What is the appropriate explanation and plan for a 33-year-old female patient with body aches, recent surgery, and a history of Bipolar Disorder, Depression, and Anxiety, who presents with laboratory results showing hyponatremia, hypercholesterolemia, elevated C-Reactive Protein (CRP), and normal sex hormone binding globulin (SHBG) levels?

Differential Diagnosis for 33-year-old Female with Body Aches

Single Most Likely Diagnosis

• Hypothyroidism: The patient's symptoms of morning body aches, similar to flu-like symptoms, and getting really hot at night could be indicative of hypothyroidism. The low sodium level (132) and slightly elevated CRP (1.05) may also support this diagnosis. Additionally, hypothyroidism is commonly associated with fibromyalgia, which the patient is concerned about.

Other Likely Diagnoses

• Fibromyalgia: Given the patient's symptoms of intense body aches, especially in the morning, and her concern about fibromyalgia, this diagnosis is a strong consideration. However, the lack of tenderness to touch and the easing of pain upon waking and becoming alert may not fully align with typical fibromyalgia symptoms.
• Medication Side Effects: The patient is on medications for bipolar disorder, depression, and anxiety. Some of these medications can cause side effects such as body aches or flu-like symptoms, which could be contributing to her current condition.
• Post-Surgical Pain: The patient had surgery a few weeks ago, and it's possible that her body aches are related to the surgical procedure or the recovery process.

Do Not Miss Diagnoses

• Adrenal Insufficiency: Although less likely, adrenal insufficiency can cause body aches, fatigue, and orthostatic hypotension. The patient's low sodium level (132) could be a hint towards this diagnosis, and it's crucial not to miss it due to its potential severity.
• Inflammatory Arthritis: Conditions like rheumatoid arthritis or lupus can cause body aches and flu-like symptoms. The slightly elevated CRP (1.05) may indicate an inflammatory process, making this a diagnosis that should not be overlooked.

Rare Diagnoses

• Pituitary or Hypothalamic Dysfunction: Given the patient's symptoms and laboratory results, including the low sodium level and elevated sex hormone-binding globulin (SHBG), a rare possibility could be a dysfunction of the pituitary or hypothalamic gland, affecting hormone regulation.
• Parathyroid Disorder: Although the patient's calcium level is not provided, a parathyroid disorder could potentially cause body aches and other symptoms. This would be a rare but possible diagnosis to consider if other more common causes are ruled out.