Increasing Physical and Mental Lethargy and Weight Gain

A 66-year-old woman with increasing physical and mental lethargy and weight gain

Author: Murtagh, John

Case History

A 66-year-old woman presented with a 10-month history of gradually increasing fatigue, lethargy, weight gain, constipation, and difficulty coping with the cold winter. She feels like sitting by the fire and doing nothing. She tends to sleep excessively. She also complains of chest tightness and shortness of breath on exertion, such as when she hurries to catch a bus.

Her daughter, who accompanied her to the medical appointment, has noticed that her mother has slowed down in her general movements and cognition. The patient appears pale and has developed a somewhat round, puffy face. She wondered if her mother was developing early Alzheimer’s disease.

  • Past history: Generally good health with the exception of type 2 diabetes mellitus
  • Drug history: Metformin, one tablet daily
  • Social history: Lives with 71-year-old husband and daughter