[41F] Experiencing unexplained weight gain and other symptoms

Patient Description

A 41-year-old female presents with a history of significant weight gain over the past decade, including a rapid increase of 50 lbs in the last year, coinciding with the initiation of a beta blocker, Metoprolol. The patient maintains an active lifestyle and a calorie-conscious diet but struggles to lose weight. Additionally, the patient reports paroxysmal swollen ankles related to her menstrual cycle, which has been occurring for the past 8 years. The patient also experiences periodic bleeding gums, particularly around the time of her menstrual cycle, despite a deep cleaning procedure. The patient has noticed hair thinning and male pattern hair growth on her chin, as well as dryness and rough texture of her skin. There are no known allergies or adverse reactions to medications, and the patient is not currently on any medications. The patient has no pre-existing medical conditions or chronic illnesses, and most standard lab tests have returned normal results.

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Arora's Assessment

What might be happening

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

  • Polycystic Ovary Syndrome (PCOS): This condition is characterized by hormonal imbalances that can lead to irregular periods, weight gain, difficulty losing weight, and excessive hair growth (hirsutism). The hormonal imbalances can also cause skin changes such as acne and oily skin.

    • Treatment typically involves lifestyle changes like diet and exercise, and medication to manage symptoms and prevent complications.
  • Hypothyroidism: This condition is characterized by an underactive thyroid gland, which can lead to weight gain, fatigue, dry skin, and hair loss.

    • Treatment typically involves taking synthetic thyroid hormone to restore normal thyroid function.
  • Cushing's Syndrome: This condition is characterized by high levels of cortisol, a hormone that can lead to weight gain, particularly in the face, upper back, and abdomen, as well as thinning skin and easy bruising.

    • Treatment typically involves reducing cortisol production, either through medication, radiation, or surgery.
  • Side effects of Metoprolol: This beta blocker can cause weight gain and fatigue in some people.

    • If you suspect this medication is causing your symptoms, you should discuss this with your doctor. They may be able to adjust your dosage or switch you to a different medication.

What you can do

You should consult a healthcare provider to discuss your symptoms. They may be able to provide a diagnosis and recommend appropriate treatment. In the meantime, you can:

  1. Continue to maintain a healthy diet and regular exercise routine. This can help manage your weight and improve your overall health.
  2. Keep a symptom diary. This can help you and your healthcare provider identify any patterns or triggers for your symptoms.
  3. Stay hydrated and practice good oral hygiene to help manage your bleeding gums.

What you should look out for

You should seek immediate medical attention if you experience:

  • Rapid weight gain or loss
  • Severe fatigue or weakness
  • Severe or persistent bleeding gums
  • Any other symptoms that concern you or interfere with your daily activities

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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11 mo ago

People Also Ask


Can Metoprolol cause weight gain?

Yes, Metoprolol, a beta blocker, can cause weight gain in some individuals. If you suspect it is affecting your weight, discuss with your doctor about possible alternatives or adjustments.


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

Common symptoms of PCOS include irregular menstrual cycles, weight gain, difficulty losing weight, excessive hair growth (hirsutism), acne, and oily skin. It is caused by hormonal imbalances.


How does hypothyroidism affect weight and hair growth?

Hypothyroidism can lead to weight gain due to a slowed metabolism. It can also cause hair thinning and loss, as well as dry skin. Treatment usually involves taking synthetic thyroid hormones.


What are the signs and symptoms of Cushing's Syndrome?

Cushing's Syndrome is characterized by high cortisol levels, leading to weight gain, especially in the face, upper back, and abdomen, thinning skin, easy bruising, and sometimes fatigue and muscle weakness.


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