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 had lowered energy, generalized fatigue, and muscle weakness for 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, and have difficulty with long-term memory as well. I feel lost, like I am floating.

I have had 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 often feel hot and sweaty.

I have had high cholesterol levels for 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 is thin and shiny. The skin of my upper arms, hands, and face has 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 noticed some increased facial hair in the past year. I have had toenail fungus for the previous five years or so. I had three rounds of anti-fungal treatment, but it would not go away.

I have had acid reflux for the past three or four years. I have always had constipation, which has gotten worse over the past five or six years. I have had extreme bloating for 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 I do not know how much more I have. About seven years ago, I had some inflammatory eye problems, which I was told was chalazia. I still have trouble with both 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 I 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 a 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 are supposed to be tested around 8 AM, but I was not tested until noon.

Please advise.

Thank you.

Thank you, doctor, for the reply.

I did haveTSH levels tested. It was in the normal range. I also had a 24UFC that was normal. I do feel like I match so many of the Cushing's symptoms. I am quite positive that I have never taken a steroid as a pain relief or as a supplement. If the TSH is normal, and ACTH is high, serum cortisol slightly elevated, but 24UFC normal could that still be Cushing's?

And, if you are attributing all the symptoms to hypothyroidism, is Cushing's also a type of hypothyroidism? If not, what is leading me to it? Why are my FH and LSH so low? That does not seem to fit any of the parameters. If it is Cushing's, what do I do about it?

If you could please look again, answer my questions and send any further suggestions as to my next steps, I would be so grateful. I am so tired, I can barely move and I feel like I have lost my life.

Please advise.

Thank you, doctor, for the reply.

I have one last question. Does my normal result for the24UFC, rule out Cushing's?

Should I have that test repeated?

Please advise.