Fatigue check: why am I always tired?

Fatigue in midlife has a small number of common and testable causes, and the pattern usually points at one of them. Tiredness that sleep does not fix suggests fragmented sleep quality rather than quantity. Breathlessness and palpitations alongside it point to iron deficiency, very common with heavy perimenopausal bleeding. Feeling cold with weight gain points to thyroid. This check sorts the pattern; a blood test settles it.

Fatigue is the symptom most often attributed to hormones and most often caused by something else that is simple to test. The useful question is not how tired you are but how the tiredness behaves.

This check sorts your answers towards the patterns clinicians distinguish. It cannot diagnose anything — every one of these causes is confirmed or excluded by a blood test — but it will tell you which tests to ask for.

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Sources

• NHS — Tiredness and fatigue
• The Menopause Society — patient education
• Sleep Foundation — Menopause and sleep

Other self-checks