1. Fatigue is a common reason people see their GP and often patients will request a blood test to find the underlying reason for their tiredness (I say this as a GP, but also as a patient who has presented fatigued hoping there is an organic reason for it (like thyroid issues or iron deficiency – anything to explain WHY I am so tired!) FYI there often isn’t an underlying cause for fatigue.


  1. In the vast majority of cases there are no medical or organic reasons for the fatigue. Most of the time fatigue is due to lifestyle factors such as poor-quality sleep (either not enough sleep, poor night time habits or frequent waking in the night), stress or lack of exercise. Fatigue is also commonly due to viral illnesses and this tends to improve over time.


  1. There can however, be organic causes for fatigue and iron deficiency can be a potential cause for fatigue particularly in adolescents (due to increasing requirements when they grow), women who are having regular heavy periods (due to iron losses) and vegetarians and vegans (due to reduced iron intake)


  1. When a GP assesses fatigue, we tend to look for what we call “red flags”– we usually enquire about the severity of the fatigue (can you still attend work? The gym?) and for other concerning symptoms such as weight loss, reduced appetite and night sweats for instance. If there are concerning features on history or examination then we may intervene with blood tests earlier.


  1. For most patients however, without concerning symptoms we tend to try and avoid blood tests and intervene on lifestyle factors first. Doing blood tests when they are not indicated can lead to more patient harm with incidental abnormalities being detected that then require investigation (which can then cause more issues for the patient). If you need a blood test your GP will do it (I promise!) but if we can pinpoint that your sleep quality could be improved or your physical activity levels we are likely to intervene on the lifestyle stuff first (as long as there are no concerning features on history or examination) and hold out on blood tests.
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