A 52-year-old female patient presented with general weakness, headaches and occasional dizziness for the past three months. She had also had occasional abdominal discomfort, moderate anorexia, and minimal intermittent weight loss due to nausea. She tired more easily than before and had a degree of anhedonia.

She was normally well, had a balanced diet and was not on regular medication. Her periods had stopped three years ago and menopausal symptoms had lessened since.

She seemed frustrated and concerned, and had done some research into possible causes for her symptoms. She was unaware of any possible reason for anaemia and there was no family history of thyroid problems, but she indicated she would like these two possibilities ruled out.