Anonymous
Post 09/13/2025 14:10     Subject: Sudden onset water weight gain in 20 y.o.
OP what people are trying to gently tell you and DD is that the incremental approach your doctor is leading you down is not appropriate. This is not POTS related.
DD either has serious kidney disease or a heart issue like congestive heart failure or cardiomyopathy.
Please go to the ER and thus she will get specialists asap. Sibley, VHC. Not some minute clinic.
Anonymous
Post 09/13/2025 14:01     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:
Anonymous wrote:They will run a complete blood count because they always do, but mine are always normal. Hemoglobin may be low (mine has slid to the very low end of normal when it was formerly in the middle of the range.

The metabolic panel run should be comprehensive, not basic. On this, you are looking for low total protein and low albumin. Fasting should make no difference to these results. Although I have kidney disease, my creatinine is always normal, but I tend to have elevated BUN and thus a high BUN/creatinine ratio. EGFR is something they look for in kidney disease; in young healthy people it is way over 100, mine is in the high 80s but that's good for my age even if I didn't have kidney disease. EGFR is not hugely reliable because factors like dehydration can have a big effect.

On the urinalysis, you are looking for a positive result for protein. Any amount of protein in the urine requires further investigation. Mine is 3+ (my first line medication appears to have done nothing, so I will have go to another option).


Not too low of an albumin level. In the normal range. I'm the poster with the father who had extensive generalized swelling and his albumin was at 25, which points to severe malnutrition. Like the starving kids in Somalia. It was the first emergency they treated in hospital.



I just looked up high albumin. It is interesting that both high and low albumin in the blood can cause swelling and foamy urine. The causes for high and low are quite different, though.
Anonymous
Post 09/13/2025 13:53     Subject: Sudden onset water weight gain in 20 y.o.
Heart and kidneys. If the doc hasn't worked these up, get a referral to the relevant specialists and get it done. Good luck.
Anonymous
Post 09/13/2025 13:51     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:They will run a complete blood count because they always do, but mine are always normal. Hemoglobin may be low (mine has slid to the very low end of normal when it was formerly in the middle of the range.

The metabolic panel run should be comprehensive, not basic. On this, you are looking for low total protein and low albumin. Fasting should make no difference to these results. Although I have kidney disease, my creatinine is always normal, but I tend to have elevated BUN and thus a high BUN/creatinine ratio. EGFR is something they look for in kidney disease; in young healthy people it is way over 100, mine is in the high 80s but that's good for my age even if I didn't have kidney disease. EGFR is not hugely reliable because factors like dehydration can have a big effect.

On the urinalysis, you are looking for a positive result for protein. Any amount of protein in the urine requires further investigation. Mine is 3+ (my first line medication appears to have done nothing, so I will have go to another option).


Not too low of an albumin level. In the normal range. I'm the poster with the father who had extensive generalized swelling and his albumin was at 25, which points to severe malnutrition. Like the starving kids in Somalia. It was the first emergency they treated in hospital.

Anonymous
Post 09/13/2025 13:47     Subject: Re:Sudden onset water weight gain in 20 y.o.
They will run a complete blood count because they always do, but mine are always normal. Hemoglobin may be low (mine has slid to the very low end of normal when it was formerly in the middle of the range.

The metabolic panel run should be comprehensive, not basic. On this, you are looking for low total protein and low albumin. Fasting should make no difference to these results. Although I have kidney disease, my creatinine is always normal, but I tend to have elevated BUN and thus a high BUN/creatinine ratio. EGFR is something they look for in kidney disease; in young healthy people it is way over 100, mine is in the high 80s but that's good for my age even if I didn't have kidney disease. EGFR is not hugely reliable because factors like dehydration can have a big effect.

On the urinalysis, you are looking for a positive result for protein. Any amount of protein in the urine requires further investigation. Mine is 3+ (my first line medication appears to have done nothing, so I will have go to another option).
Anonymous
Post 09/13/2025 13:22     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I don’t think you need the ER (something that’s been an issue for the past 2 months is not an emergency). But I would consider checking for hyperaldosteronism (either with an endocrinologist or nephrologist)

Building on this, does whatever she uses to supplement her salt intake include potassium as well as sodium?


