I am 23, female. Why am I losing weight and muscle daily?

Question

Hi doctor,

I am a 23-year-old female, with a height of 60 inches and a weight of 79 pounds. Why am I losing weight? I have been getting thinner and losing fat and muscle day by day for the past six years. Now I have lost so much weight and developed malnutrition and anemia, and have become so skinny that all my clothes do not fit me anymore. All of my shirts, pants, caps, and hats have become loose.

For the last four years, I have been living a sedentary lifestyle. I always stay at home and rarely go out. I do not do any exercise, sports, or extra physical activities, but I am still getting thinner daily. Whenever I walk or do some physical activity (stair climbing, running, etc.), I feel like I lose inches and I never gain them back. Sometimes I experience digestive issues, but they improve after taking multivitamin tablets.

I can perform my daily chores and physical activities only after taking my multivitamin or multimineral supplements. I gasp after climbing stairs and cannot walk properly because of weakness. I started eating four to five times daily, and I pass stools two to three times daily.

My periods are not regular, and there is a two- to three-month gap. I am a virgin with a low BMI. I do not smoke, and I have occasionally traveled every two to three months for the last four years. I have lost so much fat and muscle and have become very thin and weak.

My face also appears smaller, and I feel like my face and body are becoming thinner over time. My recent abdominal ultrasound was normal, except for Polycystic Ovarian Syndrome (PCOS) in the right ovary. Why am I losing weight, and why are my muscles getting thinner and weaker day by day?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Well, it is not easy to make a diagnosis out of this information at the moment. There are various causes within the abdomen and outside of the stomach for weight loss. Namely,

Celiac disease (sprue).
Whipple disease.
Others within the abdomen.
A systemic illness like myopathies (muscle disorder).
Infections like tuberculosis and HIV.

To reach a particular diagnosis amongst all the above, you must get some baseline investigation and show up to me, and then decide what to do further. The other is that you should see an internist in your area and get yourself physically checked. I write down the initial baseline workup.

I would suggest the following measures:

Complete blood count, liver function tests.
CPK (creatine-phosphokinase), serum amylase, and lipase.
TSH (thyroid-stimulating hormone),
Free T4 (thyroxine).
Free T3 (triiodothyronine).
stool detailed report.
stool for fecal calprotectin.
serum lactate, calcium, magnesium, phosphorus.
BUN (blood urea nitrogen) and creatinine test.
anti-TTG (Anti-tissue transglutaminase antibody).
IgA (Immunoglobulin A) and IgG (Immunoglobulin G).

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.