Nadia: seven doctors in eighteen months

The case (fictional)

Nadia is a 29-year-old accountant in Lahore. In eighteen months she has seen seven doctors about palpitations, a burning feeling in her stomach, tingling in her hands and constant tiredness. Her ECGs, an endoscopy, thyroid tests and a vitamin B12 level were all normal, as was a brain MRI she paid for herself. Low vitamin D was found and treated last year.

She spends hours each evening searching her symptoms online and is convinced she has multiple sclerosis or a heart condition. Each normal result brings relief "for a day or two". Three years ago a cousin died of a brain tumour at the age of 32. She has a panic attack about once a month.

She is tearful, has stopped going to the gym, and her husband is frustrated by the cost of private tests. She now asks her GP to refer her to a neurologist in Dubai. When asked, she says she sometimes feels hopeless.

She also mentions, almost in passing, that her periods are very heavy every month and she is "always exhausted".

Her GP refers her to a psychologist.