Hi this is OP. She takes about six salt tablets a day. She had one or packs of liquid IV or Gatorade. She takes a multivitamin. Doctor prescribed her a very light potassium sparing diuretic. She’s only been taking it for two days. She hasn’t noticed a difference, but she doesn’t feel any worse either.

Honestly, it sounds like her doctor sucks. 20 lbs of weight gain is extremely concerning! And potassium deficiency is a potential cause. Potassium-sparing is insufficient if her potassium levels are already low. At the same time, you have to be careful with potassium supplementation. Normally I would think there is no harm in taking a sports drink, but her electrolyte balance is so out of whack that I would not risk experimenting with anything on my own.

Since it's Saturday, your best bet is the ER to get treated immediately. But for sure you need someone who knows what they are doing, and this doctor does not sound like they do.


This is OP. Her sodium and potassium actually were in normal levels as of two weeks ago. She had another blood draw yesterday, because she started the diuretic, and doctor will look for any changes in electrolytes levels.

DD disagreed with my suggestion that she go in and be seen immediately. She thinks it’s just a bad POTS flare. I’m going to strongly suggest she been seen by cardiologist sooner, as well as endocrinologist as a PP suggested, because all of this is not normal.

OP, this sounds really hard as a parent. I have a chronic disease, and even now in my 40s my parents freak out when they feel that I'm not caring for myself properly. In college (and I assume your 20 y.o. is away in college), I for sure did not. And navigating university student healthcare was a pain anyway. At the same time, it was really important to me to start to become self-sufficient in managing my disease.

One thing that's unclear is who is currently treating her. Is it her PCP or a specialist with expertise in POTS. I agree with a PP who said that a 20 y.o. probably doesn't understand how serious this situation is. I was literally 20 y.o. when I had a pretty significant flare up of my disease, that I didn't realize was serious. Luckily, I had a very pushy specialist who knew exactly what was going on, and she gave me some tough love in addition to an aggressive treatment plan. For me that's been a lifelong reminder that sometimes I do need to take things seriously.
Anonymous
Post 09/13/2025 13:20     Subject: Re:Sudden onset water weight gain in 20 y.o.
^^ Last urinalysis was done two months ago. All normal except PH was on the high end of normal. We can have her ask for a follow up.
Anonymous
Post 09/13/2025 13:17     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:Not to go too TMI, but have her check for foam/bubbles in her urine. That is a sign (but definitely not determinative) of protein in her urine.

If she has it, it is very likely kidney dysfunction. It can be confirmed with very basic blood tests (complete blood count and metabolic panel) plus a urine test. You could also check to see if her resting blood pressure is high. A cholesterol panel is also helpful but not necessary unless her blood tests show low protein and albumin and her urine test shows protein.

Full disclosure: Something similar happened to me but more dramatic and in the space of a week. I was misdiagnosed at the ER with heart problems because they didn't do a urine test. Ultimately, I had a kidney biopsy and was diagnosed with an autoimmune kidney disease that first shows itself as nephrotic syndrome, which may be what your DD has.

One reason to go the the ER is that if tests show kidney or cardiac issues, they will locate a specialist to see her immediately. Both nephrologists and cardiologists can otherwise take months to get into even with a primary doctor referral.


Thanks so much PP. What types of issues would you see in routine bloodwork and metabolic. She just had that done two weeks ago. She has some abnormalities but doctor says these are not abnormal for someone her age. Protein was low (6.2) but she was fasting. Bilirubin, globulin and ratio were in normal range. Creatinine was the only other slightly low value (.51).
Anonymous
Post 09/13/2025 13:16     Subject: Re:Sudden onset water weight gain in 20 y.o.
^^Just to add, although I had very dramatic swelling that prompted me to go to the ER, I otherwise felt perfectly fine and would not have seen a doctor otherwise. Kidney disease is tricky that way; you can feel just fine but actually be pretty sick. So, I understand well why a 20 y.o may think this is no big deal.
Anonymous
Post 09/13/2025 13:13     Subject: Sudden onset water weight gain in 20 y.o.
Honestly, OP, I would go to the ER and get eyes on her and testing. This could be her heart or kidneys - don't want to mess with either. Worst case, you learn more and get fresh eyes on her. Also, they can refer you into a specialist more quickly.
Anonymous
Post 09/13/2025 13:10     Subject: Re:Sudden onset water weight gain in 20 y.o.
Not to go too TMI, but have her check for foam/bubbles in her urine. That is a sign (but definitely not determinative) of protein in her urine.

