Meet Priya (name changed), a 32-year-old software engineer who recently moved from Kolkata to Delhi for work. She’s always been healthy, but over the past year, she’s been feeling off—constantly exhausted, battling weird bloating after meals, and lately, even her hands and feet have started tingling like tiny pins are poking her.
She lost 8 kgs in the last 6 months without trying, and there was just this nagging fatigue that coffee won’t fix. Was it the new environment or something more sinister?
So you decide to run some tests.
CBC - Hb 9.2
B12 Levels - Normal
TFT - Normal
Meh! Just Iron Deficiency anaemia… Lets give her iron tablets, ask her to eat healthy and review after 2 months.
2 Months later… She came back worse than before. So you take a detailed history and…
The Clues Pile Up
- The Oats Experiment
- On a health kick, she tried eating oats for breakfast.
- Result? Severe bloating, cramps, diarrhoea—so bad she quit after a week.
- The North Indian Diet Shift
- Back in Kolkata, she ate mostly rice, fish, lentils.
- In Delhi? Roti, paratha, sandwiches
- The Sister’s Secret
- Her older sister has Hashimoto’s thyroiditis.
- The Mouth Ulses No One Could Explain
- Recurrent, painful canker sores—annoying but “just one of those things.”
What might the diagnosis be? How will you proceed. Answers in the comments.
You order an Endoscopy with Biopsy, and this is what you see
Serum TtG = elevated, Total IgA = Elevated
If you want to solve it yourself, you can order investigations and I will reply with the results, be sure to ask any questions if you have