# The Mysterious Case of the Tired, Tingling Woman **URL:** \ **Category:** General\ **Tags:** medical, mbbs\ **Created:** [May 15, 2025, 5:12pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655 "2025-05-15T17:12:28Z")\ **Posts on this page:** 7\ **Page:** 1
**Author:** ![Jaideep](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/jaideep/32/300_2.png) [@Jaideep](https://www.medboundhub.com/u/Jaideep)\ **Post date:** [May 15, 2025, 5:12pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/1 "2025-05-15T17:12:28Z")
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** 1. **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. 1. **The North Indian Diet Shift** - Back in Kolkata, she ate mostly **rice, fish, lentils**. - In Delhi? **Roti, paratha, sandwiches** 1. **The Sister’s Secret** - Her older sister has **Hashimoto’s thyroiditis**. 1. **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 ![image](https://canada1.discourse-cdn.com/flex033/uploads/medbound/original/1X/b54ff0d02ea0db2c33eeacf4a9bd88da8ae4de16.jpeg) _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_ ---
**Author:** ![Bhavini](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/bhavini/32/521_2.png) [@Bhavini](https://www.medboundhub.com/u/Bhavini)\ **Post date:** [May 15, 2025, 5:38pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/2 "2025-05-15T17:38:03Z")
Celiac disease ---
**Author:** ![Jaideep](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/jaideep/32/300_2.png) [@Jaideep](https://www.medboundhub.com/u/Jaideep)\ **Post date:** [May 15, 2025, 5:50pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/3 "2025-05-15T17:50:13Z")
Absolutely Correct @Bhavini! How will you Proceed with the management? ---
**Author:** ![Hbdoctor](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/hbdoctor/32/571_2.png) [@Hbdoctor](https://www.medboundhub.com/u/Hbdoctor)\ **Post date:** [May 15, 2025, 6:22pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/4 "2025-05-15T18:22:55Z")
Good clinical vignette. ---
**Author:** ![Moksha\_s](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/moksha_s/32/271_2.png) [@Moksha\_s](https://www.medboundhub.com/u/Moksha_s)\ **Post date:** [May 16, 2025, 6:36am UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/5 "2025-05-16T06:36:02Z")
The best way to manage celiac disease is lifestyle modifications n gluten free diet ---
**Author:** ![Dr.Harshwardhan](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/dr.harshwardhan/32/148_2.png) [@Dr.Harshwardhan](https://www.medboundhub.com/u/Dr.Harshwardhan)\ **Post date:** [May 16, 2025, 7:58am UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/6 "2025-05-16T07:58:46Z")
Yes correct! ---
**Author:** ![Sakshi\_Phaugat](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/sakshi_phaugat/32/5391_2.png) [@Sakshi\_Phaugat](https://www.medboundhub.com/u/Sakshi_Phaugat)\ **Post date:** [July 22, 2026, 4:42pm UTC](https://www.medboundhub.com/t/the-mysterious-case-of-the-tired-tingling-woman/1655/7 "2026-07-22T16:42:57Z")
This is a great reminder that not every case of iron deficiency anemia is due to poor diet or blood loss. When symptoms persist despite treatment, it’s important to look for the underlying cause rather than just treating the deficiency. The history of bloating after gluten-containing foods, unintentional weight loss, recurrent mouth ulcers, and a family history of autoimmune disease are all important clues. This case really highlights the value of taking a thorough history and keeping a broad differential diagnosis. Very interesting clinical scenario!