The patient is a 35 year old male who presents with the symptoms of increased fatigue and decreased libido. He also complains of headache, black, tarry stools, abdominal pain, bloated feeling following meals, nausea and vomiting, loss of facial hair, muscle pain, cold sensitivity and unintentional weight loss. He is unsure when his symptoms started. He can not identify any aggravating or alleviating factors for his symptoms at this time.