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Gaining weight rapidly, blood test showed elevated DHEA, elevated glucose, irregular periods. Have depression and stress.

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
Hello, I have an appointment 3 months from now set up with an endocrinologist but my symptoms are really concerning me. I am a female, 26 years of age, 5'3 and 180 pounds. Although I am eating heathly (1400- 1600 calories) per day and exercising I am gaining weight at such a rapid pace. I have gained 15 pounds in just the last 2 weeks. In the past 4 years I have gained 70 pounds. My BMI is around 30 now?? Just to give some background:

- Recent blood test from Obgyn came back with elevated levels of DHEA, possible symptom of PCOS (not officially diagnosed)- also mentioned adrenal glands?
- Elevated Glucose levels in recent physical
- irregular periods since I was 16, without the use of birthcontrol my menstrual cycle last 365 days per year. (With Birth control period is 2 - 2 1/2 weeks) Having heavy blood clots
- ongoing depression and irritability- have tried every antidepressant and nothing has helped (psychiatrist has recommended that I reach out to specialist)
- constant fatigue and ALWAYS STRESSED
- weight will fluctuate +10 or -10 pounds in a 24 period time, also bloated and gas
*have been tested for food allergies and everything came back negative*

What could be going on here? I am gaining a pound a day!
Posted Thu, 12 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Rahul Tawde 8 hours later

Thanks for the query.

There are a few possible causes of weight gain in your case - It could be related to depression and anti depressents drugs; you could have other hormonal problems like Cushing's syndrome; it might be part of Polycystic Ovarian Syndrome (PCOS); could also be related to lack of physical activity and relatively excess diet; Lastly genetic factors maybe responsible for obesity and weight may be a contributing factor in some of your hormonal abnormalities.

Amongst these conditions, two conditions which can explain all your symptoms are PCOS and Cushing's syndrome.

A detailed clinical and hormonal evaluation will help us narrow down the possibilities. I encourage you to visit a competent physician/endocrinologist who after careful examination can streamline relevant investigation. I can reassure you that after proper evaluation there will be relief for many of your symptoms.

In the mean time you can XXXXXXX a dietician and plan a hypocaloric diet like 800 -1000 calories per day. It would be also be good if you can incorporate an effective physical activity schedule in your daily routine.

You could also discuss with your psychiatrist and review the medicines and find out if any of the medicines are responsible for weight gain and any modifications can be made. Needless to say, your thyroid function test also has to be assessed when you XXXXXXX your endocrinologist.

Hope this helps you. Should you have any additional concerns, feel free to post your response; I will be glad to assist you further. If you are satisfied with the answer do accept the answer.

Above answer was peer-reviewed by
Follow-up: Gaining weight rapidly, blood test showed elevated DHEA, elevated glucose, irregular periods. Have depression and stress. 1 hour later
Thank you for your help. I have 2 remaining questions:

-if I go to a dietician should I ask about a "hypocaloric diet?" Or explain my symptoms? I fear that I will be put on a normal 1400 plus calorie diet that will do nothing.

- if this is cushings or pcos is there treatment options to help me get back to my healthy weight of 115- 120?
(My psychiatrist has tried every drug in the market to help with my weight problem.. prozac, lexapro, wellbutrin, paxil, zoloft, adderall, vyvannse, ... Even mood stabalizers and anti seizure medicine etc and nothing helps my depression/ anxiety or rapid weight gain)

Answered by Dr. Rahul Tawde 42 minutes later

Thanks for the follow-up.

You can request her for a 800 -1000 calorie diet explaining the need to loose weight quickly and also informing her that antidepressents are preventinng weight loss with the usual 1200 -1400 hypocaloric diet.

Regarding the second part if Cushing's is the cause of weight gain then definitely with proper treatment you may come close to your desired body weight. If PCOS is responsible then diet and physical activity are very much required and even with them wieght loss may not be that easy. You can request your endocrinologist for medications to cause weight loss.

Hope I have answered your query. Please accept my answer if you have no more queries.

Wishing you all the best.

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