Nausea for 6 weeks w/vomiting

Age: 29 Sex: Female Height: 5’5” Weight: 213 lbs Location: USA Medical history: PCOS Medications: Metformin (stopped November 2025) Medroxyprogesterone Ondansetron Hydroxyzine s Duration of symptoms: Since January 4, 2026 (6+ weeks) Since January 4, my has experienced persistent daily nausea with vomiting of bile multiple times per day, particularly when her stomach is empty. Her appetite has been significantly reduced, and she reports ongoing fatigue and malaise. She also describes dull, achy abdominal pain with bilateral flank discomfort, intermittent chills (without documented fever), and significant sleep disruption. Anxiety developed after the onset of the nausea and appears to worsen as her physical symptoms intensify and her oral intake declines. She has not had consistent diarrhea and has not had sustained fevers. She was not cycling regularly prior to this episode. She began medroxyprogesterone on January 10 to induce a withdrawal bleed and experienced approximately one week of noticeable improvement in overall symptoms, including reduced nausea. Her withdrawal bleed occurred January 24–30. After stopping medroxyprogesterone, her symptoms returned. She has not had a menstrual cycle since. Hormone labs: • DHEA 1692 (within lab reference range) • Total testosterone normal • FSH 7.9 • LH 6.5 • TSH 2.08 • Estradiol 37 • Prolactin 32.4 (elevated) Metabolic / inflammatory labs: • Glucose 107 (high) • Insulin 31.7 (high) • Triglycerides 151 (high) • HDL 46 (low) • hs-CRP 4.4 (elevated) Liver: • AST 36 (mildly elevated) • ALT 59 (elevated)