Constantly feeling tired, with everyone just telling you "it's only stress"?
Constantly feeling tired, with everyone just telling you "it's only stress"?
It is easy to assume that feeling exhausted is simply down to stress. However, in many cases, there is an underlying physical cause that we can easily spot with a simple blood test.
It is easy to assume that feeling exhausted is simply down to stress. However, in many cases, there is an underlying physical cause that we can easily spot with a simple blood test.
After moving to Vienna, Sophie felt exhausted for months. Climbing stairs became a struggle, her concentration slipped, and in the mornings, she felt as if she hadn't slept at all. The explanation seemed obvious: a new city, a new job, plenty of stress.
And that is precisely the most common misconception when it comes to persistent tiredness. Stress is a plausible explanation, but it is also an easy one. If you are constantly tired, there is a physical cause in a significant number of cases that can be easily identified with just a few laboratory values and treated.
When fatigue goes beyond normal exhaustion
Being tired after a short night is normal. You should seek medical evaluation for fatigue if it presents any of these patterns:
It persists for longer than four weeks.
It does not improve even after adequate sleep and a free weekend.
Your physical tolerance has noticeably decreased, for example during exercise or on the stairs.
Other symptoms are present: weight changes, alopecia, dyspnoea, feeling cold, palpitations or low mood.
The most common physical causes
Iron deficiency. By far the most common cause, especially in menstruating women. Typical symptoms include pallor, fatigue, reduced physical performance, feeling cold and an increased susceptibility to infection. [1] Note: Iron deficiency can exist before abnormalities appear on a complete blood count. Therefore, the ferritin level must also be determined.
Hypothyroidism. If the thyroid gland produces insufficient hormone, many bodily functions slow down. Fatigue, bradycardia, dry skin, constipation and weight gain are classic signs. [2] A single TSH level is sufficient for the initial assessment.
Sleep apnoea. Those who experience repeated pauses in breathing during the night may sleep for a long duration, but the sleep is not restorative. Marked daytime somnolence is the primary symptom. [3] Loud snoring and witnessed sleep apnoea are clear indications.
Other common causes include vitamin B12 deficiency, previously undiagnosed type 2 diabetes mellitus, chronic inflammation, adverse effects of medication and depressive disorders. Alcohol is also an underestimated factor because it reliably disrupts deep sleep.
What we investigate in cases of persistent fatigue
The first step is not a test, but a consultation. Since when has the fatigue been present, what is your sleep quality like, what medications do you take, has there been any change in your weight? From this, we determine which specific parameters are clinically relevant to measure.
In most cases, targeted laboratory diagnostics provide clarity: a full blood count, ferritin, TSH, blood glucose, inflammatory markers, liver and kidney function tests, and vitamin B12 if indicated. This is accompanied by blood pressure measurement and a physical examination. This evaluation is part of primary care and is free of charge for statutory health insurance patients.
What happened next for Sophie
Sophie finally booked appointments instead of continuing to search online. Following the consultation and laboratory tests, the cause was identified, and the treatment was straightforward. Six months later, she describes her physical tolerance as better than before her relocation. The true benefit was not the therapy itself, but the end of the uncertainty.
When fatigue goes beyond normal exhaustion
Being tired after a short night is normal. You should seek medical evaluation for fatigue if it presents any of these patterns:
It persists for longer than four weeks.
It does not improve even after adequate sleep and a free weekend.
Your physical tolerance has noticeably decreased, for example during exercise or on the stairs.
Other symptoms are present: weight changes, alopecia, dyspnoea, feeling cold, palpitations or low mood.
The most common physical causes
Iron deficiency. By far the most common cause, especially in menstruating women. Typical symptoms include pallor, fatigue, reduced physical performance, feeling cold and an increased susceptibility to infection. [1] Note: Iron deficiency can exist before abnormalities appear on a complete blood count. Therefore, the ferritin level must also be determined.
Hypothyroidism. If the thyroid gland produces insufficient hormone, many bodily functions slow down. Fatigue, bradycardia, dry skin, constipation and weight gain are classic signs. [2] A single TSH level is sufficient for the initial assessment.
Sleep apnoea. Those who experience repeated pauses in breathing during the night may sleep for a long duration, but the sleep is not restorative. Marked daytime somnolence is the primary symptom. [3] Loud snoring and witnessed sleep apnoea are clear indications.
Other common causes include vitamin B12 deficiency, previously undiagnosed type 2 diabetes mellitus, chronic inflammation, adverse effects of medication and depressive disorders. Alcohol is also an underestimated factor because it reliably disrupts deep sleep.
