[45F] Experiencing joint pain and persistent malaise

Patient Description

A 45-year-old female presents with a week-long history of constant pain in the thumb joint and big toe on the left side, rated as a 5/10 in severity, which worsens with movement. She also reports a persistent malaise for several months, characterized by a general feeling of discomfort and a lack of energy that is not alleviated by caffeine. Additionally, she has experienced a gradual increase in appetite and weight gain, along with dry skin and constipation, but no significant hair loss. The patient has a family history of hypothyroidism and a personal medical history of depression and restless leg syndrome, for which she is taking Requip (2mg as needed), Trintellix (20mg daily), and Wellbutrin (300mg daily). No known drug allergies (NKDA) have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions might be considered:

  • Hypothyroidism: This is a condition where the thyroid gland does not produce enough thyroid hormones. It can cause symptoms like fatigue, weight gain, constipation, and dry skin, which you have reported. Your family history of hypothyroidism also makes this a possibility.

    • Diagnosis typically involves a blood test to check the levels of thyroid hormones in your body.
    • Treatment usually involves taking a daily hormone replacement tablet to raise your thyroid hormone levels.
  • Depression: You have a history of depression and some of the symptoms you're experiencing, such as constant fatigue and increased appetite, can be associated with this condition. However, it's also possible that these symptoms are due to another underlying condition, such as hypothyroidism.

    • Treatment for depression often involves a combination of medication, therapy, and lifestyle changes.
  • Arthritis: This is a group of conditions that cause pain and inflammation in the joints. The pain in your thumb and big toe could potentially be due to a form of arthritis.

    • Diagnosis typically involves physical examination, blood tests, and imaging tests.
    • Treatment can include medication, physical therapy, and in some cases, surgery.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They can order appropriate tests, such as a blood test to check your thyroid hormone levels.
  2. Keep a symptom diary. Note down when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider in diagnosing your condition.
  3. Maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of many conditions, including hypothyroidism and depression.

What you should look out for

  • If your symptoms worsen or if you develop new symptoms, such as severe joint pain, swelling in your joints, or changes in your mood or behavior, seek medical attention immediately.
  • If you feel extremely tired, have trouble staying awake, or if your depression symptoms worsen, seek medical attention immediately.

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, dry skin, constipation, sensitivity to cold, and depression. A blood test measuring thyroid hormone levels is typically used for diagnosis.


How can arthritis be diagnosed and treated?

Arthritis can be diagnosed through a combination of physical examination, blood tests, and imaging tests like X-rays or MRIs. Treatment may involve medications, physical therapy, and sometimes surgery to manage pain and inflammation.


Can depression cause physical symptoms like fatigue and increased appetite?

Yes, depression can cause physical symptoms such as fatigue, changes in appetite, sleep disturbances, and a general lack of energy. These symptoms can overlap with other conditions, so it's important to consult a healthcare provider for an accurate diagnosis.


What lifestyle changes can help manage symptoms of hypothyroidism and depression?

Lifestyle changes that can help manage symptoms of hypothyroidism and depression include regular exercise, a balanced diet rich in nutrients, adequate sleep, stress management techniques, and avoiding excessive caffeine and alcohol.


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