What could be causing stomach pain, fatigue, and weight loss?

Question

Hi doctor,

I have been experiencing persistent stomach aches along with weakness, pain in my arms and legs, and noticeable weight loss. I often feel dizzy and have been feeling unusually cold even in normal temperatures. These symptoms have been affecting my daily activities and overall energy levels.

The combination of digestive discomfort, muscle pain, and fatigue is concerning, and I would like to understand the underlying cause. I seek medical evaluation and appropriate tests to determine the reason behind these symptoms.

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and can understand your concern. While I cannot diagnose you, I can help you understand possible causes and suggest what you should bring up during a medical consultation.

Your key symptoms include:

Persistent stomach ache.
Weakness and fatigue.
Pain in arms and legs.
Unintended weight loss.
Dizziness.
Feeling cold despite normal temperatures.
Reduced energy, affecting daily activities.

Possible causes (grouped by system) in your case might include:

1. Endocrine disorders:

Hypothyroidism: Feeling cold, fatigue, and weight changes are classic symptoms.
Adrenal insufficiency (Addison's disease): This can cause dizziness, fatigue, muscle pain, and stomach discomfort.

2. Gastrointestinal causes:

Celiac disease or chronic gastritis (possibly Helicobacter pylori-related).
Malabsorption syndromes: This can lead to nutritional deficiencies (iron, B12, magnesium), which could explain fatigue and limb pain.
Inflammatory bowel disease (Crohn’s or ulcerative colitis): Might present with abdominal pain, weight loss, and systemic symptoms.

3. Nutritional deficiencies:

Vitamin B12 deficiency: Causes neurological symptoms like limb pain, weakness, dizziness, and fatigue.
Iron deficiency anemia: This can lead to fatigue, dizziness, cold intolerance, and paleness.

4. Autoimmune or inflammatory conditions: Lupus, rheumatoid arthritis, or polymyalgia rheumatica may explain fatigue, muscle or joint pain, and systemic issues.

5. Chronic infection or cancer: Tuberculosis, human immunodeficiency virus (HIV), or gastrointestinal (GI) cancers can present subtly with systemic symptoms including weight loss, weakness, and GI discomfort.

I recommend you undergo a few medical evaluations, which include:

Initial workup (blood tests):

Complete blood count (CBC).
Comprehensive metabolic panel (CMP).
Thyroid function tests (thyroid-stimulating hormone and free thyroxine).
Vitamin B12, folate, iron panel, and ferritin.
Inflammatory markers: Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP).
Celiac panel (anti-tissue transglutaminase (anti-TTG), anti-endomysial antibodies (EMA)).
Helicobacter pylori antigen or breath test.
HIV and tuberculosis screening (if risk factors present).

Further tests depending on initial findings:

Abdominal ultrasound or computed tomography (CT) scan.
Endoscopy or colonoscopy (if GI symptoms persist).
Autoimmune panel (antinuclear antibody (ANA), rheumatoid factor (RF)).
Hormonal evaluation (cortisol, adrenocorticotropic hormone (ACTH).

You must see an internist or general practitioner as soon as possible. Bring this list of symptoms and potential concerns. Mention all recent lifestyle or diet changes, medications, or stressors.

I hope this answers your query.

Thank you.