19 year old moonface rapid weight gain

[allie12]

My daughter  who is 19, went to the doctor in early April because of a swollen face and eyes. The doctor put her on an antihistimine and prednisone for 3 days. A few days later went back to the doctor and was diagnosed with strep, sinus infection, ear infection and was given a Z-pac. The following week she went back to the doctor again and was diagnosed with mononucleosis.

Prior to getting ill, my daughter worked out on a regular basis and played a sport. Her normal weight was 119-125. She noticed in early April that she started gaining  quite a bit of weight, especially in abdomen and it looked like she had a moonface or steroid look to her face and body.Please note that she had already started looking like this prior to the short round of prednisone.

In June she started feeling a little better and started working out again and over a 2 week period she started looking like her old self, her swelling was going down and she was losing weight. Two weeks ago she woke up and looked to be totally back to normal and her face was small again.It looked like she had lost 20lbs over night. She went to the gym and when she returned she had the moonface again and looked heavy again which makes me think that it is actually some sort of water weight problem. Snce then, she has been extremely tired, and unable to lose weight and has a "bloated look" again.

She had a thyroid test:
TSH - 1.5
Free T4 - .88
Free T3 - 2.2
VItamin D - 44 NG/ML
ES Cortisol (fasting) - <2 UG/DL

The endocrinologist said T3 is low and told her to come back in a month for another test even though thyroid runs on both sides of family - her dad had thyroid cancer at 43, his brother passed away from antiplastic thyroid cancer, my mother had her thyroid removed at 21 and my sister has been on thyroid medicine since her early 20's...I refuse to wait that long because carrying around that much water weight cannot be healthy so we went back to the family doctor who is leaning toward an adrenal/thyroid problem and has ordered a lot of tests including thyroid scan and uptake, 24 urine, hormone testing, etc.

Please note that she is on ortho-tryclene low which she went off of for a month. In addition she drank Powerade Zero which contains suclarose along with some other diet drinks on a regular basis and also chewed quite a bit of Stride gum with sorbitol and aspartame. She quite the diet drinks when she got sick and switched to a sugared gum - Big Red for two weeks but saw no improvement so she went back to drinking 1 diet drink per day and limited the Stride gum to 3 pieces per day and started back up on the birth control pill.

I just found out yesterday that Big Red contains a small amount of aspartame in addition to regular gum so I have taken her off of all artificial sweeteners again. Is it possible that this could be the cause?

Please let me know if anyone has any advice - she is getting desperate!
Thanks

[rumpled]

Yes, I had a lot of edema and weight changes - it was bizarre to me, but the docs just said I was a "liar" and a "chronic over eater in denial"  so that took care of that.

Ah - the infamous dex test.... and done incorrectly to boot! It should have been 11pm to take the pill and the draw should have been 8am (with her fasting). If the doc says there is no effect on the urine test, find another doctor - he is not an expert - as he has already goofed one test. And if he judges your daughter on the dex test, he is really an endummy.

[allie12]

In answer to your question re- ES Cortisol - that was a blood test after taking the Dexamethasone pill 24 hours prior. I am going to call doctor and ask him about effect of BCP on her 24 hour urine.

[allie12]

Thanks for your post. I was going to call her gynecologist about taking her off BCP today, was just waiting for estrogen test and thyroid uptake to come back. Did you have the extreme up and down of the water weight?

[rumpled]

What is ES Cortisol - is that blood, saliva or urine?

I had cyclical Cushing's, and had a lot of normal tests, even though I looked awful, and was sick.

She has to be off the BCP for a while for the 24 hour urine cortisol test to be accurate - unless she is really high, the estrogen in the pills will bind to the free cortisol and her test will be lower than it really it - if that makes sense to you. Lots of meds do that. She needs several rounds of testing to know what is going on. One set does not tell you yes or no.

I don't know about the sweeteners except that I avoid them all like the plague.