[52F] Experiencing hiccups, weight loss, and hair loss post-hysterectomy

Patient Description

A 52-year-old female presents with daily hiccups, cold chills without fever, significant weight loss, loss of appetite, hair loss, vision changes, and persistent nausea. The patient reports a weight decrease from 140 to 105 pounds within the past year, with the most significant loss occurring after a total hysterectomy performed in September 2023. Appetite changes began with a sudden aversion to sweets and progressed to feeling full after eating only a small amount. Hair loss is particularly noticeable around the temples and has been ongoing for several months. The patient has a history of seronegative rheumatoid arthritis, migraines since 1994, and severe COVID-19 in 2021. Current medications include Plaquenil, Topamax, Lipitor, Trazodone, Estradiol (started September 2023), B-12, Levothyroxine, Omeprazole, and Naratriptan as needed for migraines. The patient also takes Vitamin E and Calcium supplements as recommended by a doctor. No known allergies to medications except for sulfur drugs, Cimzia, and contrast dye. The patient has not reported any side effects from current medications and has recently stopped taking an unspecified medication.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Malnutrition: This can result from not eating enough, not eating enough of the right things, or being unable to use the food that one does eat. Symptoms can include unintentional weight loss, fatigue, and hair loss.

    • Treatment typically involves replacing the missing nutrients, improving diet, and treating the underlying cause of malnutrition.
  • Hyperthyroidism: This is a condition where your thyroid gland produces too much of the hormone thyroxine. Symptoms can include unintentional weight loss, increased appetite, irritability, and hair loss.

    • Treatment typically involves medication to slow down your thyroid, and in some cases, surgery may be necessary.
  • Gastrointestinal issues: Conditions such as gastritis, peptic ulcer disease, or gastroparesis can cause feelings of fullness after eating only a small amount of food, weight loss, and nausea.

    • Treatment typically involves medication to reduce stomach acid and in some cases, dietary changes.
  • Depression or Anxiety: These mental health conditions can cause a variety of physical symptoms, including loss of appetite, weight loss, and feeling cold.

    • Treatment typically involves a combination of medication and talk therapy.
  • Autoimmune conditions: Given your history of rheumatoid arthritis, it's possible that another autoimmune condition could be contributing to your symptoms. Conditions like lupus can cause hair loss, feeling cold, and gastrointestinal issues.

    • Treatment typically involves medication to manage symptoms and prevent flare-ups.

What you can do

Given the variety of potential causes for your symptoms, it's important to consult with a healthcare provider for a thorough evaluation. They may want to run some tests, including blood tests and possibly imaging studies, to help determine the cause of your symptoms.

In the meantime, try to maintain a balanced diet as best you can, even if you're not feeling hungry. Eating small, frequent meals may be more manageable than trying to eat three larger meals a day. Staying hydrated is also important, especially if you're feeling nauseous.

What you should look out for

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

  • Severe abdominal pain
  • Persistent vomiting
  • Black, tarry stools
  • Confusion, difficulty speaking, or changes in your vision
  • A fever (temperature over 100.4°F) or chills

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis and treatment.

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People Also Ask


What could be causing my persistent nausea and loss of appetite?

Persistent nausea and loss of appetite can be caused by various conditions, including gastrointestinal issues like gastritis or gastroparesis, hyperthyroidism, or even psychological factors such as depression or anxiety. It's important to consult with a healthcare provider for a thorough evaluation.


How can I manage significant weight loss and malnutrition?

Managing significant weight loss and malnutrition involves addressing the underlying cause, improving dietary intake, and possibly supplementing with necessary nutrients. Eating small, frequent meals and staying hydrated can help. A healthcare provider can offer personalized advice and treatment options.


Could my hair loss be related to my thyroid or autoimmune conditions?

Hair loss can be associated with thyroid disorders like hyperthyroidism or autoimmune conditions such as lupus. Both conditions can disrupt normal hair growth. It's advisable to discuss these symptoms with a healthcare provider who may recommend specific tests to determine the cause.


What are the potential side effects of my current medications?

The medications you are taking, such as Plaquenil, Topamax, and Levothyroxine, can have side effects that might include gastrointestinal issues, changes in appetite, or hair loss. It's important to review these with your healthcare provider to determine if any medication adjustments are needed.


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