Persistent tiredness that doesn't resolve with rest is one of the most common reasons people seek private medical assessment. NHS appointments often don't allow time to investigate properly. We take a structured approach: a comprehensive consultation, a thorough blood and investigation panel, and a clear written plan based on what we find.
Educational information — not a substitute for clinical assessment
This page describes chronic fatigue and unexplained tiredness in general terms to help you decide whether assessment may be helpful. It is not a diagnostic tool. If you recognise yourself in what follows, please book a consultation.
Tiredness is universal. Most people feel tired sometimes. Clinical fatigue is different: it is persistent tiredness disproportionate to your activity, not relieved by rest, and significant enough to affect work, relationships, or daily life.
Common patterns we see:
Each pattern points in slightly different directions. A proper assessment doesn’t lump them together but works through each systematically.
of adults report significant tiredness lasting more than a month. The majority have a treatable cause that can be identified with proper assessment.
The list of conditions that cause fatigue is long. The most useful approach is systematic. We work through these categories:
Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a real, recognised, debilitating condition where fatigue persists for months or years without other obvious cause, often triggered by an illness. NICE Guideline NG206 updated UK guidance on ME/CFS in 2021. The key features:
ME/CFS is a diagnosis of exclusion — we have to rule out the many treatable causes first. We will take the diagnosis seriously and avoid the dismissive responses that many people with ME/CFS have unfortunately encountered. Treatment focuses on energy management ("pacing"), symptomatic relief, and addressing co-existing conditions.
Long COVID overlaps significantly with ME/CFS for many people and is approached similarly.
A 10-minute NHS appointment for "I’m tired all the time" is structurally inadequate. Our initial consultation is 45–60 minutes because fatigue assessment requires a proper history, examination, and discussion of what to investigate. Most patients leave knowing more about what’s likely going on than they have from years of previous appointments.
Onset, duration, pattern (worse mornings or evenings, post-exertion crash, fluctuating), sleep history, mood, weight changes, recent illnesses, medications, alcohol, exercise, work and life stresses. This is the most important part of fatigue assessment — bloods often reveal less than a thorough history.
Looking for signs of anaemia, thyroid disease, weight changes, lymph nodes, abdominal masses, joint swelling, neurological signs, and other clinical clues.
See the dedicated section below.
Some patients need: ECG, sleep study, chest X-ray, abdominal ultrasound, or specialist referral. We arrange what’s needed.
A written summary of findings, what we think is going on, and a clear treatment plan with follow-up.
A thorough fatigue blood panel typically includes:
Where indicated by history, we add specialist tests — autoimmune screen, Epstein-Barr virus serology, Lyme testing, or others. Tests are quoted before being done; nothing is taken without your consent.
Treatment depends entirely on cause. Some patterns:
Treating the underlying cause — iron replacement, thyroid medication, HRT, antidepressant, sleep apnoea treatment, etc. — usually leads to dramatic improvement. Some causes (e.g. coeliac, sleep apnoea) require ongoing specialist care.
Common — many patients have low ferritin AND vitamin D AND poor sleep AND stress, all contributing modestly. We treat each in parallel.
About 20–30% of fatigue patients have no clear blood-test or imaging abnormality. The diagnosis then becomes ME/CFS, fibromyalgia, post-viral fatigue, or chronic fatigue of unknown cause. Treatment focuses on:
Whatever the cause, certain lifestyle measures genuinely help:
Consider booking if:
NHS bloods are often a smaller panel than what we test, and "normal" ranges include levels at which many people genuinely feel unwell (ferritin under 30, vitamin D 30–50, TSH 4–5, etc.). We use a more thorough panel and interpret in clinical context.
The consultation fee is on our Fees page. Blood tests are quoted before being ordered — a comprehensive fatigue panel typically costs several hundred pounds. We discuss what’s essential vs. optional based on your history.
Blood results typically come back within 2–5 working days. Most patients have a working diagnosis at the follow-up consultation (often within 1–2 weeks of the initial appointment).
That’s common and treatable. We’re honest about this — sometimes the kindest finding is that depression is making the body feel exhausted, and treating mood lifts everything. We can offer psychiatric and psychological care within MHW.
Yes. We follow current UK guidance on Long COVID assessment and management, including ruling out other treatable causes and supporting energy management.
We refer where needed — endocrinology for thyroid/hormonal, sleep specialists for OSA, rheumatology for autoimmune, gastroenterology for coeliac. We stay involved in your care.
Most patients have an initial consultation, a follow-up to discuss results, and then targeted follow-up depending on what we find. Not all conditions need long-term clinic involvement.
Lifestyle exhaustion is real and we acknowledge it. But it’s also worth confirming there’s no medical contributor — many tired carers turn out to have low ferritin, low vitamin D, or undiagnosed thyroid disease on top.
Care at MHW Clinic is delivered by a small clinical team, with Dr Haydar Bolat as Clinical Director. The specific clinicians involved in your care depend on the plan agreed with you at consultation.
UK-registered GP and Clinical Director at MHW. Conducts comprehensive fatigue assessments including history, examination, ordering and interpreting blood investigations, and creating individualised management plans.
View profileLanguages spoken across the team: English, Turkish, Bulgarian, Bengali, Hindi, Albanian, Azerbaijani, German, Romanian. We can also arrange professional telephone interpreters in most other languages at no extra cost. More on languages and interpreters →
This page was reviewed by Dr Haydar Bolat, Clinical Director at MHW Clinic. Content is based on NICE Clinical Knowledge Summaries (CKS) for Tiredness/Fatigue, NICE Guideline NG206 (ME/CFS), and current UK clinical practice and current UK clinical practice. It is updated when guidance changes. Educational information only — not a substitute for clinical assessment.
Book a longer consultation with a GP who has time to actually investigate. Most patients leave with a clearer picture and a plan.