Symptom

Fatigue: Why You're Always Tired and What Tests Can Find

Fatigue is one of the most common presenting complaints in medicine. Most causes are treatable once identified with the right blood tests.

Prevalence
~45 % of GP visits
Common causes
20+ identifiable causes
Key tests
FBC, TFT, glucose, ferritin
Often missed
Iron deficiency, hypothyroidism

Common Medical Causes

CauseClue SymptomKey Test
Iron deficiency anaemiaPale skin, cold hands, brittle nailsFerritin, FBC
HypothyroidismWeight gain, cold intolerance, constipationTSH, Free T4
Type 2 diabetesThirst, frequent urinationFasting glucose, HbA1c
Sleep apnoeaSnoring, morning headacheSleep study (polysomnography)
Depression / anxietyLow mood, anhedoniaClinical assessment
Coeliac diseaseBloating, diarrhoeatTG-IgA antibody
Chronic kidney diseaseSwelling, foamy urineeGFR, urea, creatinine
ME/CFSPost-exertional worseningDiagnosis of exclusion
Start With Blood TestsAsk your GP for: FBC, ferritin, TSH, fasting glucose, U&E, LFTs, CRP, and vitamin D. These cover the most common and easily-treated causes.

When Is Fatigue 'Normal'?

Short-term fatigue after illness, intense exercise, or major life stress is expected. Fatigue lasting more than 4–6 weeks with no clear cause warrants investigation.

What blood tests should I have for tiredness?
The core panel: FBC (anaemia), ferritin (iron stores), TSH (thyroid), fasting glucose or HbA1c (diabetes), vitamin D, CRP (inflammation), and kidney/liver function.
Can vitamin D deficiency cause extreme fatigue?
Yes. Severe vitamin D deficiency is associated with muscle aches, low mood, and fatigue. A simple blood test confirms it; supplementation usually helps.
Is fatigue a sign of cancer?
Unexplained persistent fatigue — especially with weight loss, night sweats, or lumps — warrants urgent GP assessment. Most fatigue is not cancer, but red-flag symptoms should be evaluated.
How is ME/CFS diagnosed?
ME/CFS is diagnosed after other causes are excluded. The hallmark is post-exertional malaise — fatigue that worsens significantly after physical or mental activity.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.