If she has it, it is very likely kidney dysfunction. It can be confirmed with very basic blood tests (complete blood count and metabolic panel) plus a urine test. You could also check to see if her resting blood pressure is high. A cholesterol panel is also helpful but not necessary unless her blood tests show low protein and albumin and her urine test shows protein.

Full disclosure: Something similar happened to me but more dramatic and in the space of a week. I was misdiagnosed at the ER with heart problems because they didn't do a urine test. Ultimately, I had a kidney biopsy and was diagnosed with an autoimmune kidney disease that first shows itself as nephrotic syndrome, which may be what your DD has.

One reason to go the the ER is that if tests show kidney or cardiac issues, they will locate a specialist to see her immediately. Both nephrologists and cardiologists can otherwise take months to get into even with a primary doctor referral.
Anonymous
Post 09/13/2025 13:06     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I don’t think you need the ER (something that’s been an issue for the past 2 months is not an emergency). But I would consider checking for hyperaldosteronism (either with an endocrinologist or nephrologist)

Building on this, does whatever she uses to supplement her salt intake include potassium as well as sodium?


Hi this is OP. She takes about six salt tablets a day. She had one or packs of liquid IV or Gatorade. She takes a multivitamin. Doctor prescribed her a very light potassium sparing diuretic. She’s only been taking it for two days. She hasn’t noticed a difference, but she doesn’t feel any worse either.

Honestly, it sounds like her doctor sucks. 20 lbs of weight gain is extremely concerning! And potassium deficiency is a potential cause. Potassium-sparing is insufficient if her potassium levels are already low. At the same time, you have to be careful with potassium supplementation. Normally I would think there is no harm in taking a sports drink, but her electrolyte balance is so out of whack that I would not risk experimenting with anything on my own.

Since it's Saturday, your best bet is the ER to get treated immediately. But for sure you need someone who knows what they are doing, and this doctor does not sound like they do.


This is OP. Her sodium and potassium actually were in normal levels as of two weeks ago. She had another blood draw yesterday, because she started the diuretic, and doctor will look for any changes in electrolytes levels.

DD disagreed with my suggestion that she go in and be seen immediately. She thinks it’s just a bad POTS flare. I’m going to strongly suggest she been seen by cardiologist sooner, as well as endocrinologist as a PP suggested, because all of this is not normal.
Anonymous
Post 09/13/2025 12:45     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I don’t think you need the ER (something that’s been an issue for the past 2 months is not an emergency). But I would consider checking for hyperaldosteronism (either with an endocrinologist or nephrologist)

Building on this, does whatever she uses to supplement her salt intake include potassium as well as sodium?


Hi this is OP. She takes about six salt tablets a day. She had one or packs of liquid IV or Gatorade. She takes a multivitamin. Doctor prescribed her a very light potassium sparing diuretic. She’s only been taking it for two days. She hasn’t noticed a difference, but she doesn’t feel any worse either.

Honestly, it sounds like her doctor sucks. 20 lbs of weight gain is extremely concerning! And potassium deficiency is a potential cause. Potassium-sparing is insufficient if her potassium levels are already low. At the same time, you have to be careful with potassium supplementation. Normally I would think there is no harm in taking a sports drink, but her electrolyte balance is so out of whack that I would not risk experimenting with anything on my own.

Since it's Saturday, your best bet is the ER to get treated immediately. But for sure you need someone who knows what they are doing, and this doctor does not sound like they do.
Anonymous
Post 09/13/2025 12:32     Subject: Re:Sudden onset water weight gain in 20 y.o.
^^one or two packs
Anonymous
Post 09/13/2025 12:32     Subject: Re:Sudden onset water weight gain in 20 y.o.
Anonymous wrote:
Anonymous wrote:I don’t think you need the ER (something that’s been an issue for the past 2 months is not an emergency). But I would consider checking for hyperaldosteronism (either with an endocrinologist or nephrologist)

Building on this, does whatever she uses to supplement her salt intake include potassium as well as sodium?


Hi this is OP. She takes about six salt tablets a day. She had one or packs of liquid IV or Gatorade. She takes a multivitamin. Doctor prescribed her a very light potassium sparing diuretic. She’s only been taking it for two days. She hasn’t noticed a difference, but she doesn’t feel any worse either.