If you have been told by your NHS GP that you are stressed or that your blood tests are normal, but you still feel exhausted, unable to concentrate and not yourself, this appointment is for you. Dr Georgios Schoinas offers a thorough, unhurried medical investigation into the physical and psychological causes of burnout and persistent fatigue at AristoGP, 1-5 Portpool Lane EC1N 7UU — four minutes from Chancery Lane.
This is not wellness coaching. It is a proper GP assessment that takes the time the NHS cannot give.
What Makes This Different
A standard NHS fatigue appointment is 10 minutes. That is not enough time for a full history, a physical examination, an ECG, the right blood tests and a clear explanation of what the results mean. The AristoGP Burnout and Fatigue Assessment is a structured 45-minute appointment designed to leave nothing important unchecked.
Physical Examination
Every assessment begins with a full clinical examination. This is what a GP appointment used to always include and now rarely does. Dr Schoinas examines:
- Blood pressure and pulse — hypertension and arrhythmias frequently present as fatigue and are found on examination
- Heart auscultation — murmurs and irregular rhythm that suggest underlying cardiac causes
- Respiratory examination — breathlessness with exertion and reduced air entry
- Abdominal examination — liver and spleen enlargement, which can indicate systemic disease
- BMI and waist circumference — metabolic syndrome is a common and reversible cause of fatigue
- Appearance and affect — clinical signs of thyroid disease, anaemia and depression visible on examination
Resting ECG
A 12-lead resting ECG is included in every assessment. It takes five minutes and rules out conditions that commonly present as fatigue but require specific treatment:
- Atrial fibrillation and other arrhythmias — cause fatigue, palpitations and reduced exercise tolerance
- Heart block — slow conduction producing exhaustion and breathlessness
- Long QT syndrome — relevant before any medication is started
- Signs of previous silent myocardial infarction
Blood Panel
Many physical conditions produce fatigue, low mood and poor concentration that is routinely labelled as stress. Every one shows up in blood. The panel includes:
- Thyroid (TSH, free T4) — underactive thyroid affects 1 in 20 people and is frequently missed
- Full blood count — anaemia is one of the most common and most overlooked causes of fatigue
- Ferritin and iron — iron deficiency drains energy long before anaemia appears on a standard count
- Vitamin B12 and folate — deficiency causes fatigue, brain fog and low mood
- Vitamin D — deficiency is extremely common in London and affects mood and energy
- HbA1c and fasting glucose — undiagnosed type 2 diabetes is a significant and reversible cause of exhaustion
- Morning cortisol — excludes adrenal insufficiency in severe cases
- Testosterone (men) — low testosterone causes fatigue, flat mood and poor concentration
- FSH and oestradiol (women) — perimenopause is consistently under-diagnosed as burnout
- CRP and ESR — inflammatory markers flagging hidden infection or autoimmune disease
- Liver and kidney function
Sleep Apnoea Screening
Obstructive sleep apnoea is one of the most commonly missed causes of fatigue in professional adults. People with sleep apnoea wake repeatedly through the night without knowing it, producing profound daytime exhaustion that is indistinguishable from burnout. It is particularly common in men over 40 and people who are slightly overweight. Dr Schoinas uses the validated STOP-BANG questionnaire and Epworth Sleepiness Scale during the consultation. If sleep apnoea is suspected, referral for a home sleep study is arranged.
Psychological Assessment
Once physical causes have been assessed, Dr Schoinas uses validated clinical tools to assess mood, anxiety and burnout severity — including the PHQ-9 (depression), the GAD-7 (anxiety) and a structured sleep and burnout questionnaire. These are the same instruments used in NHS mental health services, applied properly and with time to explain the results.
What You Receive
- 45-minute appointment with full history, physical examination and ECG
- Blood draw at the clinic on the same day (phlebotomy £39)
- Results reviewed by Dr Schoinas within 24–72 hours
- A written report explaining every result in plain language
- A clear management plan — medication, referral, fit note or reassurance
- Referral to cardiologist, sleep clinic, psychologist or psychiatrist if indicated
- Ongoing monitoring appointments if required
Who This Is For
Anyone who has been feeling exhausted, emotionally flat or unable to function at their usual level for more than a few weeks — and particularly those who have already seen their NHS GP and been told nothing is wrong. This assessment is especially designed for professionals working in high-pressure environments in the City, Holborn and Farringdon who cannot afford to wait weeks for NHS referrals and need clear answers quickly.
Pricing
GP consultation and ECG — £150
Phlebotomy (blood draw) — £39
Laboratory tests — priced per test, discussed at booking
No referral required. Same-day appointments usually available.