Sudden Weight Loss: When to Seek Medical Advice - Internal Medicine

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Sudden weight loss can be a concerning symptom, especially when it occurs without any apparent changes in diet, physical activity, or overall health. In your father's case, losing 6 kilograms (approximately 13 pounds) without any changes in appetite or lifestyle warrants further investigation, even if he feels otherwise healthy.

Understanding Sudden Weight Loss
In medical terms, unintentional weight loss is typically defined as a loss of more than 5% of body weight over a period of six months or less, without any deliberate effort to lose weight. This can be a sign of underlying health issues that may require medical attention. Some common causes of unexplained weight loss include:
1. Metabolic Disorders: Conditions such as hyperthyroidism (overactive thyroid) can lead to increased metabolism and weight loss.

2. Gastrointestinal Issues: Problems like malabsorption syndromes, inflammatory bowel disease, or chronic gastritis can affect nutrient absorption and lead to weight loss.

3. Chronic Infections: Conditions such as tuberculosis or HIV can cause weight loss due to increased metabolic demands or decreased appetite.

4. Cancer: Various types of cancer can lead to weight loss, often accompanied by other symptoms such as fatigue or pain.

5. Mental Health Conditions: Depression or anxiety can lead to changes in appetite and weight.

6. Medications: Certain medications can cause weight loss as a side effect.


Specific Concerns in Your Father's Case
Given that your father has a history of being bitten by a chigger (恙蟲), it’s important to consider whether there could be any lingering effects from that incident. While chigger bites typically cause localized irritation, they can sometimes lead to secondary infections or other complications. Additionally, the presence of recurrent mouth ulcers (口腔潰瘍) could indicate an underlying issue, such as nutritional deficiencies, autoimmune disorders, or even systemic diseases.


When to Seek Medical Advice
It is advisable for your father to see a healthcare professional if:
- The weight loss continues or accelerates.

- He experiences any new symptoms, such as fatigue, pain, changes in bowel habits, or persistent mouth ulcers.

- There are any signs of dehydration or nutritional deficiencies (e.g., fatigue, weakness, dizziness).


Which Specialist to Consult
In this case, starting with a family physician or general practitioner would be a good approach. They can conduct a comprehensive evaluation, including a physical examination and necessary laboratory tests (such as blood tests to check thyroid function, complete blood count, and metabolic panel). Depending on the findings, they may refer your father to a specialist, such as:
- Gastroenterologist: If gastrointestinal issues are suspected.

- Endocrinologist: If metabolic disorders like thyroid issues are a concern.

- Hematologist: If there are signs of blood disorders related to the mouth ulcers.


Conclusion
In summary, while your father may feel fine and his appetite remains unchanged, the sudden weight loss and recurrent mouth ulcers are significant enough to warrant medical evaluation. Early diagnosis and intervention can be crucial in addressing any potential underlying health issues. Encourage him to seek medical advice promptly to ensure his health is thoroughly assessed.