[36F] With weakness, nausea, and dry skin patches

Patient Description

A 36-year-old female has been experiencing several symptoms over the past two weeks, including weakness, nausea, lightheadedness, and dry skin patches. The weakness, rated 6/10 in severity, occurs about 75% of the time when standing up and significantly affects daily activities. The patient also reports crampy abdominal pain, rated 7-8/10, located about 4-5 inches below the belly button, which has been intermittent for months. Nausea is felt between the rib cages and has occurred 4-5 times in the last two weeks. Lightheadedness happens a few times a day, lasting 5-10 seconds each time. The patient has dry patches on the body, including flaky areas on the eyelids, and has experienced a loss of appetite over the last two days, with difficulty gaining weight. The patient has chills but no fever. The diet mainly consists of cereal and toast, sometimes only eating once a day in the evening. The patient has a history of Hepatitis C, with the last check-up in 2017-2018 showing slightly elevated liver enzymes. Substance use includes daily marijuana smoking since age 13 and methamphetamines since age 14, with a significant recent decrease in usage. Additionally, the patient has noticed a lot of mucus during bowel movements.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Hepatitis C-Related Complications

Given your history of Hepatitis C, some of your symptoms could be related to liver function issues:

  • Weakness and Fatigue: Chronic liver disease can cause persistent fatigue and weakness.
  • Abdominal Pain: Pain below the belly button could be related to liver issues or gastrointestinal complications.
  • Loss of Appetite and Weight: These are common symptoms in chronic liver disease.
  • Dry Skin: Liver dysfunction can sometimes cause skin changes, including dryness and itching.

2. Nutritional Deficiencies

Your diet seems to lack variety and essential nutrients, which could contribute to:

  • Weakness and Fatigue: A diet low in essential nutrients can lead to generalized weakness.
  • Dry Skin: Nutritional deficiencies can also cause skin issues.

3. Substance Use Effects

Long-term use of substances like methamphetamines and marijuana can have several effects:

  • Weakness and Fatigue: Substance use can lead to chronic fatigue and weakness.
  • Abdominal Pain and Nausea: These can be side effects of substance use or withdrawal.

4. Orthostatic Hypotension

Your lightheadedness when standing up could be due to orthostatic hypotension, a condition where blood pressure drops significantly upon standing:

  • Lightheadedness: This is a classic symptom of orthostatic hypotension.

5. Other Possible Conditions

  • Gastrointestinal Issues: The mucus in your stool and abdominal pain could indicate a gastrointestinal issue like irritable bowel syndrome (IBS) or an infection.
  • Dermatological Conditions: The dry patches on your skin and eyelids could be due to eczema or another skin condition.

What you can do

Weakness and Fatigue

  1. See a Doctor: Given your history of Hepatitis C and substance use, it's crucial to consult a healthcare provider for a comprehensive evaluation.
  2. Improve Nutrition: Try to incorporate a balanced diet rich in fruits, vegetables, proteins, and whole grains. Consider taking a multivitamin supplement.
  3. Stay Hydrated: Continue to drink plenty of fluids, but try to diversify beyond milk.

Abdominal Pain and Nausea

  1. Medical Consultation: See a healthcare provider to rule out any serious gastrointestinal or liver-related issues.
  2. Dietary Adjustments: Avoid foods that can irritate your stomach, such as spicy or fatty foods. Eat smaller, more frequent meals.

Lightheadedness

  1. Slow Movements: When getting up, do so slowly to give your body time to adjust.
  2. Hydration: Ensure you are well-hydrated, as dehydration can worsen lightheadedness.

Dry Skin

  1. Moisturize: Use a gentle, fragrance-free moisturizer on the affected areas.
  2. Avoid Irritants: Avoid harsh soaps and skincare products that can dry out your skin further.

Substance Use

  1. Seek Support: Consider reaching out to a healthcare provider or support group to help manage and reduce substance use.
  2. Healthy Alternatives: Engage in activities that can serve as healthy alternatives to substance use, such as exercise or hobbies.

General Health

  1. Regular Check-Ups: Schedule regular check-ups to monitor your liver function and overall health.
  2. Symptom Tracking: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Given the complexity and severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Abdominal Pain: If the pain becomes unbearable or is accompanied by vomiting or fever.
  • Severe Weakness or Fainting: If you experience fainting or extreme weakness.
  • Yellowing of Skin or Eyes: This could indicate worsening liver function.
  • Unexplained Weight Loss: Significant weight loss without trying could be a sign of a serious underlying condition.

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a formal diagnosis and treatment plan.

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People Also Ask


What are the potential complications of Hepatitis C that could cause these symptoms?

Hepatitis C can lead to chronic liver disease, which may cause symptoms such as fatigue, weakness, abdominal pain, loss of appetite, and skin changes. It's important to monitor liver function regularly and consult a healthcare provider for management.


How can nutritional deficiencies affect my health and what can I do to improve my diet?

Nutritional deficiencies can lead to weakness, fatigue, and skin issues. Improving your diet by including a variety of fruits, vegetables, proteins, and whole grains can help. Consider consulting a nutritionist for personalized advice.


What are the effects of long-term substance use on my body, and how can I manage them?

Long-term substance use can cause chronic fatigue, abdominal pain, and nausea. Reducing or stopping substance use with the help of healthcare providers or support groups can improve these symptoms. Engaging in healthy activities can also be beneficial.


What is orthostatic hypotension and how can it be managed?

Orthostatic hypotension is a condition where blood pressure drops significantly upon standing, causing lightheadedness. It can be managed by standing up slowly, staying hydrated, and consulting a healthcare provider for further evaluation and treatment.


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