If you have been feeling tired for weeks, your energy has not come back after rest, and you have been told your blood tests are normal, it is worth a proper look for a physical cause. Dr Georgios Schoinas offers an unhurried private GP consultation for persistent tiredness at AristoGP, 1-5 Portpool Lane EC1N 7UU — four minutes from Chancery Lane.
Most ongoing tiredness has an identifiable and treatable cause. The aim of the appointment is to find it, or to rule out the important ones, and leave you with a clear plan.
A Full History First
A 30-minute consultation gives time for the questions a short appointment tends to skip: how long the tiredness has lasted and how it started, your sleep and snoring, diet and alcohol, recent infections, current medicines and supplements, periods or menopause symptoms, and any weight change.
Physical Examination
Where appropriate, Dr Schoinas examines:
- Blood pressure and pulse — high blood pressure and irregular heart rhythms can present as tiredness
- Heart and chest — murmurs, irregular rhythm or reduced air entry
- Neck and thyroid — enlargement or nodules
- Abdomen — liver or spleen enlargement
- BMI and waist circumference — metabolic syndrome is a common and reversible cause of fatigue
- Signs of anaemia and thyroid disease
Common Physical Causes We Look For
- Iron deficiency and anaemia
- Underactive or overactive thyroid
- Low vitamin B12, folate or vitamin D
- Diabetes and prediabetes
- Obstructive sleep apnoea
- Side effects of medicines
- Tiredness after a viral infection
- Hormonal causes, such as perimenopause or low testosterone
Sleep Apnoea Screening
Obstructive sleep apnoea is one of the most commonly missed causes of daytime exhaustion, particularly 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, Dr Schoinas can write a referral letter to a specialist sleep service, or to your NHS GP for NHS referral. AristoGP does not carry out sleep studies.
Blood Tests
If blood tests are needed, Dr Schoinas requests them from our laboratory, TDL. Blood is taken at TDL Patient Reception, 76 Wimpole Street W1, and the results come back to Dr Schoinas. Results are then discussed at a follow-up GP appointment. Blood tests, if needed, are charged separately.
What You Leave With
- A clear explanation of the likely causes
- A plan — investigations, treatment, referral to a specialist or reassurance
- With your consent, a letter to your NHS GP so your record stays up to date
Pricing
GP consultation — £150
Blood tests and other investigations, if needed, are charged separately. No referral required. Same-day appointments usually available.