Overview
Quick answer
If you have been tired all the time, a blood test can catch a short list of causes. Tiredness is not a diagnosis. In Australian general practice it presents at 1.4 per 100 encounters (BEACH 2011-12, cited by RACGP 2014) and is the most common unexplained complaint. Blood is a filter: it rules some things in or out so the next conversation is better, not so a report can name the feeling.
Australian guidance starts with history, examination, and a red-flag check. Therapeutic Guidelines still advocate watchful waiting for non-severe recent fatigue with no red flags (the public 2022 update restates this; the RACGP 2014 review of the earlier edition suggested about four weeks). When tests are ordered, the usual first-line set is a full blood evaluation (FBE), fasting glucose, TSH, electrolytes/kidney (EUC), liver function tests, and ESR or CRP. The eTG figure and the current RCPA Manual (updated February 2024) also include ferritin or iron studies. Vitamin B12, vitamin D, and HbA1c are add-ons, not that opening list.
A normal first-line set is a common and useful result. Gialamas et al. (Australian Family Physician, 2003), cited in that RACGP review, found only 16% of tests ordered for tiredness abnormal, and a significant clinical diagnosis in 4% of patients. If the filter is clear, the next questions are often sleep, mood, medicines, and post-viral illness, which blood cannot show.
Overview
Key takeaways
Tiredness is non-specific. A blood test can find iron deficiency, thyroid disease, anaemia, B12 deficiency, or glucose problems. It cannot find sleep apnoea, depression, burnout, or most post-viral fatigue.
Australian first-line tests for unexplained fatigue are FBE, fasting glucose, TSH, EUC, liver function, and ESR or CRP. The eTG figure and the current RCPA Manual also include ferritin or iron studies. B12, vitamin D, and HbA1c sit behind that list unless your history points to them.
Iron stores can be low while haemoglobin on the FBE still looks normal. That is iron deficiency without anaemia, and it is a recognised cause of fatigue. Ferritin under 30 µg/L is the usual Australian cut-off; the WHO well-population cut-off is under 15 µg/L.
TSH is the first thyroid test. Free T4 is added when TSH is abnormal, or when pituitary disease is suspected. Subclinical hypothyroidism (high TSH, normal free T4) is common; treating it for energy is not automatic.
Vitamin D deficiency is common in Australia, about 20.6% of adults in 2022 to 2024, but the evidence that treating it reliably fixes unexplained fatigue is thin. Medicare item 66833 does not list tiredness as a reason to fund the test.
HbA1c can sit inside the reference interval while fasting insulin is already high. Fasting glucose is the first-line glucose test in a fatigue workup; HbA1c is the better long-view marker once you are looking at diabetes risk.
About one in fifteen Australian adults (6.4% to 6.6%) had diabetes in 2022 to 2024. That is common enough to test for, and not common enough to assume.
A clear blood report is not a dead end. It narrows the search to the things blood cannot measure.
The frame
Why tiredness is a filter, not a diagnosis
Tiredness is a description, not a diagnosis. The same word covers late nights, iron deficiency, an underactive thyroid, sleep apnoea, depression, a virus that has not quite left, and a dozen other things that do not share a mechanism.
That is why a good fatigue workup starts with a conversation and an examination, not a shopping list of assays. Blood is useful when it answers a specific question: is there a store, a hormone, or a cell line that can explain this? It is less useful when it is asked to explain a feeling.
Common in the waiting room, uncommon as a lab diagnosis
Australian GPs see fatigue at 1.4 per 100 encounters, similar to UK primary care and lower than some international series. It is the most common unexplained complaint, which is a different claim from "the most common reason people visit a GP." Most visits are for something more specific.
The yield of testing is low, and that is the point of a filter
Pathology was ordered in 64.2% of Australian fatigue encounters in 2011 to 2012, at a mean of 3.63 tests when anything was requested. An Australian study found only 16% of those tests abnormal, and a significant clinical diagnosis in 4% of patients. A limited set (haemoglobin, ESR, glucose, TSH) is almost as useful as a broader battery.
Psychosocial causes are the most common non-somatic diagnoses
Australian reviews put stress, anxiety, depression, post-viral illness, and sleep disorders at the top of the probability list. Serious disease is uncommon and still must not be missed. Those two facts sit together: test carefully, then keep looking when the report is normal.
If you came here hoping a panel would name the tiredness, this is the honest frame: blood can catch a treatable minority. The rest of the work is clinical, and a clear report is part of that work, not a failure of it.
If the complaint is lost words or slower thinking more than tiredness, see the brain fog blood tests guide.
Australian practice
What Australian GPs order first
The RACGP 2014 review summarised the then-current Therapeutic Guidelines: history, examination, a red-flag screen, and often about four weeks of watchful waiting when nothing urgent is present. Delaying tests in that setting has been shown not to raise anxiety or lower satisfaction. Therapeutic Guidelines published a 2022 update that still advocates watchful waiting for non-severe recent fatigue; the current first-line panel itself sits behind the paywall. The most recent public Australian list is the RCPA Manual entry on fatigue, updated 5 February 2024.
