Weight Loss: Thyroid vs. Gastrointestinal Issues

Gastrointestinal issues / Thyroid problems

Recently, I have noticed a slight trend of weight loss.
Last September, I weighed 60 kg, and by last Tuesday, I was around 58 kg, and this morning, I weighed 57 kg.
Although my eating habits have changed (I no longer eat late-night snacks and avoid food after 7:30 PM), I have felt quite anxious since weighing myself on Tuesday.
I suspect hyperthyroidism could be causing the weight loss, so I looked up some tests.
I read that if you hold your fingers together in front of your chest and they shake, it could indicate a thyroid issue, but I did not experience that (though I'm not sure if this claim is accurate).
My neck is not swollen, and my eyes are not bulging.
Additionally, over the past week, I have been feeling hungry very easily.
I used to have breakfast around 6 AM and would start feeling hungry by about 11 AM, sometimes even as early as 10 AM, but it hasn't been like that recently.
My lower left abdomen often makes loud rumbling noises.
After having lunch at noon, I would typically not feel hungry until around 5 PM, but recently, I have started feeling empty by around 3 PM.
It seems like my gastrointestinal motility has increased (or maybe my metabolism has sped up?).
After meals, my digestive system makes a lot of noise, sometimes accompanied by a burning sensation.
Occasionally, I feel a sensation of a foreign body when swallowing, and it seems like my bowel movements have increased in frequency.
Sometimes, I feel a strong urge to go when I am anxious, and I have occasionally noticed black stools (I tend to get anxious easily).
A few days ago, I consulted a doctor who mentioned that I might have chronic gastritis, but I am still not reassured.
Could you please advise me, doctor: what conditions are more likely to explain these symptoms? Is it related to the thyroid, gastrointestinal issues, or could it be psychological factors that are causing the weight loss?

Li, 10~19 year old female. Ask Date: 2017/03/04

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your symptom description, it does not appear to be typical hyperthyroidism symptoms.
As for the weight change, a fluctuation of one kilogram is not significant and may not indicate actual weight loss.
The increased hunger you are experiencing is likely due to being in a growth and development phase, which requires more calories and nutrients, and is not necessarily a sign of illness.
The burning sensation after meals suggests you may have mild gastroesophageal reflux.
It is advisable to eat until you are about 80% full at each meal and to avoid lying down or engaging in vigorous exercise immediately after eating, as this may help improve your symptoms.
In summary, your symptoms seem to be physiological responses; if discomfort persists, consider consulting a family medicine specialist.
Thank you for your inquiry.

Reply Date: 2017/03/04

More Info

The symptoms you are experiencing, including weight loss, increased hunger, rapid gastrointestinal motility, and changes in bowel habits, can indeed be concerning and may stem from various underlying issues. Given your history and the recent changes in your health, it is essential to consider both thyroid and gastrointestinal factors, as well as psychological influences.

Thyroid Issues
Thyroid disorders, particularly hyperthyroidism, can lead to weight loss, increased appetite, and heightened metabolism. Symptoms of hyperthyroidism may include:
- Unexplained weight loss despite normal or increased appetite.

- Increased bowel movements or diarrhea.

- Nervousness, anxiety, or irritability.

- Tremors (shaking hands or fingers).

- Heat intolerance and excessive sweating.

- Changes in menstrual patterns.

You mentioned that you do not have tremors and that your neck is not swollen, which are common signs of thyroid issues. However, it is crucial to have a comprehensive thyroid panel done, including TSH, Free T4, and Free T3 levels, to accurately assess your thyroid function. If TSH is low and T4 is elevated, it may indicate hyperthyroidism.

Gastrointestinal Issues
On the gastrointestinal side, your symptoms of increased hunger, abdominal noises, and changes in bowel habits could suggest several conditions:
1. Gastritis or Peptic Ulcer Disease: Chronic inflammation of the stomach lining can lead to discomfort, increased gastric motility, and changes in appetite. If you have been diagnosed with chronic gastritis, it could explain some of your symptoms, including the burning sensation and increased hunger.

2. Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder can cause symptoms like abdominal pain, bloating, and changes in bowel habits. Stress and anxiety can exacerbate IBS symptoms, leading to increased bowel movements and discomfort.

3. Malabsorption Syndromes: Conditions like celiac disease or lactose intolerance can lead to weight loss and changes in appetite due to the body's inability to absorb nutrients effectively.

4. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function, leading to increased motility and changes in appetite. If you find yourself feeling anxious or stressed, this could be contributing to your symptoms.

Recommendations
1. Medical Evaluation: It is crucial to follow up with your healthcare provider for a thorough evaluation. This should include blood tests to assess thyroid function and possibly imaging studies or endoscopy to evaluate your gastrointestinal tract.

2. Dietary Adjustments: Keep a food diary to track what you eat and how it affects your symptoms. Eating smaller, more frequent meals may help manage hunger and gastrointestinal discomfort.

3. Stress Management: Consider incorporating stress-reducing techniques such as mindfulness, yoga, or counseling to help manage anxiety, which may be contributing to your symptoms.

4. Monitor Symptoms: Keep track of any changes in your symptoms, including bowel habits, appetite, and weight. This information will be valuable for your healthcare provider in determining the underlying cause of your symptoms.

5. Avoid Self-Diagnosis: While it is helpful to research your symptoms, avoid jumping to conclusions without professional guidance. Many conditions can present with similar symptoms, and a healthcare provider can help differentiate between them.

In conclusion, your symptoms could be related to thyroid issues, gastrointestinal disorders, or psychological factors. A comprehensive evaluation by a healthcare professional is essential to determine the underlying cause and appropriate treatment.

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