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Nausea vomiting feeling no appetite
Hi sir/mam
I am 32 yrs old lady having diabetes since 3 years under controlled (recent hb1ac 5.7) bp is also control(under 120/80 ,82)
Subclinical hypothyroidism since one year taking mild dose 12.5 mg in morning
Diabetes medicine
Istamet50/500 twice in a day after food
Telma 40 for bp in morning
And antidepressants bcz of insomnia and negative running thoughts
Serta-150mg in morning
Petril0.5 mg in morning one tablet
Night-
2 tablet of petril in night
Yesterday I went to gastroenterologist for this nausea, vomiting feeling,loss of appetite and 7-8 months I have faced 5-6 kgs weight loss without doing anything, all blood reports are normal ultrasound shows mild fatty liver with normal enzymes, ct scan whole abdomen came normal earlier mild Protein leak in urine (uacr 23 three months back now came 10) according to nephrologist it's fine, but she advised me not to have more protein( can take in small portions) and avoid painkillers so
I m following her instructions, Please advise
Answers (30)
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Chronic nausea with 5-6 kg weight loss despite normal tests suggests MEDICATION SIDE EFFECTS or DIABETIC GASTROPARESIS.
Likely Causes:
1. Medication Side Effects (MOST LIKELY):
- Metformin 500 twice daily - causes nausea/GI upset
- Sertraline 150mg - common GI side effects
- Multiple medications together
2. Diabetic Gastroparesis:
- Delayed stomach emptying
- Common in diabetes even when controlled
3. Other:
- Hypothyroidism (though on treatment)
- Fatty liver
- Depression/anxiety related
Solution:
1. Medication Review:
- Switch Metformin to EXTENDED RELEASE form (causes less nausea)
- OR try Vildagliptin/Sitagliptin instead
- Sertraline 150mg is high dose - discuss reducing with psychiatrist
- Take all medicines AFTER food, not before
2. For Gastroparesis:
- Add Prokinetic: Domperidone 10mg before meals
- Small frequent meals (6 times daily)
- Low-fat, low-fiber diet
- Avoid lying down after meals
3. Immediate Relief:
- Ondansetron 4mg for severe nausea
- Ginger tea helps
- Eat small portions
Need gastric emptying study to confirm gastroparesis.
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Hope you are following your consulting doctor's instructions. Your anxiety is completely valid. Your test reports (USG and urine analysis) aren't something to be very concerned about. Have adequate fluids through the day and get atleast 7 hours of sleep.
Hope this helps.
Dr. Harshita Bhakat
Next Steps
You can reach out to me on whatsapp at 967464336zero.
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Good day to you
I feel your anxiety regarding your condition however I advise you to go for a one to one consultation as the history provided by you on broad view is very detailed and their can be many possible causes for your condition which will have to be diligently investigated and ruled out which cannot be done via this platform alone
I hope this advice provides you with much needed insight.
Wishing you a speedy recovery
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You can consult me directly on Practo, or reach out via WhatsApp:
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Early consultation helps avoid complications — feel free to connect.
Only whatsapp message no calls
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Hi. You have to be very careful with your medications now. Diabetes, BP, Hypothyroidism, antidepressants, proteinuria. Side effects of medicines followed by thoughts have led to decreased appetite. Kindly consult with me on 94 two six 86 seven eight 96.
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Hello, I am Dr. Romain Rajan, General Physician.
Your case has been allotted to me.
I understand your concern. You are maintaining your diabetes and blood pressure very well which is excellent. The recent symptoms of nausea, loss of appetite and gradual weight loss with mild fatty liver on ultrasound and normal CT scan are most likely due to a combination of gastric slowdown caused by long term diabetes, effect of antidepressants and mild liver sluggishness rather than any serious disease.
â
Advices
Eat small light meals every three to four hours instead of heavy ones.
Avoid oily, spicy, fried and late night foods.
Keep drinking sufficient water and include fruits like papaya, banana and apple in small portions.
What to Monitor
Appetite, nausea intensity and any vomiting after meals.
Weight trend every two weeks.
Management
You can start the following after meals for relief:
⢠Tablet Pan D once daily before breakfast for 10 days to reduce nausea and acidity.
⢠Syrup Liv 52 one teaspoon twice daily after meals for liver support.
Continue your diabetes and thyroid medicines regularly and take antidepressants only as advised by your psychiatrist. Avoid unnecessary painkillers.
When to Consult a Doctor Immediately
If vomiting persists or appetite worsens.
If weight loss continues despite eating normally.
If yellowing of eyes, dark urine or abdominal pain develops.
Every patientâs condition is unique. For complete recovery, it is important to assess the medication timing, stress levels and diet pattern in detail.
ð You can reach out to me directly for this case and also connect with me in future for any medical consultation.
I am available on Practo or on WhatsApp at 85271646 seven seven for a one on one consultation where you will receive
A personalized treatment and diet plan
Safe medicine guidance
Quick follow ups to track your recovery
Take care and wishing you good health.
Best regards,
Dr. Romain Rajan
General Physician
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Do you take any antacids ??
