help manage edema. If it persists, a doctor may prescribe diuretics to help reduce the fluid buildup.
  • Hypothyroidism: Since you have a history of hypothyroidism, it's possible that your thyroid hormone levels are not well-controlled, which can lead to swelling in the lower extremities.

    • Treatment: Ensuring that you are taking the appropriate dose of thyroid hormone replacement therapy and having regular check-ups with your doctor to monitor your thyroid levels.
  • Venous Insufficiency: This occurs when the veins in your legs are not working effectively, making it difficult for blood to return to the heart. This can cause swelling, especially after prolonged periods of standing or walking.

    • Treatment: Elevating your legs, wearing compression stockings, and avoiding long periods of standing or sitting can help. In some cases, medical procedures may be necessary.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help alleviate your symptoms:

  1. Elevate Your Feet: Try to elevate your feet above the level of your heart for 15-30 minutes several times a day to help reduce swelling.
  2. Stay Hydrated: Drink plenty of water to help flush out excess salt and fluids from your body.
  3. Reduce Salt Intake: Lower your salt intake as it can contribute to fluid retention.
  4. Wear Compression Stockings: These can help improve circulation and reduce swelling.
  5. Monitor Your Symptoms: Use the MDandMe app to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Sudden or Severe Swelling: If the swelling becomes severe or comes on very suddenly, it could be a sign of a more serious condition.
  • Shortness of Breath or Chest Pain: These could be signs of a more serious condition such as a blood clot or heart problem.
  • Persistent or Worsening Symptoms: If your symptoms do not improve with self-care measures or if they worsen, it's important to see a healthcare professional.

Remember, while these tips can help manage your symptoms, it's crucial to consult with a healthcare provider for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What causes edema in the feet and ankles?

Edema in the feet and ankles can be caused by prolonged standing or walking, fluid retention due to dietary factors, or underlying health conditions such as hypothyroidism or venous insufficiency.


How can hypothyroidism lead to swelling in the lower extremities?

Hypothyroidism can lead to swelling in the lower extremities because low thyroid hormone levels can cause changes in the body's metabolism and fluid balance, leading to fluid retention.


What are some effective ways to reduce swelling in the feet and ankles?

Effective ways to reduce swelling include elevating the feet, reducing salt intake, staying hydrated, wearing compression stockings, and avoiding prolonged periods of standing or sitting.


When should I seek medical attention for swelling in my feet and ankles?

You should seek medical attention if the swelling becomes severe or sudden, if you experience shortness of breath or chest pain, or if the symptoms persist or worsen despite self-care measures.


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