Review of systems should seek symptoms that suggest possible causes, such as Weight loss and fatigue (cirrhosis, undernutrition, chronic kidney disease, hyperthyroidism) Skin discoloration (chronic kidney disease, cirrhosis) Hair loss and frequent infections (undernutrition) Fragility fractures (undernutrition, hypogonadism) Mood and cognitive changes (hypogonadism) Tremor, heat intolerance, and diarrhea (hyperthyroidism) Past medical history should address disorders that can cause gynecomastia and include a history of all prescribed and over-the-counter drugs.