The commonest explanation is not always a disease
- Inadequate sleep
- Insomnia
- Stress
- Anxiety or low mood
- Caring responsibilities
- Shift work
- Recent illness
- Low physical activity
- Medication
- Pregnancy or hormonal changes such as menopause
Could I be anaemic?
Yes. Iron-deficiency anaemia can cause tiredness, shortness of breath, palpitations, pallor and reduced exercise tolerance. Heavy menstrual bleeding is one common reason for iron deficiency in women. A blood test can check haemoglobin and, where appropriate, iron stores.
Could it be my thyroid?
Both overactive and underactive thyroid disease can affect energy. Other symptoms may include changes in weight, temperature tolerance, bowel habit, heart rate, periods, skin or hair. Thyroid blood tests are commonly considered when the history suggests thyroid disease.
Could it be diabetes?
Fatigue accompanied by excessive thirst, increased urination or unexplained weight loss can prompt testing for diabetes.
Could poor sleep be the real problem?
Absolutely. It is possible to spend eight hours in bed and still have poor-quality sleep. Think particularly about sleep apnoea if you have loud snoring, witnessed pauses in breathing, choking or gasping during sleep, morning headaches or significant daytime sleepiness.
What about vitamin deficiencies?
Sometimes nutritional deficiency contributes to fatigue, but ordering every available vitamin and hormone test is not necessarily useful. Testing should be guided by your symptoms, diet, medical history and examination.
Depending on the situation, a GP may consider a full blood count, ferritin, thyroid function, glucose or HbA1c, kidney and liver tests, B12 or folate, or other targeted investigations.
What about haemochromatosis?
Haemochromatosis is particularly relevant in an Irish context because it is an inherited iron-overload condition. Fatigue can occur, but so can joint pain, weight loss, sexual symptoms and other features. HSE advises assessment if you have persistent suggestive symptoms or a parent or sibling with haemochromatosis.
| PrivateGP.ieIf persistent tiredness is affecting your day-to-day life, an online GP consultation can form part of convenient and timely care or to provide an additional medical opinion. Through PrivateGP.ie, an Irish GP can review the pattern of your symptoms and advise whether you need blood tests, an examination, sleep assessment or another next step. It is important to note that in most cases of persistent tiredness updated blood tests and in person assessment are almost always usually required too. |
When should I speak to a GP?
- Fatigue has persisted for several weeks.
- It is interfering with work or family life.
- There is no obvious explanation.
- You are losing weight unexpectedly.
- You are breathless.
- You have abnormal bleeding.
- You have significant mood changes.
- You snore heavily or stop breathing in sleep.
- You have other new symptoms.
References and further information