What is the reason for nausea and loss of appetite?

Hi,

Welcome to icliniq.com.

I have gone through and understand your concern.

Based on your query, my opinion is as follows:

Increased serum ferritin (a marker of chronic inflammation) along with symptoms of nausea, loss of appetite, and morning discomfort suggests a gastric cause, likely chronic gastritis with mild esophagitis (inflammation of the stomach and esophagus).

A normal endoscopy can occasionally miss mild inflammation. The weight loss and muscle loss you described are likely due to poor appetite and reduced calorie intake, leading the body to use muscle protein for energy. This reduced intake may also explain the low sodium levels.

If thyroid hormone levels are normal after taking Levothyroxine, then the medication is working. However, if TSH is low and T3/T4 are high, the Synthroid dose may need adjustment. Please share the latest thyroid values for further guidance. Low thyroid levels can cause fatigue, appetite loss, and weakness, so monitoring is essential. Since Finasteride has been discontinued, it is unlikely to contribute to current symptoms.

At present, the most likely issue is chronic inflammation of the stomach or esophagus. Continue Omeprazole 20 mg twice daily, as it can take two to three weeks for full acid control and symptom improvement.

Additional recommendations:

• Eat small, regular meals (four to six times daily).
• Avoid spicy, fried, or sour food.
• Follow a protein-rich diet and stay well-hydrated (25 to 33 cups of water/day).
• Practice stress reduction through meditation or counseling.
• Maintain regular sleep (eight to nine hours at night).
• Engage in moderate physical activity.

Investigations advised:

• Thyroid profile (TSH, T3, T4).
• Hemoglobin and complete blood count (CBC).
• Erythrocyte sedimentation rate and C-reactive protein (CRP) for inflammation.
• Stool examination to rule out malabsorption or parasitic infection.
• Blood sugar levels are to ensure normal metabolism.

Overall, your symptoms and laboratory findings point toward chronic gastritis with systemic inflammation. Managing acidity, improving nutrition, and addressing any thyroid imbalance will help restore your energy and appetite.

If nausea persists, Domperidone may be added under medical supervision to reduce vomiting and discomfort.

I hope this helps you.

Thank you.

Hi,

Welcome back to icliniq.com.

I reviewed the attached laboratory values (attachment removed due to patient identity protection). Based on your query and the results, here is my opinion:

Thyroid hormone levels are within the normal range, indicating that Levothyroxine is effective and necessary. With normal TSH and T4, there is no current thyroid concern.

Some variation in testosterone is normal. Since muscle mass and energy were adequate before symptom onset, there is no immediate concern. Exogenous testosterone may only be needed if infertility, impotence, or specific symptoms appear. Values near the lower limit can still be normal in some individuals. Decisions should be based on clinical symptoms, not laboratory values alone.

Mild inflammation is the likely cause of symptoms. Continue Omeprazole, along with diet and lifestyle modifications (small, frequent meals, avoid spicy or sour food, stress reduction, hydration).

Crohn’s disease is unlikely; endoscopy would have detected it, and most of the current symptoms suggest upper gastrointestinal tract involvement. If symptoms persist despite therapy, a biopsy can be considered to check for residual inflammation or rare upper GIT Crohn’s involvement. However, signs like lower GIT involvement or oral lesions are usually present first in Crohn’s.

The current findings point toward chronic gastritis due to acidity rather than Crohn’s disease. Focus on acid control, diet, and lifestyle, and monitor for any new symptoms that may require further evaluation.

I hope this helps you.

Thank you.