PT  - JOURNAL ARTICLE
AU  - Kate M Evans
AU  - Daniel E Flanagan
AU  - Terence J Wilkin
TI  - Chronic fatigue: is it endocrinology?
AID  - 10.7861/clinmedicine.9-1-34
DP  - 2009 Feb 01
TA  - Clinical Medicine
PG  - 34--38
VI  - 9
IP  - 1
4099  - http://www.rcpjournals.org/content/9/1/34.short
4100  - http://www.rcpjournals.org/content/9/1/34.full
SO  - Clin Med2009 Feb 01; 9
AB  - Fatigue and stress-related illnesses often become diagnoses of exclusion after extensive investigation. ‘Tired all the time’ is a frequent reason for referral to the endocrine clinic, the implicit question being – is there a subtle endocrine pathology contributing to the patient's symptoms? Often initial assessment suggests not but there are no clear data to address the question of whether overt pathology will develop in the future. This study observed outcomes after five years in 101 consecutive and unselected referrals to secondary care for ‘fatigue? cause’, where initial assessment did not suggest treatable endocrine pathology. The findings suggest that the clinical diagnosis of fatigue, based on history and tests to exclude anaemia, hypothyroidism and diabetes, is secure: these patients do not subsequently demonstrate excess morbidity and mortality, and their presenting symptoms are not early features of significant endocrine pathology.