Fatigue as a first-time presenting symptom: Management by family doctors and one year follow-up

Eliezer Kitai, Gari Blumberg*, David Levy, Avivit Golan-Cohen, Shlomo Vinker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Fatigue is a common complaint in primary care and has a broad differential diagnosis, making the approach complex and often ineffective. objectives: To follow the course of adults without a significant known background disease who complain of fatigue for the first time, and to characterize the family physician's approach. methods: The study population comprised a random sample of 299 patients aged 18-45 who presented with fatigue as a first-time single complaint to their family physician. Excluded were patients with chronic diseases or states that may include signs of fatigue. We analyzed the index encounter data, the diagnostic and laboratory tests, the medications prescribed and the one year clinical outcome. results: Seventy percent were women, average age 30.5 years, and 69% had no known co-morbidities; 57% of the patients were physically examined at the first visit and most (78.6%) were sent for laboratory analysis. Five percent of laboratory tests were positive. Eighty patients (26.8%) were given a specific diagnosis, with the leading diagnoses being anemia and infectious diseases; 18.7% were given sick leave at the first visit. Fatigue was more common in early summer. conclusions: The majority of young healthy patients com- plaining of fatigue are not diagnosed with an organic physiological disorder. Many of the study patients were sent for laboratory tests but in most cases these tests were not contributory to the diagnosis or management. It seems likely that the most efficient strategy would be watchful follow-up with a minimum of testing.

Original languageEnglish
Pages (from-to)555-559
Number of pages5
JournalIsrael Medical Association Journal
Issue number9
StatePublished - Oct 2012


  • Differential diagnosis
  • Fatigue
  • Medical encounter
  • Primary care
  • Workup


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