Unexplained Weight Loss: Possible Causes and Concerns Beyond Cancer

Weight has been consistently decreasing?

Hello doctor, I haven't been on a special diet for the past three months, but my weight has dropped from 50 kg to 47 kg.
I visited a family medicine clinic nearby, and the doctor conducted many tests.
All stool tests came back normal, and a complete blood panel of eight items also showed normal results, including white blood cells, blood sugar, creatinine, sodium, potassium, GOT, GPT, LDL, thyroid-related tests, as well as CEA and SSC tumor markers.
A general urine test was also normal, and the gastroscopy did not reveal any significant issues.
The ultrasound was normal, and I do not have depression or other mental health issues.
Could you please advise what other reasons might cause such significant weight loss? Is it possible that this could be pancreatic cancer? Given that CEA and SSC are normal, is there still a possibility of pancreatic cancer?

Mr. Huang, 20~29 year old female. Ask Date: 2021/04/05

Dr. Liao Yaopan reply Family Medicine

Hello, unexplained weight loss should still be monitored.
If you have any concerns as mentioned above, you may discuss them further with your family physician or arrange for self-paid advanced imaging examinations.
Maintaining a balanced diet and regular exercise is also an important reminder for weight management.
Please note that online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2021/04/05

More Info

Unexplained weight loss can be concerning, especially when it occurs without any intentional changes in diet or exercise. In your case, a drop from 50 kg to 47 kg over three months is significant, and it's understandable that you are worried about potential underlying health issues, including cancer. However, it's important to note that weight loss can be attributed to a variety of factors beyond cancer.

Firstly, it's reassuring that you have undergone a comprehensive evaluation, including blood tests, stool tests, and imaging studies, all of which returned normal results. Normal levels of white blood cells, glucose, liver enzymes (GOT, GPT), kidney function (creatinine), electrolytes (sodium, potassium), and thyroid function suggest that there are no immediate concerns regarding metabolic or systemic diseases. Additionally, normal tumor markers like CEA (Carcinoembryonic Antigen) and SSC (Squamous Cell Carcinoma) further reduce the likelihood of malignancy, including pancreatic cancer, which often presents with weight loss.

There are several non-cancerous reasons for unexplained weight loss that you might consider:
1. Dietary Changes: Sometimes, even subtle changes in your eating habits can lead to weight loss. If you've been eating less or have altered your diet in ways that are not immediately obvious, this could contribute to weight loss.

2. Increased Physical Activity: If you've unintentionally increased your activity level, even slightly, this could lead to weight loss. This includes daily activities that may not be classified as exercise but still burn calories.

3. Stress and Anxiety: Psychological factors can significantly impact weight. Even if you do not feel overtly depressed or anxious, underlying stress can lead to changes in appetite and metabolism.

4. Gastrointestinal Issues: Conditions such as malabsorption syndromes, where your body does not absorb nutrients effectively, can lead to weight loss. This can occur due to conditions like celiac disease or chronic pancreatitis, which may not always be evident in initial tests.

5. Hormonal Changes: Hormonal imbalances, such as those related to the thyroid (hyperthyroidism) or adrenal glands, can lead to weight loss. While you mentioned that thyroid tests were normal, it might be worth discussing with your doctor if any other hormonal evaluations are necessary.

6. Chronic Infections: Certain infections, even if they are not causing overt symptoms, can lead to weight loss. Conditions like tuberculosis or chronic viral infections can sometimes present this way.

7. Medications: If you are taking any medications, check with your healthcare provider to see if weight loss is a known side effect.

Given that your medical evaluations have not indicated any serious underlying conditions, it may be beneficial to monitor your weight and any accompanying symptoms closely. If the weight loss continues or if you develop new symptoms (such as fatigue, changes in appetite, or gastrointestinal issues), it would be prudent to follow up with your healthcare provider for further evaluation.

In conclusion, while unexplained weight loss can be alarming and is often associated with serious conditions like cancer, the normal results from your recent tests are encouraging. It is essential to consider a broad range of potential causes and to maintain open communication with your healthcare provider about your concerns and any changes in your health. Regular follow-ups and monitoring can help ensure that any emerging issues are addressed promptly.

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