Fatigue (persistent tiredness)

Fatigue lasting more than 2-4 weeks, that doesn't get better with rest, is one of the most common reasons women in their 30s-50s come to our OPD. It is also one of the most under-investigated symptoms — patients write it off as "modern life", and doctors sometimes mirror that back. We take it seriously because the underlying cause is usually findable, and treatable.

Most common causes in our OPD

• Iron deficiency anaemia — especially in menstruating women. Often missed because it builds up slowly and the patient adapts. Treated with iron supplementation; root cause (heavy periods, poor intake, blood loss) addressed in parallel.
• Hypothyroidism — particularly common in Indian women (8-12% prevalence after age 30). Often missed because the symptoms look like "tired post-pregnancy" or "stressed working mother". Diagnosed with a single TSH blood test.
• Vitamin B12 deficiency — common in long-term vegetarians. Fatigue, tingling in feet, mood changes. Treated with injections then oral supplements.
• Vitamin D deficiency — very common across India despite the sunshine. Muscle aches, fatigue, low mood. Treated with weekly sachets.
• Diabetes — early diabetes often presents as just tiredness + frequent urination.
• Chronic kidney disease — uncommon as a first presentation but worth testing in older patients and diabetics / hypertensives.
• Depression and anxiety — common, often co-exist with the medical causes above.
• Sleep apnoea — patients (usually men) snore loudly, wake unrefreshed, are sleepy through the day.

Standard workup

A first-pass fatigue workup at Asian Hospital includes: CBC (anaemia), TSH (thyroid), HbA1c (diabetes), vitamin B12, vitamin D, creatinine, calcium, liver function. The whole panel runs about ₹2,500-3,500 and one of these 8 tests turns up the cause in roughly 60-70% of patients.

If the panel is normal we look harder: sleep history (sleep apnoea), psychological evaluation (depression), in rare cases markers for autoimmune conditions or chronic infection.