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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8781
Experience:  Doctor of Medicine
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A complex query for a digestive tract expert re XXXXX XXXXX,

Resolved Question:

A complex query for a digestive tract expert re XXXXX XXXXX, aged 77
I already suffer from diabetes type 2, rheumatoid arthritis (now spread to the lung),barretts syndrome (not inflamed),osteoporosis (arms particularly)

For the past 9 -12 months I have increasingly lost all appetite and lost 10kgs plus of weight down to approx 75kgs now. For months this was a curiosity but not too problematic. Not long before Christmas I felt increasingly sick and was eventually reduced to Complan and a special fruit drink and just do not want to eat. In the meantime I have had 2 CT scans and one endoscopy. All three were completely clear. However I still feel very weak and ill and cannot help getting the impression from local doctors that their machines are never wrong. I have a follow up appt next week. Can you possibly think of anything to account for this?

Current medication 3mgs twice/day lansoprazole, 3 doses sulphasalazine twice/day, I metformin tablet and one allopurinol per day, 2 tablets of Domperidone 3 times day, 250mgs diltiazem per day.

Happy to give extra information
Thanks for any help you can give.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. SH replied 3 years ago.

Dr. Shahzad MD :

Hi there.

Dr. Shahzad MD :

Thank you for your question.

Dr. Shahzad MD :

I will be helping you out with your queries.

Dr. Shahzad MD :

If you have not had a thyroid function test done that is the first thing that I would like that you should have done because it is a very common problem and can cause unintentional weight loss.

Customer:

had a thyroid check done but not very recently

Dr. Shahzad MD :

There is a list of other causes that should be considered as well:


Addison's disease (for which you will require a blood cortisol or a salivary cortisol level done)
Cancer (which is being considered which is why you have had the CT scan all the tests)
Celiac disease (which is a condition in which there is reduced absorption of nutrients and can happen at any age)
Depression (if you have been depressed lately it can lead to weight loss and loss of appetite)
Diabetes (if your blood glucose has not been well controlled it can cause this to happen as well)

Dr. Shahzad MD :

You should have your thyroid function repeated as well.

Dr. Shahzad MD :

Heart failure (I am sure that they would have checked for that and if you had heart failure you would have been really short of breath one walking)
HIV/AIDS (which you may have had done with an HIV test, this test is not required if you have been practicing safe sex and monogamous)

Dr. Shahzad MD :

Hypercalcemia (a high calcium level should be looked at and ruled out)
Tuberculosis (sometimes presents only with weight loss and there is no other clue. A very high ESR or CRP may be the only clue)

Dr. Shahzad MD :

So I would like that the above conditions should be considered and ruled out.

Dr. Shahzad MD :

Are you with me?

Customer:

yes, I follow. Don't actually know which of these tests has been completed

Dr. Shahzad MD :

I understand. Just make a note of these things and discuss with your doctor.

Dr. Shahzad MD :

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Dr. Shahzad MD :

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Dr. Shahzad MD :

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Dr. Shahzad MD :

Kindest Regards

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