Anorexia Nervosa

Sign/Symptoms
Absence or Loss of Menstruation (Amenorrhoea) Anaemia (Anemia) Behaviour: Aggressive When Forced To Eat Behaviour: Deterioration in Family Relationships Behaviour: Excessive Exercise Behaviour: Food Restrictions Behaviour: Refusing to eat Food Behaviour: Self Harm Behaviour: Substance Abuse Behaviour: Withdrawal from Friendships Behaviour: Withdrawal from Peer Relationships Blood Circulation Poor Blood Flow Reduced (Ischaemia) Blood Pressure Below Normal (Hypotension) Blood: Zinc Deficiency Body Temperature Below Normal (Hypothermia) Bruising (Contusion) Constipation Creaking Bones Creaking Joints Difficulty in Moving the Feet Erection Failure: Impotence Eyes Sunken Fainting (Syncope) Feeling Cold Fingernails: Brittle (Onychorrhexis) Fluid Collection in Ankles at Daytime Fluid Collection in Eyes at Night Growth Impairment or Stunted Hair Thinning Hair: Fine Hair Growth (Lanugo) Headache (Cephalgia) Heartbeats Felt By Patient (Palpitations) Immune Dysfunction Libido (Sex Drive) Decrease Lips Chapped Mind: Depression Mind: Distorted Body Image Mind: Large Self Evaluation of Body Shape and Weight Mind: Low Self Efficacy Mind: Low Self Esteem Mind: Mood Swings Mind: Obsessive Thoughts About Food Mind: Obsessive Thoughts About Weight Mind: Perfectionism Mind: Poor Insight Mind: Sensitive To Body References Mind: Sensitive to Weight References Mind: Suicidal Ideation Muscle Weakness Nerve Deterioration Osteoporosis (Reduced Bone Density) Reduced Immune System Function Skin Dry Tooth Decay (Cavities or Caries) Weight Loss (Body Mass Index Decreased) White Blood Cell Count Reduced (Leukopenia)

Drugs

Our Records are Incomplete for Drugs

Treatments
Medical Procedure Fluid input and output monitoring Vitamins Calcium Supplement Weakly in Favour Low Evidence Vitamin A Strongly in Favour High Evidence Vitamin D3 Weakly in Favour Low Evidence Minerals Calcium Supplement Weakly in Favour Low Evidence Alternative Medicine Essiac Tea (Flor Essence) No Recommendation Low Evidence Goldenseal (Hydrastis Canadensis) Weakly Against Low Evidence Mugwort (Artemisa Vulgaris) No Recommendation Very Low Evidence Saw Palmetto Extract No Recommendation Very Low Evidence Strychnos Nux Vomica (Maqianzi, Poison Nut) Strongly Against Very Low Evidence Medical Therapy Cognitive Behavioural Therapy Weakly in Favour Low Evidence Fluid input and output monitoring Weakly in Favour Low Evidence

Attributes

Our Records are Incomplete for Condition Attributes

Further Tests
Anion Gap Anion Gap (Excluding Potassium) (Increased) Apolipoprotein A Concentration Apolipoprotein A (Apo A) (Increased) Apolipoprotein B Concentration Apolipoprotein B (Apo B) (Increased) Carbon Dioxide Total Content (TCO2) Carbon Dioxide Total Content (TCO2) (Decreased) Eosinophils Count Eosinophils (Decreased) Folic Acid (Folate) Concentration Folic Acid (Folate) (Decreased) Folic Acid (Folate) Concentration Folic Acid (Folate) (Decreased) Follicle-Stimulating Hormone (FSH) Concentration Follicle-Stimulating Hormone (FSH) (Decreased) Luteinizing Hormone (LH) Concentration Luteinizing Hormone (LH) (Decreased) Neutrophil Absolute Count Segmented Neutrophils (Decreased) Prolactin Concentration Prolactin (Increased) Renin Assay Renin (Decreased) Somatotropin Concentration Test Cortisol (Increased) Urine Estradiol (E2) Concetration Urine Estradiol (E2) (Decreased) Urine Estriol (E3) Concentration Urine Estriol (E3) (Decreased) Urine Ketone Concentration Urine Ketone (Increased)

Anorexia Nervosa

Anorexia nervosa is an eating disorder typified by a distorted body image, an abnormally low body weight, and an extreme fear of gaining weight.

