Peer Reviewed
Investigations in endocrinology

Investigating lethargy

Arushi Madan, Bernard Champion
Abstract
Lethargy is a common presenting problem in general practice. A careful history, examination and judicious use of investigations can identify red flags indicating serious underlying pathology or allow reassurance in most patients in whom lethargy is a manifestation of work–life pressures and stresses.
Key Points

    Generalised lethargy or fatigue is a common presenting symptom in general practice, reported in 1 to 7% of general practice encounters and it is often a diagnostic dilemma.1,2 Lethargy may be defined as extreme fatigue or drowsiness in the absence of increased physical activity, unrelieved by rest. Although the most common causes tend to be psychosocial or lifestyle related, serious pathology may underpin such presentations.

    Picture credit: © Ridvan Celik/iStockphoto. Model used for illustrative purposes only.

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