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The patient may feel:
When approaching a patient with TATT, bear in mind the potential causes below and consider investigations for them either if there is good evidence that they might be the cause or if the symptoms fail to resolve after 3 months from initial presentation.
Examination should include blood pressure and urine analysis.
Initial postponement of blood test ordering in favour of a watchful wait approach may be appropriate (providing there are no red flags), however if tests are ordered they should be limited in the first instance to FBC, HbA1c, TSH and Viscosity – not B12. If initial testing is ordered, or if the patient returns within 4 weeks, please use the ‘Tired All The Time (1 Month)’ test collection on ICE to support your requesting.
If symptoms persist for over 3 months from initial presentation, then more detailed tests may be required using the ‘Tired All The Time (3 Months)’ test collection on ICE to support this (UEG, LFTs, Calcium, TTG and Viscosity).
Chronic Fatigue Syndrome should not be diagnosed until the symptoms have persisted for over 4 months.
GPs should try and explain how common fatigue is, that it mainly resolves, and that providing any serious underlying causes have been considered and excluded, it can be self-managed positively by the patient and GP. Encouragement should be given to: