[37M] With sudden onset of muscle soreness and gastrointestinal changes

Patient Description

A 37-year-old male reports experiencing extreme aches and soreness immediately upon waking, which lasts a few hours and then subsides. The pain is described as sharp and throbbing, with soreness being more pronounced. The patient has not had any recent changes in activity level, injuries, or strains. Additionally, the patient reports a sudden change in bowel habits, with multiple bowel movements occurring each morning over a 2-hour period, contrasting with his usual pattern of constipation. No recent dietary changes or signs of infection such as fever or chills were noted. The patient mentions a roommate with a staph infection but has not experienced symptoms of staph infection himself. The patient also experiences chronic back pain, described as burning in the rhomboids and stabbing above the sacrum, which is unrelieved by strong narcotic pain relievers. Over the past 8 months, the patient has experienced zero sex drive, erectile dysfunction, chronic fatigue, and weight gain. The patient is currently taking Levothyroxine for Hashimoto's disease but has not reported recent thyroid hormone level checks.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've shared, it seems like there could be multiple factors contributing to your current condition:

  1. Hashimoto's Disease and Low Testosterone: Your chronic fatigue, weight gain, and decreased libido could be related to your Hashimoto's disease and low testosterone levels. Hashimoto's can lead to hypothyroidism, which often causes fatigue, weight gain, and muscle aches. Low testosterone can also contribute to fatigue, decreased libido, and erectile dysfunction.

  2. Muscle Pain and Back Pain: The sharp, throbbing muscle pain and soreness you experience upon waking could be related to your existing back pain issues. This might be due to muscle strain, poor sleeping posture, or an underlying musculoskeletal condition.

  3. Diarrhea: The sudden onset of frequent bowel movements in the morning could be due to a gastrointestinal issue, such as irritable bowel syndrome (IBS) or a reaction to stress or dietary factors. However, since this is a new symptom, it would be wise to consult a healthcare provider for further evaluation.

What you can do

For Hashimoto's Disease and Low Testosterone:

  • Consult your doctor: It's important to have your thyroid hormone levels checked regularly to ensure your levothyroxine dosage is appropriate. Discuss your symptoms with your healthcare provider to see if your testosterone levels need to be re-evaluated or if additional treatment is necessary.
  • Lifestyle modifications: Maintain a balanced diet, regular exercise, and adequate sleep to help manage symptoms.

For Muscle and Back Pain:

  • Physical therapy: Consider consulting a physical therapist for exercises and techniques to alleviate pain and improve posture.
  • Pain management: Over-the-counter pain relievers, such as ibuprofen, may help manage pain. However, consult your doctor before taking any new medication.
  • Sleep hygiene: Ensure your mattress and pillows provide adequate support, and try different sleeping positions to reduce strain on your back.

For Diarrhea:

  • Dietary adjustments: Keep a food diary to identify any potential triggers and consider a low-FODMAP diet, which can help manage IBS symptoms.
  • Hydration: Stay hydrated by drinking plenty of water, especially if you're experiencing frequent bowel movements.

Consider using MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

While your symptoms are concerning, they do not appear to be immediately life-threatening. However, you should seek medical attention if you experience any of the following:

  • Severe or worsening pain
  • Unexplained weight loss
  • Blood in your stool
  • Persistent fever or signs of infection

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

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2 mo ago

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People Also Ask


What could be causing my extreme aches and soreness upon waking?

The extreme aches and soreness upon waking could be related to muscle strain, poor sleeping posture, or an underlying musculoskeletal condition. It may also be influenced by your existing back pain issues.


Why am I experiencing a sudden change in bowel habits with multiple bowel movements in the morning?

The sudden change in bowel habits could be due to a gastrointestinal issue such as irritable bowel syndrome (IBS) or a reaction to stress or dietary factors. It's important to consult a healthcare provider for further evaluation.


How can Hashimoto's disease and low testosterone affect my energy levels and sex drive?

Hashimoto's disease can lead to hypothyroidism, which often causes fatigue, weight gain, and muscle aches. Low testosterone can contribute to fatigue, decreased libido, and erectile dysfunction. Both conditions can significantly impact energy levels and sex drive.


What are some effective ways to manage chronic back pain that isn't relieved by narcotic pain relievers?

To manage chronic back pain, consider consulting a physical therapist for exercises and techniques to alleviate pain and improve posture. Over-the-counter pain relievers like ibuprofen may help, but consult your doctor before taking new medication. Ensuring proper sleep hygiene with adequate mattress and pillow support can also be beneficial.


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