Table 1

Frequent causes of fatigue and suggested first-line assessment

Common causes of fatigueFirst-line assessment
Drug-induced fatigueSteroids, anti-arrhythmic, anti-hypertensive, benzodiazepines or other antidepressant and sedative agents, anti-histaminic, diureticsMedication review
AnaemiaIron or vitamin deficienciesC-reactive protein, haemoglobin, Coombs test, ferritin, B9 and B12 vitamins
Metabolic disordersHypothyroidism, adrenal insufficiency, panhypopituitarismTSH, fasting glucose…
Vitamin D insufficiencyVitamin D levels
InfectionChronic bacterial (mycobacterial) or viral (HIV, hepatitis B and C, EBV) infectionsC reactive protein
Hepatitis B/C, EBV and HIV serology
Organ failureCardiac insufficiency
Respiratory insufficiency
Liver insufficiency
Kidney insufficiency
BNP, chest X-ray, echocardiography creatinine, full hepatic tests
Sleep disordersObstructive sleep apnoea syndrome
Jet lag syndrome in frequent travellers
  • b-HCG, b-human chorionic gonadotropin hormone; BNP, brain natriuretic peptide; EBV, Epstein-Barr virus; TSH, thyroid-stimulating hormone.