BP medication requires antacids too
Book consultation for details
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Continue to follow her advise. No need to worry.
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Follow advice of your doctor
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Hello,
For consultation
1. Pay ( ₹ 500 only, 50 % off ) and consult by practo.
2. Or pay ( ₹ 500 only, 50 % off ) and send message by GPay. My mobile number is +91959508739nine.
3. If required call to +91959508739nine.
Take a glass of milk daily.
Thanks.
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I see your condition
According to me your medication is the reason for your weight loss, nausea and reduced appetite.
Sertraline and Clonazepam can cause these side effects
Next Steps
you can adjust your psychiatric medicines
after consulting
in my opinion reduce the dose of both or your psychiatrist can change the medication according to your needs
for mild fatty liver - walk 30 mins, reduce fried food, sweets and oily food
mild protein leak
your ACR improved from 23 to 10 which is normal and telma is kidney protective
here's what you can do - avoid painkillers, keep bp under control, sugar control
no other treatment required
Health Tips
don't worry it is normal side effects of antipsychotics consult your psychiatrist and mention the above things
hope you feel better after this
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What is your main complaint?
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Hello, I understand your concern. You’re already managing multiple conditions very responsibly — diabetes, thyroid, and blood pressure are all well controlled, which is good.
Your current symptoms of nausea, vomiting, and loss of appetite with some weight loss could be due to a few possibilities — sometimes related to your medications (especially metformin or antidepressants), mild liver changes, or even functional stomach issues like gastritis or slow gastric emptying which can occur in diabetics.
Since your recent reports and scans are largely normal, it’s important now to review your medication timings, diet pattern, and look for subtle issues like vitamin deficiencies or diabetic gastroparesis. These can be managed well with minor changes in medicines and lifestyle once identified.
I’d suggest we go over your current medicines in detail and plan the next steps accordingly. Please book a video consultation so I can review your reports and advise specific changes to help improve your appetite and relieve the nausea safely.
Warm regards,
Dr. Yash Duragkar
MD Medicine | Internal Medicine & Diabetes Care
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For long run its required. Plant protein u can have.
Pain killers as u have fatty liver.
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Kindly consult directly on practo as I need more details
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Overtime medications like sertra and less likely can lead to such symptoms because of its action
Next Steps
suggest taking alternatives
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Hlo ma'am If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a free detailed discussion
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Need some more details kindly consult
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Take frequent small meals, avoid fatty and spicy food, drink more water.
Tab pantop d, one every morning and evening for 10 days.
Tab practin 25mg one every 8 hours for 5 days.
Connect with me for further guidance after starting this treatment.
Continue meds for high b.p. and diabetes.
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Need few more details
Kindly consult
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plz connect with me
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Avoid fried andbspicy food
Water intake more
Do connect and consult
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Hello,
I’ve reviewed your history in detail. You have well-controlled diabetes (HbA1c 5.7%), mild subclinical hypothyroidism, and currently mild fatty liver with a normal CT and no significant protein leak in urine (UACR 10). These are all good signs.
Your present complaints of nausea, loss of appetite, and mild weight loss are likely related to either fatty liver, medication side effects (particularly Serta or Petril), or gastritis/metformin-related gastric irritation.
My suggestions:
1. Continue your current diabetes and thyroid medicines as advised.
2. Take Istamet after meals and not on an empty stomach.
3. Avoid oily, spicy foods and late-night heavy meals.
4. For nausea, you can take Tab. Domperidone 10 mg or Ondansetron 4 mg before food (as advised by your doctor).
5. Continue following your nephrologist’s advice — moderate protein intake and avoid painkillers (NSAIDs).
6. Monitor weight and appetite; if weight loss continues, repeat thyroid and liver function tests after 4–6 weeks.
7. Ensure adequate hydration and small frequent meals.
8. If nausea persists despite above measures, consider reviewing antidepressant dose — sometimes Serta can affect appetite or cause nausea. Discuss this with your psychiatrist.
Overall, your reports are reassuring. Focus on balanced diet, proper sleep, and avoiding unnecessary medications.
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Needs to be evaluated
Do consult
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Dr. Shaikh Huzaif
General Physician
18 yrs exp
Aurangabad
Please consult
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Have bland diet
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Dr. Navneet
General Physician
3 yrs exp
Ambala
Your condition is not related to single diagnosis,it has differential diagnosis,you have subclinical hypothyroid with diabetes ,u saw sudden loss of weight from few days it can be due to your endocrine gland,u should have your thyroid profile check for weight loss,usg n CT abdomen is fine,ur uacr is fine ,
Next Steps
routine examination like cbc,lft rft,SE,Thyroid profile to rule out any abnormality in present condition thyroid profile to rule out weight loss with serum cortisol levels for insomnia
Health Tips
control your sugar levels ,take minimal protein,stay hydrated to increase energy levels
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Dr. Indravijaysinh
General Physician
4 yrs exp
Rajkot
Kindly check ( s.electrolytes) and then continue medicine
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Dr. Sachin Bhiwaji Sanap
General Practitioner
7 yrs exp
Hingoli
need more information
kindly consult
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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