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"I have hypertension and very rapid weight gain with stretch marks. Could this be PCOS, something in my adrenal/pituitary or a combination of the two?"
I am a 22 year old female that got diagnosed with hypertension after consistently high readings. I was put on Lisinopril HCTZ to control the hypertension. In less than 6 months I gained over 50 pounds going from 125-170. The weight has continued to come on and today I weigh 192. I am 5'5 and never had weight issues until recently. I have stretch marks on my breasts, hips, inner thighs and oblique area. I have had my cortisol measured through serum, urine and saliva tests and all results were normal. I also have done a 1mg dextamethasone supression test which also came back normal. Recently my prolactin, plasma renin activity, 17-OH progesterone and free/total testosterone have come back elevated. My thyroid testing is also normal. Could this be PCOS, something in my adrenal/pituitary or a combination of the two? Thank you.
Thank you for this interesting question, and I am sorry to hear about your troubles of late. In order to provide an accurate diagnosis, a doctor would need to review your entire medical history and perform a thorough physical exam. In addition, the doctor would need to review the full details of your prior lab testing. Only after collecting this information will it be possible to provide recommendations. In addition, you may require further testing. Therefore, I strongly encourage you to schedule an appointment with an endocrinologist. Hypertension in someone your age is atypical and should prompt a workup for secondary hypertension. This refers to hypertension triggered by another process, often an endocrine or renal disorder. Clinically, your weight gain, hypertension, and stretch marks are all concerning for Cushing's syndrome. This is characterized by abnormal levels of cortisol. You have had several tests examining this possibility, all of which were reportedly normal. However, I feel you should see an endocrinologist who can interpret the subtlety of these values more carefully. Other disorders, such as pheochromocytoma, primary kidney disease, and renovascular disease, can also cause hypertension. Various lab tests and imaging studies can help look for these. Overall, I strongly encourage you to see an endocrinologist.
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