Fatigue and chronic stress, Johannesburg
Always tired? Fatigue investigated properly.
A doctor-led assessment for chronic fatigue, low energy, burnout and chronic stress, aimed at identifying contributors that can be treated and recognising when referral is needed.
The approach
Understand first. Then treat.
Being told your bloods are normal while you still feel exhausted is one of the most common experiences in medicine. Persistent fatigue has a broad differential, and more than one contributor is common.
Testing is targeted rather than maximal, guided by your history and examination. Depending on the picture, that may include thyroid function, iron and nutrient status, hormones, glucose and insulin, inflammation, sleep quality, gut symptoms, infection and training load.
What may be investigated
- Thyroid function and autoimmune thyroid disease
- Iron, ferritin, vitamin B12, folate and vitamin D
- Hormones, including perimenopause, menopause and low testosterone
- Glucose, insulin resistance and blood sugar instability
- Inflammation and autoimmune markers
- Sleep quality, sleep apnoea risk and recovery
- Gut symptoms, including irritable bowel syndrome, where relevant
- Chronic stress and burnout, with cortisol assessment where clinically indicated
- Medication effects and other contributors identified on history
- Red-flag features that require prompt or specialist assessment
Why fatigue gets missed
A brief appointment and a small panel of tests may not explain persistent tiredness, and symptoms are sometimes attributed to stress before other contributors have been considered. Equally, not every case has a single measurable cause.
Chronic stress is physiological
Sustained stress affects sleep architecture, blood sugar, thyroid signalling, sex hormones, immune function and gut health. We assess those systems rather than treating stress as a personality issue.
A plan you can follow
Findings are explained clearly and translated into treatment: correcting deficiencies, restoring sleep, stabilising blood sugar, addressing hormones and rebuilding capacity at a realistic pace.
Review and adjustment
Energy is tracked over time, with repeat testing where useful, so the plan changes as you improve. Features such as unexplained weight loss, fever, night sweats, breathlessness or new neurological symptoms prompt further or specialist assessment.
Common questions
Answers before you book.
My tests were normal. Is there any point?
Sometimes. A normal result means within a population reference range, and some relevant tests are not part of routine screening. Normal results may also mean that no measurable abnormality is present, in which case sleep, mood, workload and recovery matter more than further testing.
Do you treat chronic fatigue syndrome?
We assess persistent fatigue, identify contributors that can be treated and manage them. Myalgic encephalomyelitis and chronic fatigue syndrome are specific diagnoses made against defined criteria, and are not the same as fatigue in general. Where care belongs with another specialty, we refer appropriately.
Is burnout the same as chronic fatigue?
They overlap. Burnout relates mainly to sustained demand without adequate recovery, and it can coexist with hormonal, metabolic or nutrient problems.
This page is general health information and is not medical advice. Investigation and treatment follow individual clinical assessment.
Ready to start properly?
Centre of Advanced Medicine, 13 Scott St, Waverley, Johannesburg
Monday to Friday, 07:40 to 17:00
011 440 8721