Tiredness and endocrine disorders

With a focus on adults Dr Chahal is a Consultant in Endocrinology, Diabetes, Bariatric Medicine, and General Internal Medicine at Imperial College Healthcare NHS Trust. He is also Honorary Clinical Senior Lecturer at Imperial College, London.

In this short article, Dr Chahal gives some thoughts on the link between tiredness and endocrine disorders.

Many endocrine conditions present with non-specific symptoms including tiredness. It is important to make sure fatigue is not related to an endocrine disorder as some can cause significant morbidity and mortality.

Conditions to rule out include:

• Diabetes,
• Thyroid disease,
• Parathyroid disorders,
• Adrenal problems,
• Pituitary abnormalities,
• Polycystic ovarian syndrome,
• Calcium metabolism,
• Oestrogen deficiency (menopause)
• Testosterone deficiency.

In addition, several endocrine conditions are associated with an increased prevalence of other disease processes where fatigue is a common complaint. These conditions include:

• Coeliac disease
• B12 deficiency (pernicious anaemia),
• Autoimmune diseases
• Anaemia
• Haemochromatosis
• Obstructive sleep apnoea.

As well as tiredness other symptoms and signs of endocrine disease can include:

• Weight changes
• Low mood
• Dry skin
• Muscle aches
• Temperature changes
• Hair loss
• Abnormal sweating
• fast heart rate
• Dizziness, fainting & funny turns
• Change in blood pressure
• Absent or irregular periods
• Flushing
• Excess body hair (hirsutism)
• Acne
• Headaches
• Low sex drive
• Reduced fertility
• Change in bowel habits
• Increase in urine frequency
• Thirst & appetite changes
• Anxiety and irritability
• Breathing difficulties

It is vital to have a thorough endocrine examination and appropriate endocrine investigations to determine if your symptoms of tiredness are related to imbalances in the endocrine system so that appropriate treatment can be started.

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