Dawaa Reference

Clinical reference

Underweight

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class TS50 - condition scope only, no dose · Irritable Bowel Syndrome - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK534810/ · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • The story is weight loss the patient never intended, poor appetite and feeling full early [poor appetite · weight loss]
  • Weight keeps falling even when intake looks adequate or has gone up
  • Tiredness, falling physical function, less exercise capacity and trouble with daily activities [fatigue]
  • Part of that tiredness is anaemia from the underlying chronic illness [anaemia · fatigue]
  • It arrives late in cancer or another chronic disease, so the history usually confirms a suspicion already held

Signs — what you find (4)

  • Marked muscle wasting, especially in the limbs, giving a gaunt look and a weak grip [muscle wasting]
  • Less fat under the skin, with shoulders, collarbones, ribs, hips and cheeks standing out
  • BMI is low, typically under 20 kg/m2
  • Look for pallor, swelling or enlarged organs from the illness underneath [pallor]

Tests (10)

  • The definition is unintended weight loss over 5%, or a BMI under 20 kg/m2, alongside continuing muscle loss, fatigue, poor appetite and declining function
  • Work out baseline calorie and protein intake and the needs on top, allowing for raised resting energy use
  • Bioelectrical impedance or DEXA quantifies muscle mass and fat stores and tracks change
  • Grip strength below 20 kg in men or below 14 kg in women shows impaired muscle function and predicts poor outcomes
  • Albumin, prealbumin and transferrin gauge protein status and nutritional reserve
  • A raised CRP points to inflammation driving the wasting, and tracks with how bad it is
  • A full blood count picks up anaemia and may hint at inflammation or infection
  • Electrolytes with liver and kidney function show malnutrition and organ damage
  • Check testosterone and thyroid hormones, which can worsen weight loss, wasting and fatigue
  • Look for deficiency of iron, vitamin D, B12 and folate, all common in chronic disease

If not this — what else fits (7)

  • Anorexia nervosa and other eating disorders lose weight severely but without the muscle wasting or metabolic changes
  • Plain starvation from too little food strips fat and lean mass without inflammation, and recovers with feeding
  • Heart failure, kidney failure, cancer and COPD cause malnutrition without the inflammatory pattern, though they can progress into it
  • Sarcopenia is age-related muscle loss with functional decline, but without inflammation or big weight loss
  • Most who are cachectic are also sarcopenic, but most with sarcopenia are not cachectic
  • Endocrine disease, malabsorption and psychiatric disorders also belong here
  • History, examination and relevant blood tests usually separate them

SourceStatPearls "Anorexia and Cachexia" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

A nonspecific finding; the GP's task is to identify and treat the underlying cause (malnutrition, chronic disease, eating disorder, overactive thyroid) rather than prescribe for being underweight itself. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A nonspecific finding; the GP's task is to identify and treat the underlying cause (malnutrition, chronic disease, eating disorder, overactive thyroid) rather than prescribe for being underweight itself.

Cautions
  • Unintentional significant weight loss can be a red flag for malignancy, tuberculosis, or other serious systemic illness and needs work-up.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.