What should you know about PMR and fatigue?

Fatigue can mean reduced energy, unusual sleepiness, slower thinking or difficulty completing normal activities. The pattern matters: note when it began, whether rest helps, and whether it follows exertion. Anaemia, coeliac disease, chronic kidney disease, COVID-19, burnout, alcohol use disorder and chronic fatigue syndrome are among the possibilities a clinician may consider, but fatigue alone cannot diagnose any one of them. Weight change, pain, breathlessness, mood changes, fever and bowel symptoms add useful clues.

Keep a brief fatigue diary covering sleep, meals, fluids, activity, medicines and associated symptoms. Aim for a regular sleep routine, gentle activity within your limits and steady hydration. Avoid using stimulants to push through severe exhaustion, and do not stop prescribed medicines without advice. Arrange a primary-care appointment if tiredness persists, interferes with work or self-care, or keeps returning. A clinician may examine you and choose tests based on your history rather than ordering every test at once.

Get urgent help for fatigue with chest pain, severe breathlessness, fainting, new confusion, one-sided weakness, black or bloody stools, or inability to keep fluids down. Same-day assessment is sensible when exhaustion is rapidly worsening or comes with a high fever, severe dehydration signs or a major change in alertness.

Which features of my fatigue are most concerning? Could my medicines, sleep or mood be contributing? What examination or blood tests fit my symptoms? How should I pace activity while we investigate?