[42F] Experiencing Unintentional Weight Loss and Other Symptoms

Patient Description

A 42-year-old female reports unintentional weight loss, decreasing from 119 lb to 113 lb within the last year. She is experiencing frequent urination, dry mouth, and increased sweating, including night sweats, but no fevers. The patient has severe fatigue at times and shortness of breath, which she attributes to vaping and a past smoking habit. She has a history of anemia resolved with a Mirena IUD, and well-managed depression/anxiety. The patient had COVID-19 in March 2023. She has been on a high-protein diet following an HbA1c of 5.9. Notable lab findings include slightly elevated lipase and abnormalities in MCH or MCHC. She reports dry skin, a rash that responded to sulfacetamide, and skin-colored bumps on her face. She is currently taking Zoloft 100 mg nightly, Buspar 30-60 mg as needed, naratriptan for headaches a few times a month, and Adderall XR 5-10 mg not on a daily basis. She uses BC powder (aspirin with caffeine) for non-migraine headaches. The patient had a rash from lamotrigine in the past but reports no other medication allergies.

Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be contributing to your symptoms:

Diabetes: Unintentional weight loss, frequent urination, increased thirst, and dry mouth are common symptoms of diabetes. An HbA1c level of 5.9% is at the high end of the prediabetes range (5.7% to 6.4%). Diabetes can also cause fatigue and skin changes.
- Treatment typically involves lifestyle changes, such as diet and exercise, and sometimes medication to control blood sugar levels.
Thyroid disorders: Hyperthyroidism, or overactive thyroid, can cause weight loss, increased sweating, and fatigue. Hypothyroidism, or underactive thyroid, can cause dry skin and depression.
- Treatment typically involves medication to regulate thyroid hormone levels.
Depression/Anxiety: These conditions can cause a variety of physical symptoms, including weight loss, fatigue, and headaches. Your current medications, Zoloft and Buspar, are commonly used to treat these conditions.
- Treatment typically involves a combination of medication, therapy, and lifestyle changes.
Anemia: This condition can cause fatigue and shortness of breath. You mentioned a history of anemia due to heavy menstruation.
- Treatment typically involves addressing the underlying cause and may include iron supplements or other medications.

Please note that this is not an exhaustive list and other conditions may also be causing your symptoms. It's also possible that more than one condition is contributing to your symptoms.

What you can do

You should schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform additional tests, such as blood tests or imaging studies, to help determine the cause of your symptoms. In the meantime, continue to take your prescribed medications as directed and try to maintain a balanced diet and regular exercise routine.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

Severe abdominal pain
Difficulty breathing
Chest pain
Confusion or difficulty speaking
Severe headache
Any other severe or worsening symptoms

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with your healthcare provider for accurate information.

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1 yr ago

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