This case has been tough to figure out. A thread 🧵. 38 year old female who established with me about 3 months ago also at that time brought up a concern for unintentional weight loss over the preceding 6 months or so. Her beginning weight was 180-190 and her weight now is 116. Her medical history is previous drug use (now on methadone for 8 years), Hep C (self-resolved), GERD, and hypothyroidism. Associated symptoms have been vague abdominal discomfort, loose stools, and fatigue.