[38F] Experiencing weight gain, acne, joint and back pain, and fatigue

Patient Description

A 38-year-old female presents with a range of symptoms including significant weight gain of over 20 kilos in the last 5 years, with difficulty losing weight despite diet and exercise efforts. The weight gain is primarily around the abdomen, and she also experiences emotional eating at night. She has developed acne on her chin that worsens before her menstrual cycle and has new hair growth on her chin. Additionally, she reports fatigue, joint pain in multiple areas including the neck, shoulders, and back, with numbness in the hands during sleep and joint cracking. She has a history of high inflammation in blood tests from 6 years ago and is currently taking Vigia 200mg daily. There is a family history of thyroid issues and diabetes. She does not report any known drug allergies or other medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Polycystic Ovary Syndrome (PCOS): This condition is characterized by hormonal imbalances that can cause irregular periods, acne, and hair growth on the face and body. Weight gain and difficulty losing weight are also common symptoms of PCOS. The hormonal imbalances associated with PCOS can also lead to mood swings and fatigue.

    • Diagnosis typically involves blood tests to check hormone levels and an ultrasound to look for cysts on the ovaries.
    • Treatment often involves lifestyle changes like diet and exercise, as well as medication to manage symptoms.
  • Hypothyroidism: This is a condition where the thyroid gland does not produce enough thyroid hormone. Symptoms can include fatigue, weight gain, joint and muscle pain, and depression.

    • Diagnosis typically involves a blood test to check levels of thyroid-stimulating hormone (TSH) and the thyroid hormone thyroxine.
    • Treatment usually involves daily use of the synthetic thyroid hormone levothyroxine.
  • Cushing's syndrome: This is a condition that occurs from exposure to high cortisol levels for a long time. The most common cause of Cushing's syndrome is the use of oral corticosteroid medication. The condition can also occur when your body makes too much cortisol. Symptoms include weight gain, particularly of your trunk and face with sparing of your arms and legs, acne, and fatigue.

    • Diagnosis typically involves urine and blood tests, and possibly a scan of the adrenal or pituitary glands.
    • Treatment usually involves stopping corticosteroid medications or surgery to remove growths.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to manage your symptoms:

  1. Maintain a healthy, balanced diet and regular exercise routine. This can help manage weight gain and fatigue.
  2. Practice good skincare hygiene to manage acne. This includes washing your face regularly with a gentle cleanser, avoiding touching your face, and not picking at acne.
  3. Try to manage stress as it can exacerbate many of your symptoms. This can include activities like yoga, meditation, or other relaxation techniques.
  4. Over-the-counter pain relievers may help manage your joint and muscle pain. However, long-term use should be discussed with a healthcare provider.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or if you develop new symptoms
  • If your periods stop altogether
  • If your weight gain continues despite diet and exercise
  • If your acne becomes severe or painful
  • If you experience severe fatigue or depression

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common symptoms of Polycystic Ovary Syndrome (PCOS)?

Common symptoms of PCOS include irregular menstrual cycles, acne, excessive hair growth on the face and body, weight gain, difficulty losing weight, mood swings, and fatigue. Diagnosis often involves blood tests to check hormone levels and an ultrasound to look for cysts on the ovaries.


How is hypothyroidism diagnosed and treated?

Hypothyroidism is diagnosed through blood tests that measure levels of thyroid-stimulating hormone (TSH) and the thyroid hormone thyroxine. Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine to normalize hormone levels.


What lifestyle changes can help manage weight gain associated with hormonal imbalances?

Lifestyle changes that can help manage weight gain due to hormonal imbalances include maintaining a balanced diet, engaging in regular physical activity, managing stress, and getting adequate sleep. Consulting with a healthcare provider for personalized advice is also beneficial.


What are the potential causes of joint pain and numbness in the hands during sleep?

Joint pain and numbness in the hands during sleep can be caused by conditions such as carpal tunnel syndrome, arthritis, or hypothyroidism. It is important to consult a healthcare provider for a proper diagnosis and treatment plan.


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