Fatigue is common but has many possible causes. Insufficient sleep, caring stress, inactivity and irregular meals may contribute, while anaemia, thyroid disease, diabetes, kidney disease, infection, sleep apnoea, medicine effects, anxiety and depression should also be considered. A general label of constitutional weakness cannot explain every case.
A two-week record of sleep, activity, diet, menstrual or other bleeding, weight change, medicines and associated symptoms can help. Based on the history and examination, a clinician may consider a blood count, glucose, kidney, liver or thyroid tests. More testing is not always better; investigations should address plausible causes.
TCM may provide supportive care based on sleep, appetite, digestion, pain and the overall presentation, but tonics are not suitable for everyone. Fatigue with chest pain, breathlessness, black stools, persistent fever, significant weight loss, neurological symptoms or severe low mood requires prompt medical assessment.
It helps to distinguish fatigue, sleepiness and muscle weakness. Wanting to sleep, lacking energy and being unable to perform previously manageable actions may point to different causes. Describing the difference and whether onset was sudden or gradual can make the assessment more focused.
