Weight Loss and Excessive Sleep: A Concern
Summary: Age 33, Female, standing at 5 feet 2 inches and weighing 120 pounds. Currently diagnosed with Myasthenia Gravis and Cutaneous Lupus. Medications currently prescribed: - IVIG infusions - Imuran (azathioprine) 75 mg – recently initiated approximately one month ago following a hospitalization due to an Myasthenia Gravis crisis - Hydroxychloroquine 200 mg - Cymbalta 60 mg Current situation: In the past month, I have noticed some concerning changes in my well-being. Recently, I discovered that I've shed around 15 pounds over the course of just one month. I am battling severe fatigue and find myself sleeping the majority of the day, yet I still awaken feeling drained after a full night's slumber. Additionally, I'm facing issues such as swollen joints, pronounced rashes, and some thinning of my hair. This ongoing situation is significantly impacting my ability to work and carry out everyday tasks. Unfortunately, both my neurologist and rheumatologist have departed from their respective practices, resulting in a lack of specialist follow-up until June. My primary care physician is insistent that I need to consult with a specialist soon. My inquiry: Could the new symptoms I am experiencing be related to the side effects of Imuran or might there be another underlying issue? Some of the symptoms appear to be linked to lupus, though historically, my lupus has primarily affected my skin. The last time I had blood work done, which was about a month ago, my white blood cell count was slightly below normal.
Answers (1)
2/9/2026, 6:10:35 PM
OpenHealth AI
It seems that you are experiencing several concerning symptoms, including significant weight loss, severe fatigue, prolonged sleepiness, swollen joints, rashes, and thinning hair. These changes can indeed be distressing and may be related to your medications or the underlying conditions you have.
Explanation:
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Medications: Imuran (azathioprine) is known to have side effects that can include fatigue, nausea, and hair loss. Hydroxychloroquine can also affect your energy levels, though it is primarily used to help manage lupus symptoms. The combination of these medications might be contributing to your feelings of exhaustion and possibly the weight loss due to decreased appetite or increased metabolism.
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Underlying Conditions: Your primary health issues, Myasthenia Gravis and Cutaneous Lupus, can cause fatigue and exacerbate symptoms such as joint pain and skin rashes. Lupus can also lead to systemic symptoms that affect energy levels and well-being.
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Current Symptoms: The below-normal white blood cell count you mentioned could further contribute to feeling unwell, making you susceptible to infections, which may explain your fatigue and sleepiness.
Next Steps:
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Hydration and Nutrition: Focus on staying well-hydrated and consider small, frequent meals that are rich in nutrients to help manage weight and energy levels. Foods high in protein and healthy fats can support your body.
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Symptom Tracking: Keep a daily diary to track your symptoms, noting when they worsen or improve, including details about your sleep patterns, joint swelling, rashes, and any other changes. This can provide valuable information when you are able to see a specialist.
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Communication with Primary Care: Schedule an appointment with your primary care physician sooner if you notice worsening symptoms, such as increased fatigue, persistent fever, or new rashes. They might be able to run additional tests or adjust medications in the interim before you see a specialist.
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Explore Alternative Specialist Options: Since your specialists have left, consider looking for other rheumatologists or neurologists in your area. Many clinics may be accepting new patients and could provide the specialized care you need sooner than June.
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Prioritize Rest: While it is essential to be active, your body is signaling the need for significant rest. Allow yourself the time to recover by balancing light activities with periods of rest.
Please remember that these recommendations are intended to provide support until you can see a healthcare provider. If you experience severe changes, such as difficulty breathing, chest pain, or other alarming symptoms, it would be important to seek immediate medical attention.
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