Causes

In many cases, the onset of anorexia nervosa can be attributed to either or both of hereditary and social factors; namely, the cultural stigma associated with obesity.

The disorder usually develops during or slightly prior to adolescence, and is most prevalent in those of middle to upper socioeconomic status.

Symptoms and diagnosis

The symptoms of anorexia nervosa will vary greatly, depending on the severity of the disorder. Some mild cases may not even be identified.

The first indication of anorexia nervosa may be a preoccupation with dieting and weight loss. They are preoccupied with food; counting calories, studying diets and cooking for others, while abstaining from consumption.

Some people with anorexia nervosa binge eat then purge, while others restrict their consumption significantly.

Other symptoms of anorexia nervosa include:

· Severe weight loss;

· Amenorrhoea – loss of menstruation;

· Low heart rate, body temperature and blood pressure;

· Growth of fine soft hair over skin;

· Bloating and constipation;

· Erosion of tooth enamel, from excess regurgitation.

Diagnosis of anorexia nervosa is often achieved by physical examination, along with the doctor questioning and evaluating the patient’s mental state; particularly in regard to their weight and body image. Anorexia nervosa is considered to be likely if the patient presents with one or more of the following:

· Low body weight, or a body mass index (BMI) less than 17.5;

· Denial of the disorder;

· Absence of menstruation in women of reproductive age; and

· Abnormal fear of obesity.

Treatment

In severe cases, people with anorexia nervosa are hospitalized to ensure that they consume sufficiently many calories and nutrients. People with milder cases are treated as outpatients, with regular check-ups from a doctor and/or nutritionist.

Other problems arising from poor nutrient intake may also need to be addressed; for example, calcium supplements may be needed for lost bone density. Sometimes psychiatric counseling is also required.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Vitamin B Complex [1, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47]:

Please note, this management does NOT treat the condition itself. It may mildly help in preventing some of the symptoms, and even then has insufficient evidence to back up this claim at present. Please note, this acts as a PREVENTATIVE treatment, and not necessarily symptomatic relief. Supplements should only be taken if they contain no more than 100% of the recommended daily value

Recommendation: Strongly in favor (Vitamin B may help in preventing anorexia due to its role in maintaining appetite)

Grade of Evidence: High quality of evidence

Vitamin A [1, 31, 32, 33, 34, 35, 36, 37]:

Recommendation: Strongly in favor (Vitamin A may help in treating/preventing anorexia nervosa due to its role in improving poor appetite)

Grade of Evidence: High quality of evidence

Strychnos Nux-Vomica (Maqianzi, Poison Nut) [1, 28, 29, 30]:

WARNING! This substance is HIGHLY POISONOUS. The seeds contain Strychnine, which may cause convulsions, breathing difficulties and death, even if as little as 5 milligrams is ingested.

Recommendation: Strongly against (There is no evidence in the form of clinical trials which reports the effectiveness of Strychnos Nux-Vomica, because it is highly poisonous to humans, and is not recommended.)

Grade of Evidence: Very low quality of evidence

Saw Palmetto Extract [1, 21, 22, 23, 24, 25, 26, 27]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Palmetto extract may cause side effects, though these are uncommon. They may include headache, vomiting, dizziness, constipation, diarrhoea, insomnia or fatigue. Long term effects have not yet been researched.

Recommendation: No recommendation (There is insufficient evidence to support claims that saw palmetto helps to treat anorexia nervosa. More research is needed.)

Grade of Evidence: Very low level of evidence

Mugwort (Artemisa Vulgaris) [1, 18, 19, 20]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat symptoms of anorexia nervosa. More research is needed.)

Grade of Evidence: Very low quality of evidence

Cannabis (Marijuana, weed, hemp) [1, 9, 10, 11, 12, 13, 14, 15, 16, 17]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (Evidence shows that smoking or ingesting cannabis may help in relieving symptoms of decreased appetite in anorexia nervosa, and may aid in patients regaining lost weight, although some studies have yielded mixed results)