Unexplained Weight Increase
At 23 years old, my weight transformation has been alarming. In August 2023, I tipped the scales at 58 kg, but only six months later, I found myself weighing 73 kg. Despite my active lifestyle and a calorie intake of just 1,400 a day, I seemed to be gaining weight at an unprecedented rate. The only way I could shed any pounds was by drastically reducing my food intake. Recently, when I visited my general practitioner, she dismissed my concerns and suggested that all the added weight was purely muscle mass. I was skeptical and expressed my worry about my family’s history of hypothyroidism, which prompted me to request a blood test. Initially, she was reluctant, claiming the NHS was overwhelmed and suggesting I shouldn’t expect such tests frequently. Nevertheless, I was eventually given one. The thyroid test revealed a Serum TSH level of 4.72 miu/L, which falls within normal ranges. Further blood work returned mostly normal results, aside from a slight deficiency in iron, for which I started taking supplements. However, my concerns grew as I continued to notice an increase in body fat, despite not hitting the gym as often (though I still maintain some activity). I urged her for another round of blood tests since my weight wasn't stabilizing. Again, she reprimanded me, asserting that the NHS permits only one blood test annually, which I found to be quite unreasonable, especially since I have monitored my thyroid levels multiple times at a young age. Currently, I’m still consuming very few calories yet witnessing a rapid gain in weight. To mitigate this, I've incorporated running two miles daily, along with intermittent fasting and gym sessions, but the situation remains unchanged. Here are the rest of my blood test results: **Liver and Bone Profile:** - Total bilirubin: 5 umol/L - Alanine aminotransferase: 22 iu/L - Alkaline phosphatase: 59 iu/L - Total protein: 72 g/L - Albumin: 38 g/L - Globulin: 34 g/L - Calcium: 2.20 mmol/L - Adjusted calcium: 2.22 mmol/L **Full Blood Count:** - Hemoglobin: 122 g/L - Total white blood cells: 6.33 10^9/L - Platelets: 277 10^9/L - Hematocrit: 0.375 - Red blood cell count: 4.41 10^12/L - Mean cell volume: 85 fL - Mean cell hemoglobin: 27.7 pg - Mean cell hemoglobin concentration: 325 g/L - Red blood cell distribution width: 14.6% - Neutrophils: 2.50 10^9/L - Lymphocytes: 3.23 10^9/L - Monocytes: 0.36 10^9/L - Eosinophils: 0.21 10^9/L - Basophils: 0.03 10^9/L **Urea and Electrolytes:** - Serum sodium: 140 mmol/L - Serum potassium: 4.0 mmol/L - Serum urea: 4.9 mmol/L - Serum creatinine: 74 umol/L **HbA1c:** - Hemoglobin A1c: 36 mmol/mol **Serum Ferritin:** - 8 ng/mL **eGFR:** - Greater than 90 (using creatinine per 1.73 square meters)
Answers (1)
3/20/2025, 12:20:59 PM
OpenHealth AI
It sounds like you’re experiencing a concerning and frustrating issue with weight gain despite maintaining an active lifestyle and eating very few calories. Let’s break this down and address your concerns thoughtfully.
Main Points
- Weight gain can have many causes, including hormonal imbalances, metabolic issues, or stress factors.
- Your blood test results showed a thyroid-stimulating hormone (TSH) level within the normal range, but high levels can still signify an underlying issue in some cases.
- Iron deficiency may also contribute to how your body metabolizes energy, affecting weight management.
Explanation
Despite your TSH levels being within the normal range, it's important to understand that hypothyroidism can manifest in various ways. Since you have a family history of hypothyroidism, it's reasonable to keep monitoring your thyroid function, as symptoms can vary and sometimes arise within normal lab ranges.
Your slight iron deficiency (as indicated by a ferritin level of 8 ng/mL) suggests that your body may not have enough iron to carry oxygen effectively, which can lead to fatigue and a reduced metabolic rate, complicating weight management.
High stress levels, lack of sleep, or dietary imbalances could also contribute to changes in body composition, even when maintaining activity and caloric restriction.
Next Steps
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Monitor Your Symptoms: Keep a detailed diary of your weight, dietary intake, energy levels, exercise routines, and any other symptoms you may experience. This information will be valuable for any future doctor visits.
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Consider a Wellness Check: Even though the NHS has protocols for blood tests, voicing your ongoing weight concern can help you advocate for further tests if necessary. You might request specific screenings for adrenal function (like cortisol levels) or a repeat thyroid panel, including free T4 and antibodies, to rule out more subtle thyroid issues.
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Focus on Iron-Rich Foods: Along with iron supplements, increase dietary intake of iron-rich foods, such as lean meats, beans, lentils, dark leafy greens, and fortified cereals. Pair these with vitamin C-rich foods (like oranges or bell peppers) to improve iron absorption.
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Evaluate Stress and Sleep: Pay attention to your stress levels and quality of sleep, as both can significantly impact weight. Consider mindfulness practices or relaxation techniques, and aim for a regular sleep schedule.
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Assess Your Caloric Needs: You might want to review your dietary intake with a nutritionist who can help you ensure that you're meeting your nutritional needs while managing your calorie intake effectively.
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Stay Active: Continue with your physical activities. Consistent, varied exercise can help improve metabolism and muscle tone, which is beneficial in managing weight.
Reassurance
Your concerns are valid, and addressing them proactively is the best approach. Keep monitoring your situation and consider seeking further advice if your weight gain continues or if new symptoms arise. Remember that you're not alone, and there are pathways to feeling better and achieving your health goals.
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