Perdita di appetito: cosa rivelano gli esami

A loss of appetite lasting several weeks is a symptom that may point to anything from liver inflammation to vitamin deficiencies. Blood tests help distinguish a temporary state from a more serious condition.

Liver: The Silent Appetite Regulator

Liver inflammation (hepatitis) is one of the most common causes of appetite loss. Elevated ALT and AST (more than 2 times the upper limit) indicate hepatocellular damage. GGT and ALP help differentiate cholestatic from hepatocellular patterns. Albumin below 35 g/L suggests decreased liver synthetic function — a later-stage finding (Source — StatPearls, 2023).

Kidneys and Uremia

Declining kidney function leads to toxin accumulation that suppresses appetite. Elevated creatinine and BUN with decreased eGFR indicate kidney insufficiency. Uremia (BUN above 20 mmol/L) directly affects the digestive tract and reduces appetite.

Inflammation and Infections

Chronic inflammation suppresses appetite through cytokine (TNF-alpha, IL-6) effects on the hypothalamus. hs-CRP above 3 mg/L and elevated ESR indicate systemic inflammation. A complete blood count may reveal infection: elevated white blood cells (bacterial) or decreased (viral).

Iron and Zinc

Iron deficiency (ferritin below 30 ng/mL) causes fatigue and decreased appetite. Zinc deficiency directly reduces taste perception (hypogeusia), making food unappealing. Zinc levels below 70 mcg/dL may be significant.

Thyroid and Hormones

Hypothyroidism slows metabolism and reduces appetite, although weight may increase due to fluid retention. Hyperthyroidism does the opposite — increases appetite but reduces weight. TSH and free T4 show the direction. Decreased cortisol (adrenal insufficiency) also causes appetite loss and fatigue.

Practical Checklist: What to Test

1. ALT, AST, GGT, ALP, albumin — liver function 2. Creatinine, eGFR, BUN — kidney function 3. hs-CRP, ESR, complete blood count — inflammation and infections 4. Ferritin, iron, zinc — nutrient deficiencies 5. TSH, free T4 — thyroid 6. Cortisol (morning) — adrenal glands

When to Seek Immediate Help

If appetite has completely disappeared and weight is dropping more than 5% per month, if skin or eyes have turned yellow, if there is fever or night sweats — see a doctor urgently. Sudden weight loss with appetite loss may indicate a serious condition.

Questions for Your Doctor

• Do my liver markers indicate inflammation?
• Is my kidney function adequate, or could uremia be present?
• Should zinc levels be checked for taste changes?
• Does my cortisol indicate adrenal insufficiency?