What we investigate in cases of persistent fatigue
The first step is not a test, but a consultation. Since when has the fatigue been present, what is your sleep quality like, what medications do you take, has there been any change in your weight? From this, we determine which specific parameters are clinically relevant to measure.
In most cases, targeted laboratory diagnostics provide clarity: a full blood count, ferritin, TSH, blood glucose, inflammatory markers, liver and kidney function tests, and vitamin B12 if indicated. This is accompanied by blood pressure measurement and a physical examination. This evaluation is part of primary care and is free of charge for statutory health insurance patients.
What happened next for Sophie
Sophie finally booked appointments instead of continuing to search online. Following the consultation and laboratory tests, the cause was identified, and the treatment was straightforward. Six months later, she describes her physical tolerance as better than before her relocation. The true benefit was not the therapy itself, but the end of the uncertainty.
"I thought I just needed to pull myself together. But actually, there was a reason for it that could be measured."
"I thought I just needed to pull myself together. But actually, there was a reason for it that could be measured."
"I thought I just needed to pull myself together. But actually, there was a reason for it that could be measured."
Practical Advice
If your fatigue persists for more than one month, seek medical evaluation before doubting your self-discipline. A blood test takes five minutes and reliably rules out or identifies the most common causes.
At the PVZ Primary Care Centre in Vienna's Josefstadt, we investigate this as part of general medical care or directly during a preventative medical examination. Appointments can be scheduled via Appointments and Contact.
Frequently Asked Questions
At what point is persistent fatigue a matter for a doctor?
If it lasts longer than four weeks, does not improve with sleep, or noticeably impairs your performance. If weight changes, dyspnoea or palpitations also occur, you should not delay.
Which blood parameters are determined in cases of fatigue?
Standard parameters include a complete blood count, ferritin as an iron storage marker, TSH for the thyroid, blood glucose, inflammatory markers, as well as liver and kidney function parameters. Depending on your medical history, vitamin B12 may also be included.
Can iron deficiency cause fatigue even if the blood count is normal?
Yes. Iron stores can already be depleted before the haemoglobin levels change. This is why ferritin is also determined.
Is fatigue a sign of depression?
It can be. Persistent exhaustion is one of the common symptoms of depressive disorders. Therefore, evaluation always involves both aspects: the physical examination and the clinical consultation.
Do iron or vitamin supplements from the chemist help?
Only if a deficiency actually exists. Taking iron supplements on suspicion is not harmless and can cause adverse effects. Have your blood parameters determined before you start supplementation.
Sources
Austrian Health Portal. Iron deficiency and iron deficiency anaemia. Link
Austrian Health Portal. Thyroid: Function and disorders. Link
Austrian Health Portal. Obstructive sleep apnoea. Link
This article is for general information purposes only and does not replace individual medical advice.
Practical Advice
If your fatigue persists for more than one month, seek medical evaluation before doubting your self-discipline. A blood test takes five minutes and reliably rules out or identifies the most common causes.
At the PVZ Primary Care Centre in Vienna's Josefstadt, we investigate this as part of general medical care or directly during a preventative medical examination. Appointments can be scheduled via Appointments and Contact.
Frequently Asked Questions
At what point is persistent fatigue a matter for a doctor?
If it lasts longer than four weeks, does not improve with sleep, or noticeably impairs your performance. If weight changes, dyspnoea or palpitations also occur, you should not delay.
Which blood parameters are determined in cases of fatigue?
Standard parameters include a complete blood count, ferritin as an iron storage marker, TSH for the thyroid, blood glucose, inflammatory markers, as well as liver and kidney function parameters. Depending on your medical history, vitamin B12 may also be included.
Can iron deficiency cause fatigue even if the blood count is normal?
Yes. Iron stores can already be depleted before the haemoglobin levels change. This is why ferritin is also determined.
Is fatigue a sign of depression?
It can be. Persistent exhaustion is one of the common symptoms of depressive disorders. Therefore, evaluation always involves both aspects: the physical examination and the clinical consultation.
Do iron or vitamin supplements from the chemist help?
Only if a deficiency actually exists. Taking iron supplements on suspicion is not harmless and can cause adverse effects. Have your blood parameters determined before you start supplementation.
Sources
Austrian Health Portal. Iron deficiency and iron deficiency anaemia. Link
Austrian Health Portal. Thyroid: Function and disorders. Link
Austrian Health Portal. Obstructive sleep apnoea. Link
This article is for general information purposes only and does not replace individual medical advice.
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