Unintentional Weight Loss and Blood Pressure Concerns - Internal Medicine

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Unintentional weight loss, especially when it occurs over a relatively short period without any deliberate effort to change diet or exercise habits, can be a concerning symptom that warrants further investigation. In your mother's case, the gradual decrease in weight from 48.9 kg in 2019 to 44.9 kg this year, despite no changes in lifestyle, could indicate an underlying health issue.
There are several potential causes for unintentional weight loss in adults, particularly in those over the age of 50. These can include:
1. Metabolic Disorders: Conditions such as hyperthyroidism can lead to increased metabolism and weight loss. Thyroid function tests can help rule this out.

2. Gastrointestinal Issues: Problems such as malabsorption syndromes, peptic ulcers, or gastrointestinal cancers can lead to weight loss. Symptoms like changes in appetite, bowel habits, or abdominal pain should be evaluated.

3. Chronic Infections: Conditions like tuberculosis or HIV can cause weight loss. If there are any accompanying symptoms such as fever, night sweats, or fatigue, these should be investigated.

4. Cancer: Unexplained weight loss can sometimes be an early sign of malignancy. If there are any other concerning symptoms, a thorough evaluation is warranted.

5. Psychological Factors: Depression or anxiety can lead to changes in appetite and weight. If there are signs of mood changes, this should be addressed.

6. Medications: Certain medications can cause weight loss as a side effect. A review of her current medications may be necessary.

Given these possibilities, it would be advisable for your mother to consult with her primary care physician or an internist. They can perform a comprehensive evaluation, including a detailed history, physical examination, and possibly laboratory tests to identify any underlying conditions.

Regarding her blood pressure reading of 138/78 mmHg, this is considered to be in the "elevated" category according to the American Heart Association guidelines. While it is not classified as hypertension (which is defined as a reading of 130/80 mmHg or higher), it is important to monitor it regularly. Lifestyle modifications such as maintaining a healthy diet, regular physical activity, and managing stress can be beneficial.
In terms of medication, the decision to start antihypertensive treatment should be based on a comprehensive assessment of her overall cardiovascular risk, including factors like age, family history, and any other existing health conditions. If her blood pressure remains consistently elevated or if there are other risk factors present, her doctor may recommend starting medication.
In summary, your mother should see her primary care physician to discuss her unintentional weight loss and blood pressure concerns. A thorough evaluation will help determine if any further investigations or treatments are necessary. Regular monitoring and lifestyle changes can also play a significant role in managing her blood pressure effectively.