[56F] Experiencing itchy skin, shoulder pain, and nasal stuffiness

Patient Description

A 56-year-old female reports a week-long occurrence of itchy skin without visible hives or rash, primarily affecting the upper back and lower calves. The itchiness is described as random and feels like tiny mosquito bites under the skin. Additionally, the patient has a stuffy left side of the nose and has been experiencing chills. She also mentions fatigue and shoulder pain that has persisted for 6 months, which worsens with arm movement and after weightlifting but subsides shortly after. The pain is localized between the collar bone and shoulder and is rated as a 5 out of 10 in severity. The patient has a history of Hashimoto's disease, for which she takes 100mcg of levothyroxine daily. She has been practicing intermittent fasting and consumes Kachava, a meal replacement shake. No other medications or supplements are being taken, and the patient has an allergy to Bactrim. No recent injuries, fever, night sweats, or unexplained weight loss were reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible explanations for your symptoms include:

  • Allergic Reaction: Allergies can cause symptoms like itching, stuffy nose, and fatigue. They can be triggered by a variety of substances, including food, medication, and environmental factors.

    • Treatment typically involves avoiding the allergen and taking antihistamines to manage symptoms.
  • Dry Skin or Dermatitis: Dry skin or dermatitis (inflammation of the skin) can cause itching. This can be due to environmental factors, such as dry air, or certain soaps or detergents.

    • Treatment usually involves moisturizing the skin and avoiding irritants.
  • Hashimoto's Disease: This is an autoimmune condition that can cause fatigue and other symptoms. It can also cause changes in skin sensation, although this is less common.

    • Treatment typically involves hormone replacement therapy, which you are already receiving.
  • Musculoskeletal Strain or Injury: Your shoulder pain could be due to a musculoskeletal strain or injury, especially given your regular weightlifting routine.

    • Treatment often involves rest, ice, and over-the-counter pain relievers. Physical therapy may also be helpful.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms. It's important to consult with a healthcare provider for a formal diagnosis.

What you can do

In the meantime, here are some things you can try:

  1. Keep a symptom diary to track when your symptoms occur and any potential triggers. This can be helpful information to share with your doctor.
  2. Try over-the-counter antihistamines to see if they help with your itching.
  3. Moisturize your skin regularly and avoid harsh soaps or detergents that could be irritating your skin.
  4. Rest your shoulder and avoid lifting heavy weights until you can see a doctor. Applying ice to your shoulder for 15 minutes at a time may also help with the pain.

What you should look out for

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

  • Difficulty breathing or swallowing
  • Swelling of your face, lips, tongue, or throat
  • Severe pain, especially if it's associated with weakness, numbness, or tingling
  • Symptoms that are worsening or not improving despite self-care measures

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

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1 yr ago

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People Also Ask


What could be causing my itchy skin without a visible rash?

Itchy skin without a visible rash can be caused by several factors, including allergies, dry skin, or dermatitis. Environmental factors, such as dry air or irritants like certain soaps, can also contribute. It's important to identify and avoid potential triggers and consider using moisturizers or antihistamines to manage symptoms.


How can Hashimoto's disease affect my overall health and symptoms?

Hashimoto's disease is an autoimmune condition that primarily affects the thyroid, leading to symptoms like fatigue, weight gain, and sensitivity to cold. It can also cause changes in skin sensation, although this is less common. Treatment usually involves hormone replacement therapy to manage thyroid hormone levels.


What are some common treatments for shoulder pain related to weightlifting?

Common treatments for shoulder pain related to weightlifting include rest, ice application, and over-the-counter pain relievers. Avoiding activities that exacerbate the pain and considering physical therapy can also be beneficial. It's important to ensure proper form and technique during weightlifting to prevent further strain.


Can intermittent fasting and meal replacement shakes like Kachava affect my symptoms?

Intermittent fasting and meal replacement shakes like Kachava can affect your symptoms, especially if they lead to nutritional imbalances or changes in energy levels. It's important to ensure you're getting adequate nutrition and to monitor how these dietary choices impact your overall health and symptoms.


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