OpenHealth Q&A

Mystery of Unexplained Weight Loss

Greetings, everyone. I'm reaching out to share my recent experiences over the past couple of months and seek some insights. I'm a 28-year-old male and at the end of April, my weight was 67 kg. Gradually, I've noticed a decline, and currently, my weight hovers between 63.7 and 64.3 kg. The positive aspect is that my weight seems to have stabilized instead of continuing to decrease, and I hope it remains that way. This situation has raised some red flags for me, prompting me to undergo a series of tests to uncover the cause behind this unintended weight loss. One of the primary concerns that prompted my investigation was an abnormal leptin level. For someone with a lower body weight, I should have lower levels, yet two months ago, mine was 42, and a month back, it had only dropped to 37—quite elevated. This anomaly is concerning since elevated leptin is associated with inflammation and has been linked to serious health conditions, including advanced cancer. Consequently, driven by my weight loss and the elevated hormone level, I've been undergoing thorough examinations to find potential explanations. The tests I've undergone include a colonoscopy, gastroscopy, brain MRI, an abdominal ultrasound (including the urinary tract), testicular ultrasound, transabdominal prostate ultrasound, a TRUS prostate, and both chest and abdominal X-rays, along with multiple blood, urine, and stool analyses. Testing my prostate became necessary as I’ve experienced urge incontinence for about a year and frequently find myself waking up at night needing to urinate. My PSA levels were unexpectedly high for my age, measuring at 1.57, 1.43, and 1.63 over the past month. As for my test results, the concerning findings are highlighted below: - Significantly high leptin levels. - A PSA that is elevated for my age, with a free PSA ratio of only 14%, although the TRUS results indicated no abnormalities, just fibrosis in the prostate, suggesting past inflammation. - Diagnosis of duodenitis and esophagitis stemming from GERD. The rest of the results came back normal. This lack of clarity regarding my weight loss is perplexing. I have not altered my lifestyle or eating habits, so this unexpected change is baffling. I'm contemplating requesting a CT scan of my abdomen and pelvis to rule out anything that might have slipped through the cracks of my previous tests. Do you think it would be beneficial to pursue a CT scan? I wonder if it could reveal any issues with the pancreas or small intestine, which the ultrasound might not completely capture. I understand that at 28 years old, the likelihood of having advanced cancer causing weight loss is quite low, but this is the first time I've experienced such a decline in weight without a clear reason, which is a bit alarming. Although this period has been stressful, the weight loss began occurring before that, which leads me to believe that stress might not be the culprit, as my eating patterns remain unchanged. I appreciate any thoughts or advice you may have, and I apologize for the lengthy message!

Answers (1)

7/20/2025, 1:20:41 PM

OpenHealth AI

It’s understandable that experiencing unexplained weight loss and concerning test results can be alarming. Elevating leptin levels and changes in PSA, coupled with gastrointestinal issues, requires careful consideration to ensure you are addressing your health appropriately.

Key Points:

• You're experiencing unexplained weight loss, elevated leptin, and slightly elevated PSA levels.
• You've undergone extensive testing but still feel uncertain about the root cause of your weight loss.
• You are considering further investigation with a CT scan.

Explanation:

Unexplained weight loss can be caused by various factors, including gastrointestinal issues (like your diagnosed duodenitis and esophagitis), endocrine imbalances, or even psychosocial stressors, although you've indicated that stress doesn’t seem to be a contributing factor in your case. Elevated leptin can indeed reflect complex metabolic or inflammatory processes, and PSA results in younger men can sometimes be challenging to interpret without accompanying signs of prostate issues.

Given the extensive tests you've already completed, a CT scan can be a beneficial next step. A CT scan of the abdomen and pelvis can provide a more detailed view of internal organs, including the pancreas and small intestine, identifying any underlying issues not visible through other imaging techniques.

Next Steps:

1. Consider Requesting a CT Scan: Discuss with your healthcare provider the potential benefits of a CT scan to further investigate your abdominal and pelvic regions. It can help rule out or confirm concerns about internal organs.

2. Monitoring Symptoms and Weight: Keep tracking your weight closely and note any additional symptoms, such as changes in appetite, digestion issues, or new physical symptoms (fatigue, pain, etc.). This information can be useful for your healthcare provider.

3. Review Dietary Habits: Although you mentioned no changes in eating habits, consider maintaining a food diary for a couple of weeks to ensure you're getting adequate caloric intake and nutrients. Sometimes, even unintentional subtle changes can affect weight.

4. Consult Your Doctor About Leptin and PSA: Discuss the implications of your elevated leptin and PSA levels with your doctor to understand what further evaluations or monitoring might be prudent.

5. Seek Support: In times of uncertainty, talking about your concerns with a trusted friend or a mental health professional can also provide support and help alleviate some stress.

Reassurance:

While it's good to be proactive, many conditions can cause weight changes that aren’t serious. Trust your instincts and keep communicating with your healthcare team about your concerns. You're not alone in navigating this situation.