Mysterious Symptoms Persist for Nearly Three Years with No Diagnosis: Unexplained Weight Fluctuations and Elevated ESR
As a 36-year-old woman from the Middle East, standing at 164 cm and weighing 89 kg, I lead a life devoid of smoking or drinking, and currently, I am not on any medication. Five years ago, I underwent a Septoplasty to address an internal deviated septum, which incredibly alleviated a chronic sinus condition that had plagued me for 17 years. However, nearly three years ago, I unexpectedly began to gain weight, skyrocketing from 72 kg. Initially, I attributed this change to my sedentary job, where I spend the entirety of my working hours in front of a computer. Despite having maintained this office role for eight years without previous weight changes, the sudden growth in size baffled me. Alongside the weight gain, I started experiencing severe, widespread pain and debilitating fatigue each day. I became sensitive to cold for the first time in my life and often found myself sleeping less than five hours due to constant discomfort. My face, legs, and hands became noticeably swollen, and I grappled with a poor appetite; in fact, just a cup of milk could keep me feeling full for over 12 hours, at which point I'd realize I hadn’t consumed anything since breakfast. Furthermore, my fingers exhibited stiffness upon waking, requiring significant effort to regain movement. Along with these issues came bouts of dizziness and persistent brain fog. In an attempt to improve my situation, I altered my diet and became more active—engaging in walking, running, and gym workouts. Yet, rather than shedding pounds, I noticed my swelling intensified. My muscles were often on the verge of tearing, leading my doctor to recommend gentler exercises. Despite reducing my workout intensity, the swelling persisted, often worsening during physical activity. I have undergone numerous medical tests from various specialists, including assessments for thyroid, kidney, and liver function; all results returned normal except for a consistently elevated ESR, ranging from 30 to 80, with a peak at 84 when not on antibiotics. Complement levels C3 and C4 showed 246 mg/dl and 105.8 mg/dl respectively. Other tests, like CCP, Anti-ds-DNA, and rheumatoid factor, yielded negative results. Despite consulting with many healthcare professionals—including internists, immunologists, and orthopedists—no one has been able to determine the cause of my symptoms. I also tried Plaquenil at a dosage of 200 mg, which did assist in reviving some of my energy, but nothing more substantial came out of it. Recently, I’ve enjoyed better sleep over the past two months and have improved my diet by incorporating three meals a day for the last five months. While I've also managed light exercise through walking, my weight remains stagnant, and the swelling is worsening. Sometimes, the swelling in my feet becomes so severe that I can no longer walk, as my shoes tighten uncomfortably, and wearing socks feels constricting. I consistently experience numbness and joint stiffness. I find myself exhausted, unable to exercise properly, lose weight, or regain my flexibility. It feels as though my body is gradually stiffening, resembling a log of wood, despite my earnest efforts. This seems like a lingering, unexplained medical condition. What steps should I take next?
Answers (1)
2/12/2026, 12:31:53 AM
OpenHealth AI
I'm sorry to hear that you've been experiencing these persistent and complex symptoms. It sounds incredibly challenging, and it's commendable that you've made efforts to improve your diet and activity levels despite the difficulties. Let's focus on how you can address your situation moving forward.
Key Points:
- You have unexplained symptoms, including weight fluctuations, fatigue, swelling, and elevated ESR, despite extensive testing.
- It's essential to continue monitoring your symptoms and considering potential underlying conditions.
- Exploring a holistic approach with lifestyle changes and symptom management might help alleviate some discomfort.
Explanation:
Your symptoms, such as unexplained weight gain, widespread pain, fatigue, swelling, and elevated ESR, indicate that your body may be dealing with some form of systemic inflammation or rheumatologic condition. Elevated ESR suggests an ongoing inflammatory process, but without clear identification, it can be frustrating. Your tests ruled out several potential issues, which leaves you in a challenging position.
While waiting for a definitive diagnosis can be frustrating, there are still several steps you can take to manage your symptoms and potentially improve your quality of life.
Next Steps:
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Continue Monitoring Symptoms:
- Keep a detailed journal of your symptoms, diet, activity levels, and any changes in your health. This can help identify patterns or triggers and is valuable information for doctors.
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Joint and Muscle Care:
- Incorporate gentle stretching and flexibility exercises daily to combat stiffness. Yoga or physical therapy can be beneficial if tailored to your needs. It's important to find activities that don't exacerbate your swelling.
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Evaluate Your Diet:
- Consider keeping a food diary to track your diet and any correlations with changes in your symptoms. Some individuals find relief by reducing inflammatory foods, such as processed items, sugar, and dairy, while increasing anti-inflammatory foods like fatty fish, nuts, seeds, fruits, and vegetables.
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Hydration:
- Ensure you are drinking enough water throughout the day. This can help manage swelling and improve overall health.
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Consider Alternative Therapies:
- Look into acupuncture or therapeutic massages, which can sometimes provide relief for chronic pain and improve circulation.
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Home Modifications:
- Use supportive footwear and consider compression socks or sleeves to help manage swelling in your feet and legs. Elevating your legs when sitting or lying down can also reduce swelling.
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Follow-Up with a Specialist:
- Since you have seen numerous specialists, it might be worth discussing the possibility of a rheumatologist who specializes in complex cases. Ensure that you communicate all your symptoms clearly, as some autoimmune conditions can take time to manifest in tests.
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Consider a Multidisciplinary Approach:
- If you haven’t already, you might benefit from a team approach involving nutrition, physical therapy, and possibly a psychologist or counselor to help cope with the emotional toll of your symptoms.
Support and Reassurance:
It’s understandable to feel overwhelmed with these ongoing health challenges, especially when seeking answers can seem like a long road. Remember that you are advocating for your health, which is an essential part of the process. Take small, manageable steps to care for your well-being, and don’t hesitate to reach out for support from friends, family, or support groups who understand chronic health issues. You're not alone in this journey.
Feel free to ask if you have further concerns or if something specific needs addressing!
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