FEEL BETTER! When someone tells me they feel generally unwell and their tests were normal, my first question is which tests. It is usually fewer than they think.
What I want to see, through your GP: full blood count, iron studies including ferritin — haemoglobin can be normal with depleted iron stores and that is the commonest miss — thyroid function, vitamin B12 and folate, vitamin D, coeliac serology while you are still eating gluten, glucose or HbA1c, and kidney and liver function. Add a sleep study if there is snoring with pauses or daytime sleepiness.
Why I insist. I have seen people spend a year and a considerable amount of money on complementary treatment for tiredness that turned out to be a ferritin of 9, an underactive thyroid, or undiagnosed coeliac disease. Those are treatable in weeks with the right thing and untouched by the wrong one.
Once it is clear, what I assess is the shape of it: tired on waking despite the hours, or flat by mid-afternoon, or fine until exertion and then wiped out for two days. Three different problems. And what I treat is sleep, digestion, pain that is interrupting rest, and the physical side of a hard stretch — with a measure and a four-week review.
If the picture is mostly mood, a GP mental health treatment plan and psychology will do more than I can. The clinic is in Lane Cove, opposite the library.
