BMJ  2007;334:1221 (9 June), doi:10.1136/bmj.39182.615405.94

Practice

10-minute consultation

Tiredness

Bicester Health Centre, Bicester OX26 6AT

The first 150 words of the full text of this article appear below.

During a routine appointment a 48 year old woman tells you that she feels tired all the time. You know that she has changed jobs recently and that her daughter has recently returned to university.

What issues you should cover

Reasons for consulting
Tiredness is a common presenting symptom. Often the cause may be physical; diseases such as hypothyroidism, autoimmune disease, liver or kidney disease, or even cancer may result in tiredness. Tiredness is, however, more often due to depression or the stresses of life circumstances.

Tiredness may not be the main focus of her concerns, and she may only offer it as an initial symptom to see whether you are sympathetic and interested. Her main issue may be a more sensitive one, such as the menopause or the stress of recent events in her life. Patients may consider tiredness to be a more legitimate symptom to bring to a doctor than, say, unhappiness. Although such a patient . . . [Full text of this article]

Defining tiredness
Physical examination
Tiredness: symptoms, diagnoses, and investigations
Symptoms
Diagnoses
Investigations

What you should do

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Rapid Responses:

Read all Rapid Responses

The myth of Chronic Fatgue Syndrome

Shirwan A. Mirza, MD, FACP, FACE, et al.
bmj.com, 9 Jun 2007 [Full text]

The "two questions" are better at excluding depression.

Julian T Spinks
bmj.com, 10 Jun 2007 [Full text]

Differential diagnosis for tiredness

Wilhelmina J. Rietsema, et al.
bmj.com, 14 Jun 2007 [Full text]

Other Causes of Tiredness

Ray F O'Connor, et al.
bmj.com, 29 Jun 2007 [Full text]

Iatrogenic Causes of Tiredness

Zafran Rahman, et al.
bmj.com, 5 Jul 2007 [Full text]