Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
Can long working hours lead to exhaustion and poor health?
How does stress impact weight gain and energy levels?
Could family history affect my energy levels?
How can I manage stress-related low energy?
Is hypothyroidism likely if I have low energy but none of the typical symptoms?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hello! I understand you're here because you're experiencing low energy. Is that right?
Patient
Yes, that's right. I've been really exhausted lately, and it's been tough to find the energy for much of anything.
Cody, the AI Doctor
I'm here to help. Can you tell me how long you've been feeling this way?
Patient
It's been going on for about four months now. I thought it might improve on its own, but it hasn't.
Cody, the AI Doctor
I'm sorry to hear that. Did anything significant happen around the time your symptoms started, like an illness or a change in your daily routine?
Patient
Well, I did have Covid about four months ago, but I got over it pretty quickly. I also started working longer hours around the same time.
Cody, the AI Doctor
Covid can be a rough experience, and long hours certainly add to stress. What type of work do you do?
Patient
I'm part of the marketing team at a tech start-up. It's pretty demanding, and I often feel like I don't have much time for myself.
Cody, the AI Doctor
I understand. That can be quite overwhelming. Have you been able to keep up with any exercise or physical activities?
Patient
Not really. I've been too tired after work to do much. I used to be more active, but that's fallen to the wayside.
Cody, the AI Doctor
These lifestyle changes can have an impact. I noticed you mentioned some weight gain over the past few years. What do you think has contributed to that?
Patient
Mostly a poor diet and lack of exercise. With work being so busy, I haven't been able to keep up with healthy habits.
Cody, the AI Doctor
Balancing everything can definitely be challenging. Have you experienced any other changes, like mood shifts or anything different with your weight aside from what you mentioned?
Patient
I do feel a bit down, especially because I work so hard and feel like I don’t have time for anything else.
Cody, the AI Doctor
Thank you for sharing that with me. Have you seen any doctors about these symptoms before coming here?
Patient
Yes, but it felt like they just dismissed my concerns and said it was stress-related.
Cody, the AI Doctor
I'm sorry to hear that. It's important to feel heard. Can I ask if there's any family history of health issues that we should be aware of?
Patient
Yes, my mom has hypothyroidism, but I haven't been diagnosed with anything like that.
Cody, the AI Doctor
Family history is worth considering. Have you noticed anything like increased sensitivity to cold or any changes in your skin or hair?
Patient
No, nothing like that. My skin and hair seem normal to me.
Cody, the AI Doctor
Thank you for mentioning that. How have your menstrual cycles been? Any noticeable changes?
Patient
They're normal, moderate bleeding for about four days each time.
Cody, the AI Doctor
Got it, thanks for clarifying. Let me summarize what you've told me, and we can discuss potential next steps
Cody's AI Summary
- You are a 25-year-old woman who has been experiencing low energy for four months, beginning after a Covid infection and coinciding with increased work stress.
- This has affected your activity levels and contributed to weight gain.
- You report feeling down due to work pressures and a lack of personal time.
- There's a family history of hypothyroidism on your mother's side, though you haven't experienced associated symptoms like changes in skin or hair quality.
- Your menstrual cycles remain normal.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Deconditioning( 80 % probability)
Reduced physical activity combined with poor diet, leading to low energy and weight gain.
2. Depression(15 % probability)
Low mood and energy, potentially related to job stress and lifestyle changes.
3. Hypothyroidism(5 % probability)
Family history suggests consideration, though less likely given the absence of specific symptoms like cold sensitivity or changes in skin and hair.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
Upon reviewing this case, the symptoms and historical background provide clear areas for investigation and intervention. Here are my assessments and recommendations:
1. Deconditioning(60% probability)
The history you've shared provides a valuable context for considering potential diagnoses. The most probable cause for your persistent low energy appears to be deconditioning, which is corroborated by reduced physical activity and changes in diet.
2. Depression(30% probability)
Depression, related to life and work stress, is a significant consideration given your low mood, which aligns with lifestyle changes over the past months.
3. Hypothyroidism(10% probability)
While your family history of hypothyroidism is notable, the lack of symptoms such as sensitivity to cold or changes in skin and hair makes this less likely. However, it’s important to confirm with appropriate testing.
Next Steps for Evaluation
Diagnostic Recommendations:
Conduct thyroid function tests (TSH, free T4) to exclude hypothyroidism.
Complete blood count (CBC) to check for anemia.
Comprehensive metabolic panel to assess overall health status.
Vitamin D levels, as deficiency can contribute to fatigue.
Consider a depression screening questionnaire to evaluate mood changes.
Potential Treatment Modalities
Exercise Recommendations: To gradually increase your energy, start with activities that require minimal time and can be easily fit into your daily routine. Begin with brisk walking for 20-30 minutes daily, aiming to include this at lunchtime or after work to manage energy highs and lows. Adding resistance training, such as using light weights or body-weight exercises twice a week, can improve muscle strength and endurance. Integrate stretching or yoga to enhance flexibility and reduce stress, which contributes to overall well-being.
Dietary Adjustments: Incorporate a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Ensure regular meals to maintain energy levels throughout the day, avoiding long gaps between eating. Choose complex carbohydrates like oats and quinoa to provide sustained energy. Staying hydrated is crucial; aim for at least 8 glasses of water daily. Consider reducing caffeine and sugar intake, as they can lead to energy crashes.
Addressing these lifestyle changes is imperative. Evaluating work stress management, such as setting boundaries and allocating time for relaxation, would also be advantageous. If symptoms persist, laboratory tests including thyroid function tests, complete blood count, and comprehensive metabolic panel are warranted to exclude underlying organic causes like hypothyroidism.
Stress Management:Encourage techniques such as mindfulness, yoga, or meditation to manage stress.Set realistic work boundaries to ensure adequate personal time and sleep, driving overall improvement in mental and physical health.
Conclusion: Addressing lifestyle factors is crucial, through both exercise and nutrition, to combat deconditioning and potential psychological influences on energy levels. By incorporating these strategies, alongside necessary medical evaluations, a significant improvement in quality of life and energy levels can be achieved.
Resource Center
Testimonials
CodyMD is a very precise and accessible app. My consultation with CodymMD is commendable and I highly recommend it for others to try CodyMD especially for assessment and consultation purposes.
TrustPilot Review
Dr Cody spot on, better than most Human Drs. Also far more pleasant. Try him, he could better help you understand your issues. He will give you good info for your Drs visit as well.
TrustPilot Review
It gave me the best response possible and suggested simple self care treatment options which I'm in favor with. It has a to the point interface and brief answer for better understanding.
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