Brief Answer:
Fatigue due to gastrointestinal issues

Detailed Answer:

Hi,

Since your T3, T4 levels are within normal range, I do not think hypothyroidism is the reason behind your fatigue.

Most probably reason for fatigue is the inflammation in the intestines that has been diagnosed as gluten allergy. Since you started on gluten free diet (which is not our normal XXXXXXX diet), combined with inflammation in intestine, this is the most probably reason.

I will like to know more details about your condition:
- Frequently gluten allergy is also associated with breathing or lung issues. Do you have any of these? Does your lung expand to the full while breathing? Is there any cough?
- Have you completely eliminated gluten or you are able to take wheat to some extent? Gluten intolerance maybe partial or complete. What are you taking in your diet?
- how is your blood pressure? Concor maybe adding to the fatigue
- Do you drink clean drinking water and hygienic food?
- How did gluten energy start? Any exposure to allergens e.g pets at home?

Best way to overcome this problem is to exercise daily for at least 30 min. Best exercise is to dance. Other exercise like yoga, swimming, cycling, gym etc., are also helpful. Meditation is also a good way to increase energy.

Since B12, D3 are normal, I do not think multivitamin will be helpful

Hope it clears your doubt. Let me know if I can assist you further.
Dr Vaishalee

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Brief Answer:
Blood test is available

Detailed Answer:

Hi,

If you can upload biopsy reports, it will be helpful for me to recommend further.

In your diet proteins and fats are lacking. Best is the wheat protein itself. It is not recommended to eliminate wheat protein completely unless you are having too many problems from it. Most gluten intolerant people are able to take gluten to some extent.

Blood test to detect gluten allergy is called anti-gliaden antibody test, TISSUE TRANSGLUTAMINASE (tTG) ANTIBODY, IgA and IgG. These maybe expensive but needed.

How are your gastrointestinal symptoms after eliminating gluten? This is a confirmatory method in itself. If your symptoms didnt improve or only improved for sometime, means you are not intolerant to gluten.

Dr Vaishalee

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Brief Answer:
No cause found

Detailed Answer:
Hi again

In biopsy report cause is not found. Most probably it is postinfectious type of inflammation. It means that there was an infection in the past and now the gut is recovering. Another cause could be an overgrowth of candida or another normal flora germs.

Anyways we need to implement lifestyle measures to normalise it:
- Drink water from RO system and take hygienic home cooked foods at all times
- If gluten elimination from diet is not effective is normalising symptoms, then its not the culprit. We can slowly start the normal diet. Firstly start taking a few biscuits and slowly when you feel comfortable, start the rotis etc.
- Avoid antibiotics. These can bring more harm then good
- Take probiotics like Yakult milk
- Exercise more often. Its best way to restore health and increase energy levels
- If at any time you notice any weird symptoms like blood in stools, weight loss with fever etc, please consult doctor immediately. These could be symptoms of inflammatory bowel disease, typhoid, etc.

Till then enjoy life and do not think too much about the inflammation. Inflammation only helps in recovering from infection etc.

Since your TSH is getting higher, please do a test called anti-TPO antibody test. This will also help rule out any auto-antibodies circulating in the body and attacking the body organs. Alongwith get tested for gluten. Though its not an emergency to do the tests at the earliest. You can do these in 3 weeks time after observing changes with healthy lifestyle.

Dr Vaishalee

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