Basic medical work-up
Full blood count, ferritin, B12, folate, TSH, glucose and CRP may be relevant before more specialised investigation.
Assessment-led fatigue care
Persistent fatigue needs clinical sorting before specialist testing
Persistent fatigue can have medical, psychological, sleep-related, nutritional and medication-related causes. We begin with the symptom pattern, red flags and completed work-up, then identify the primary root cause or decisive combination driving the fatigue.
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Defined scope
Scope of this care area
This route assesses persistent fatigue in context: onset and daily pattern, activity tolerance, sleep, medicines, mental health, prior diagnoses and results. Ordinary causes and red flags remain central.
If a defined question remains, selected endocrine, metabolic, nutritional or gut measurements may be discussed. No home panel gives a complete explanation of fatigue.
Who this care area may help
- People with fatigue that persists despite rest and an appropriate basic medical review.
- People who need sleep, activity tolerance, medicines, nutrition and previous results considered together.
- People whose fatigue pattern varies across the day or is associated with poor recovery.
- People who want help deciding whether standard testing, sleep assessment or a selected specialist measurement is the next useful step.
Who this care area is not designed to help
- Anyone with new, severe, rapidly worsening or urgent symptoms.
- Anyone seeking a specialist panel instead of an appropriate basic medical work-up.
- Someone seeking an “adrenal fatigue” diagnosis from a cortisol result.
- Someone expecting IV or IM treatment to replace investigation or guarantee recovery.
Clinical method
What “root cause” means in fatigue care
At MediBalans, root cause means the primary driver, or decisive combination of causes, identified by combining medical history, clinical assessment, established medical diagnostics and carefully selected functional laboratory tests. In our clinical work, we identify the primary root cause — or the decisive combination of causes — in almost every case.
Fatigue can reflect several interacting causes, including sleep, thyroid or iron status, medicines, psychological health, inflammation and nutrition. The clinical task is to identify which are decisive and the order in which they should be addressed; no single test or finding is treated as the whole explanation. Treatment response is individual and monitored clinically.
- Start with safety and basics. Review red flags and whether an appropriate basic work-up has been completed.
- Map the pattern. Consider onset, daily variation, post-activity response, sleep, medicines and associated symptoms.
- Use selected tools. Add a measurement only when it addresses a defined clinical question and contributes to identifying or characterising a cause relevant to care.
- Set review points. Agree what will be followed, when it will be reassessed and when another care pathway takes priority.
Tests are optional tools
The question determines the measurement
Metabolic and nutritional panels
NutrEval® or Metabolomix+ report selected organic acids and other markers. No value explains an energy disorder by itself.
Timed cortisol profile
A saliva profile reports cortisol and DHEA-related measurements across the day. It does not diagnose “adrenal fatigue”.
Other defined questions
Sleep assessment, hormone-related evaluation, gut testing or fatty-acid measurements may be considered only where history supports the question.
Within clinic care
Meet Mario supports continuity
When included in your MediBalans plan, Meet Mario may help keep daily priorities, practical questions, educational explanations and the agreed plan connected between visits.
It does not replace clinical judgement, is not continuously monitored and must not be used for urgent or emergency symptoms.
Separate direct purchase
Genova ordering is not fatigue care
A test bought through the Genova Diagnostics direct-order service is a standalone purchase. The report does not establish the cause of fatigue or a MediBalans patient relationship; medical interpretation, treatment and follow-up are separate.
Every Genova test ordered through MediBalans includes one complimentary month of Meet Mario to explore the report, receive contextual explanations and collect questions.
Evidence and boundaries
Evidence and limitations
- Persistent fatigue has many possible medical, psychological, sleep-related, nutritional and medication-related causes.
- No home panel, cortisol curve, intracellular marker or metabolite provides a complete explanation by itself.
- Specialist measurements must be interpreted with symptoms, medicines, standard results and the quality limits of the assay.
- IV or IM administration is a separate medical treatment route and does not replace diagnosis or guarantee an outcome.
For the fuller current description, see the existing in-depth chronic-fatigue page and the separate existing fatigue-biology resource.
Evidence base
Sources for scope and safety boundaries
The sources below support broad medical assessment, differential diagnosis and individualised follow-up for persistent fatigue; they do not show that HRV, a cortisol curve or a metabolic panel can diagnose the cause by itself, and activity should not be increased automatically when post-exertional malaise is present.
- 1177 — Fatigue during illness
- NICE NG206 — ME/CFS: diagnosis and management
- Region Stockholm Viss — ME/CFS clinical knowledge support
These sources do not validate Genova, ALCAT, CMA, HRV or any proprietary panel, and they do not promise diagnosis, improvement or any particular outcome.
Questions
Frequently asked questions
Is persistent fatigue the same as ME/CFS?
No. Persistent fatigue is a symptom with many possible causes. ME/CFS is a specific diagnosis with defined criteria and requires an appropriate medical assessment.
Does everyone with fatigue need specialist laboratory tests?
No. History, sleep, activity tolerance, medicines, red flags and an appropriate basic medical work-up come first. A specialist measurement is considered only when it can answer a defined question.
Does a cortisol profile diagnose adrenal fatigue?
No. A timed saliva profile reports cortisol and DHEA-related measurements across the day. It does not diagnose adrenal fatigue or determine a treatment protocol by itself.
Can IV or IM treatment replace a fatigue investigation?
No. IV or IM administration is a separate treatment pathway after physician assessment. It is not a shortcut that replaces diagnosis, ordinary medical care or assessment of the primary root cause or decisive combination of causes.
Next step
Map the fatigue before selecting a test
Book an assessment so the symptom pattern, safety questions and work-up already completed can guide the next step.
Book a clinical assessment