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When You’re Always Tired: How Your GP Investigates Fatigue

ByTeam Sandstone Healthcare

How GPs think about fatigue as a symptom

Fatigue and Chronic Fatigue is one of the most common reasons people see their GP, accounting for roughly 1-2% of all consultations in Australian general practice. When you come in feeling exhausted, we’re thinking about three broad areas:

  • Physical causes include anaemia, thyroid problems (both underactive and overactive), diabetes, sleep disorders like sleep apnoea, and chronic infections. We also consider whether medications you’re taking might be contributing. Things like blood pressure tablets, antihistamines, or pain medications can all cause fatigue.
  • Mental health can be part of the picture. About 69% of people with depression present with physical symptoms rather than low mood, and fatigue is often the main one. Depression and anxiety don’t always feel like sadness or worry, sometimes they just feel like exhaustion that won’t shift.
  • Lifestyle factors matter enormously. Shift work, broken sleep, caring responsibilities, and accumulated stress all take a real physical toll.

What blood tests can reveal, and what they can’t

When we order blood tests for chronic fatigue, we’re typically looking at a focused set: a full blood count (checking for anaemia or infection), inflammatory markers, thyroid function, blood glucose, and kidney and liver function. Sometimes we’ll add iron studies if there’s reason to suspect deficiency.

Here’s the thing: serious physical disease is found in only about 4-8% of people who present with fatigue in general practice. That includes conditions like significant anaemia (around 3% of cases), thyroid disorders (1-3%), diabetes, or more rarely, things like heart failure or undiagnosed cancer.

Most of the time, blood tests don’t identify a single clear cause. In one large study following fatigued patients for a year, more than half never received a diagnosis that fully explained their tiredness. Normal results are genuinely useful information! They tell us we can focus on other contributing factors: sleep quality, mood, stress, work patterns, and how all of these interact.

Our passion shows up as partnership, too. Partnership with you, because you know your own life best. And with each other, because great healthcare isn’t a solo act. Our collaborative approach means we work closely with you to understand the full context of your fatigue, including your lifestyle, stressors, and emotional wellbeing. It also involves coordinating with other healthcare professionals when needed (e.g. Mental health counsellors or dieticians) to ensure a comprehensive evaluation and health management plan.

By combining your knowledge with medical experience, the partnership aims to identify the root causes of your fatigue and develop tailored strategies to improve your energy levels and quality of life.

When to see your GP for fatigue symptoms

If you’ve been tired for more than a few weeks, particularly if it’s affecting your ability to work or do things you enjoy, it’s worth seeing your GP.

We’ll want to know about:

  • The pattern of your fatigue
  • Your sleep patterns
  • Your mood and any changes
  • Any other symptoms, and
  • What’s happening in your life that could contribute

We’re also vigilant for “red flags” and indicators of serious underlying medical conditions that require prompt and thorough investigation.

For most people, though, the process is gradual. We do some basic tests, we talk about mood and stress, we look at your medication list, and we start addressing the most likely contributors. Sometimes it’s about treating depression or anxiety. Sometimes it’s about practical changes to sleep routines or work patterns. Often, it’s several things working together.

Investigating fatigue isn’t about a single test providing a clear yes-or-no answer. Instead, it’s an ongoing conversation that develops as we gather more information. Even when blood tests come back normal, these results serve as a crucial starting point to identify the underlying causes and determine the best ways to relieve fatigue.

Further Reading 

If you’re experiencing persistent tiredness or unexplained fatigue, don’t hesitate to consult your GP for a comprehensive evaluation and personalised treatment plan.

BOOK AN APPOINTMENT.

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Author: Team Sandstone Healthcare

Our Sandstone Healthcare team includes doctors, nurses, allied health practitioners and partners, putting our heads together to exchange questions, discoveries and expertise. This is another way we can pass along the best of what we find.
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