Answered by Dr. Uphar Gupta

Recent health issues: weight gain and hair loss. Why?

Hello doctor,

I am a 43 year old female. My height is 5 feet 6 inches, and I weigh 185 lbs. I feel awful. Please tell me what you think may be wrong. Most of my adult life weight was 150 to 155 lbs. A sudden weight gain started five years ago. My weight is now always in the 175 to 185 range. I eat an extremely healthy diet. I do not eat any processed meat, almost no processed food, wheat, sugar or dairy. I eat only whole foods. I cannot control my weight unless I starve. The majority of the weight is concentrated only in the abdomen, breast, neck, and face. I have isolated fat pockets shaped like eggs above the collar bones, and my face is round and red. My upper back has an odd fat hump. My legs and arms are thin, calves too thin, butt too small, and, I look nine months pregnant.

I was bulimic from the age of 23 up to 40. I still struggle with eating disorders, but I am not purging as much as I used to. Osteopenia was detected last year. I have lowered energy, generalized fatigue, and muscle weakness from the past two years. My sleep issues have gotten much worse in the past four or five years. I have trouble falling asleep, and sometimes I am awake throughout the night. I have depression, anxiety and get extremely emotional of late. I suffered a nervous breakdown, extreme sensitivity, paranoia, high anxiety, and worry. I rarely, if ever, leave the house. So, I have no friends. Sometimes, I will not even go outside for two or three weeks at a time. My cognitive difficulties have become very noticeable in the past three years or so. I often cannot find words, have trouble with spatial intelligence, have no short term memory, have difficulty with long-term memory as well. I feel lost like I am floating.

I have had a high blood pressure for at least five years now, but it was never officially diagnosed. My BP still fluctuates and is not controlled with the daily 20 mg Lisinopril. My legs and feet have been swollen for the past three or four years. My hands and neck too sometimes look swollen and puffy. My feet feel hot and sweaty often. I have high cholesterol levels from five years, but it is currently untreated. My legs, arms, and hands bruise extremely easily. It takes a very long time to heal. The skin on my hands and arms are thin and shiny, The skin of my upper arms, hands, and face, have lots of broken capillaries. My hair once almost fell out completely, about 60 percent of it, all at once. Now my hair is odd, thin and dry. I also notice some increased facial hair in the past year. I have toenail fungus from the previous five years or so. I had three rounds of anti-fungal treatment, but it would not go away. 

I have acid reflux from the past three or four years. I always have constipation, which has gotten worse over the past five or six years. I have extreme bloating from the past five or six years. It happens anytime I eat, irrespective of what type of food it is. I first encountered kidney stones five years ago and had to undergo surgery the same year and, one again in the subsequent year. I was informed by my urologist that I have many stones. I have passed one since, but do not know how much more I have. About seven years ago, I had some inflammatory eye problem, which I was told was chalazia. I still have trouble with both the eyes. Sometimes, they are painful, and I spend the morning with a blurred watery vision. I was diagnosed with scoliosis as a teenager, for which I underwent a spine reconstruction surgery last year.  I am recovering well, but do not know yet if the bone graft was a complete success. I still experience some pain. I had a rectocele repair surgery twenty years ago. I still have some issues, but I think it is due to chronic constipation. Also, I have recurring hemorrhoid which I also believe is due to chronic constipation. I have been on some form of opioid for the past two years. And, the six months following my surgery, I was on extremely strong medicines. I took Dilaudid for about three months.

I had lab tests done ten days prior, and I am concerned about few values. Cortisol - 19.5, ACTH-Mayo - 63 pg/mL , FSH - 6.4 mlU/mL, LH - 2.1 mlU/mL, Progesterone - 0.21 ng/mL, and Estradiol - 21. I have stopped all of my supplements for about two months except collagen and biotin. I did not think it would affect any of my results. Then, I read that biotin can cause false high positives. I do not think this would have impacted my results, as they are all relatively low. Also, as I noted, the cortisol and ACTH is supposed to be tested around 8 AM, but I was not tested until noon.

07 May 2024 - 1 min read

Can a person have cervical cancer with negative pap smear?

Hi doctor,

I am a 19-year-old female with a weight of 60 kilograms. I have consulted many doctors to know the cause of my issue. I have a list of symptoms such as headache, swollen lymph nodes, chest pain, bone, muscle, and joint pain, low-grade fever, pelvic pain, irregular periods, vaginal discharge, loss of appetite, weight loss, bright bloody stool, constipation, fatigue, and abdominal pain. I have done two CT scans of the abdomen and pelvis. But nothing was shown. I did a transvaginal ultrasound six months back. It does not show any cysts on my cervix. I did a CT scan and MRI of my head and nothing was shown. A CT scan of the throat was taken and nothing was shown.

An ultrasound of the abdomen was taken and it showed a 6 mm polyp on my gallbladder. My ultrasound of the pelvis does not show anything. I took an X-ray on my chest, back and pelvis. Nothing was shown. A degenerative disc was shown in my lower back. I have done all types of blood tests. Everything came back normal. Now, I have a polyp in my gallbladder, a while lesion on my cervix which was found during a pelvic examination, and a degenerative disc in my lower back. I had a pap smear and nothing abnormal was found. CBC, ANA, blood test for RA, lupus came back negative. Lyme disease and Rocky mountain fever came back negative. I can see a trace of blood in my urine. I have lost the urge to urinate. Can I have cervical cancer which is not being found in any scans or blood tests? I do not have any anxiety regarding my pain. Kindly help me.

03 May 2024 - 1 min read

How to understand the outcome of a brain tumor surgery?

Hi doctor,

Three months back, I had CyberKnife surgery for a brain tumor. Today, I had my MRI again. I want to know the report. Please explain.

25 Apr 2024 - 1 min read

What could be causing persistent diarrhea, allergies, and malabsorption issues?

Hello doctor,

I am 21 years old and at the age of 18, I began experiencing severe, unexplained diarrhea during lunchtime, which continues to this day. I have been cleared of Crohn's disease, but a doctor at the emergency room suggested celiac disease based on observations of my eyes and mouth. Despite a normal celiac blood test, my gallbladder blood test appeared fine, although a subsequent scan revealed a complete blockage. I have a barium swallow and MRI scheduled. Will these tests help diagnose celiac disease? I frequently end up in the emergency room due to throat and lip swelling, along with a recurring rash and persistent bruising. I also have malabsorption and undetectable vitamin D levels. Additionally, a few years ago, I discovered I was allergic to orange juice after months of constant vomiting.

Thank you.