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Weight loss,normal colonoscopy,pelvic ct scan,spot on liver,hyperthyroidism

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I have been losing weight for several months now for no reason, doctor did blood work and referred me to a endocrinologist, had a pretty unremarkable colonoscopy, then had a stomach and pelvic ct scan with contrast which showed a spot on my liver just under one inch. liver panel seems normal with elevated cea levels after more blood work. radiologists say the spot looks benign so they won't do a biopsy. now out of no where I am starting to smell the slight odor of ammonia. my sister in law said I should get a thyroid panel that I may have hyperthyroidism. I have went from a size 10 to a 4 without trying to lose weight and I am concerned to say the least. any input would be helpful. I also care full time for my disabled husband who had a massive heatstroke back in 2005
Posted Thu, 3 May 2012 in Liver and Gall Bladder
Answered by Dr. Poorna Chandra K.S 15 hours later

Thanks for the query.

I have gone through your description and I understand your concerns. Losing weight drastically is a matter of concern.

There are significant unintentional weight loss in a otherwise normal person could be because of
1) Diabeties mellitus
2) Hyperthyroidism
3) Vitamin B12, folic acid defeciency
3) Intestinal malabsorption - bacterial overgrowth
4) Occult malignancy

As your CEA levels are elevated and the CT contrast shows a lump in the liver about an inch suggests to me that you need a follow up on this and a liver biopsy would be ideal.

There can always be a probability of occult malignancy and has to be ruled out in any case. It requires good physical examination with some directed investigations like Pap smear, CT chest, Rectal tissue biopsy, Tests for malabsorptions, Liver biopsy, MRI of the abdomen to point out the cause. After going through all these reports it would be easier to come to a conclusion and for directed treatment.

Hence see your GastroEnterologist/Gynecologist for complete examination and evaluation.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

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