[51F] Experiencing fatigue, dry eyes, and joint pain

Patient Description

A 51-year-old female presents with fatigue, moderate swelling and dryness of the eyes that is most severe in the mornings, and joint pain. The patient has a history of thyroid cancer diagnosed 20 years ago and is currently on Synthroid, vitamin D, calcium, and hormone replacement therapy including estrogen patches, progesterone, and testosterone cream. The patient also reports achy back pain that is persistent and knee pain that fluctuates in intensity, rating the knee pain a 6 out of 10. The patient has a known allergy to Naproxen, which causes swelling and hives. Additional symptoms include a weird skin spot on the leg by the ankle and transient sores on the tongue.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Dry Eye Syndrome: This condition is characterized by a lack of sufficient lubrication and moisture on the surface of the eye. It can be caused by a variety of factors, including aging, certain medications, and medical conditions like thyroid disorders. The symptoms you described, such as needing eye drops to open your eyes in the morning and having swollen eyelids, are consistent with this condition.

    • Treatment typically involves artificial tears, lubricating eye ointments, and managing any underlying conditions.
  • Hypothyroidism: You mentioned that you have hypothyroidism, a condition in which your thyroid gland doesn't produce enough thyroid hormones. This can cause a variety of symptoms, including fatigue, joint and muscle pain, and dry eyes. It's important to continue taking your prescribed thyroid medication and to have regular check-ups with your doctor to ensure your condition is well-managed.

  • Osteoarthritis: This is a type of joint disease that results from breakdown of joint cartilage and underlying bone. The most common symptoms are joint pain and stiffness, which you described in your back and knees. It typically worsens with age.

    • Treatment usually involves a combination of lifestyle changes, physical therapy, and medications to manage pain and improve function.
  • Hidradenitis suppurativa: This is a chronic skin condition featuring lumps in places like the armpits or groin. You mentioned having this condition, which could be related to some of the skin symptoms you described.

  • Oral Ulcers: The sores on your tongue that come and go may be oral ulcers. These can be caused by a variety of factors, including stress, certain foods, or underlying conditions.

    • Treatment usually involves managing pain, maintaining oral hygiene, and avoiding triggering foods or substances.

What you can do

  1. Continue to take your prescribed medications as directed by your doctor.
  2. Apply warm compresses to your eyes in the morning to help alleviate dryness and swelling.
  3. Maintain a healthy diet and regular exercise routine to help manage symptoms of osteoarthritis.
  4. Keep your skin clean and dry to help manage symptoms of hidradenitis suppurativa.
  5. Avoid spicy or acidic foods that may trigger oral ulcers.

What you should look out for

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

  • Severe eye pain or sudden vision changes
  • Severe joint pain or swelling
  • Signs of infection, such as fever, redness, or pus from skin lesions
  • Difficulty swallowing or severe mouth pain

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


What are the common causes of dry eye syndrome?

Dry eye syndrome can be caused by aging, hormonal changes, certain medications, environmental factors, and underlying medical conditions such as thyroid disorders.


How can hypothyroidism affect joint and muscle pain?

Hypothyroidism can lead to joint and muscle pain due to decreased metabolism, which affects muscle function and can lead to stiffness and discomfort.


What lifestyle changes can help manage osteoarthritis symptoms?

Lifestyle changes that can help manage osteoarthritis include maintaining a healthy weight, engaging in regular low-impact exercise, using assistive devices if needed, and following a balanced diet rich in anti-inflammatory foods.


What are some common triggers for oral ulcers?

Common triggers for oral ulcers include stress, certain foods (like spicy or acidic foods), nutritional deficiencies, and underlying health conditions. Avoiding these triggers can help reduce the frequency of ulcers.


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