Full blood evaluation (FBE)
Also printed as FBC, full blood count. Looks at haemoglobin, red cell size (MCV), white cells, and platelets. Anaemia, infection patterns, and clues toward iron or B12/folate deficiency show up here. It does not measure iron stores.
Fasting glucose
A same-day reading after an overnight fast. This is the first-line glucose test in an Australian fatigue workup, not HbA1c. Finger-prick glucose and a urine dipstick are often done in the rooms before a formal venous sample.
TSH
Thyroid-stimulating hormone, the pituitary signal that tells the thyroid to work. It is the first-line thyroid test. Free T4 is added when TSH is abnormal, not as a routine extra on day one.
Ferritin, with CRP or ESR
Ferritin estimates stored iron. CRP or ESR flags inflammation, which can push ferritin up and hide a real deficiency. The RACGP 2014 prose list omitted ferritin; the eTG figure in that same paper included it, and the RCPA Manual now lists iron studies. Australian GPs already order ferritin in about one in five fatigue workups (21.0%).
EUC and liver function tests
Electrolytes, urea, and creatinine look at kidney function and salt balance. Liver enzymes can point to alcohol, fatty liver, or other illness that presents as low energy. Neither is a tiredness test; both are cheap ways to catch something the history might miss.
Vitamin B12, vitamin D, and HbA1c are not in that first-line list. They are add-ons when the history points to them: restrictive diet or metformin for B12, bone or malabsorption risk for vitamin D, diabetes risk for HbA1c. Commercial "fatigue panels" that lead with reverse T3, DUTCH hormones, or a vitamin D as the star test are selling a different story from Australian guidelines.
Red flags that skip the wait-and-see step include recent-onset fatigue in a previously well older person, unintentional weight loss, abnormal bleeding, shortness of breath, unexplained lumps, fever, and new organ-system symptoms. Those belong with a GP the same week, not with a preventative membership page.
For haemoglobin units, the WHO anaemia cut-off, and why a normal FBE can still hide iron deficiency, see the full blood count guide.
Reading your results
How to read a fatigue workup report
Australian pathology reports print each marker with the lab's own name, unit, and reference interval. Field names vary. Match the row, not a remembered US unit.
"Haemoglobin" or "Hb"
In g/L. WHO and Australian practice treat anaemia as under 120 g/L in non-pregnant women and under 130 g/L in men. A normal haemoglobin does not rule out low iron stores.
"MCV"
Mean cell volume, in fL. Small cells (typically under 80) point toward iron deficiency or thalassaemia. Large cells (typically over 100) point toward B12 or folate deficiency, alcohol, or liver disease. Mild iron deficiency can still have a normal MCV.
"Ferritin"
In µg/L. Australian labs commonly flag under 30 as low. A result between 15 and 30 can read as "not deficient" against the WHO well-population cut-off and "depleted" against Australian practice.
"TSH"
In mIU/L. The RCPA manual default adult interval is 0.4 to 4.0, and individual labs vary. Always use the interval printed on your report.
"Free T4" / "FT4" and "Free T3" / "FT3"
In pmol/L. These measure unbound thyroid hormone. They are not first-line on their own. RCPA advice is to add free T4 when TSH is abnormal, and free T3 when TSH is suppressed but free T4 is still in range.
"Vitamin B12" and "Active B12"
Total B12 in pmol/L. Active B12 (holotranscobalamin) is the cell-available fraction, used when total B12 is indeterminate or in pregnancy. Do not treat the two numbers as interchangeable.
"25-OH vitamin D"
In nmol/L. Australian adequacy is 50 nmol/L or above at the end of winter. US pages that talk in ng/mL are using a different unit: divide nmol/L by 2.5.
"HbA1c"
In mmol/mol, often with a percentage beside it. They are the same result in two units, not two tests. Diabetes is 48 mmol/mol (6.5%) or above; prediabetes is 42 to 47 mmol/mol (6.0% to 6.4%).
Reference intervals are population statistics, not personal targets. A result just inside the printed range can still be worth a conversation, and a result just outside it is not a diagnosis on its own.
For what ALT, AST and GGT actually measure, how to read the rest of a liver panel, and why a normal result does not rule out fatty liver disease, see the liver function test guide.
Iron
Iron, with and without anaemia
Iron is the cause most worth understanding on a fatigue page, because the FBE can look fine while stores are already empty.
Stores fall before anaemia appears
Ferritin estimates iron locked in the liver, spleen, and bone marrow. Haemoglobin only drops once those stores are exhausted enough to slow red cell production. That gap is iron deficiency without anaemia: low ferritin, normal haemoglobin, and a person who can still feel wiped out.
Why energy falls before the blood count does
Iron is not only for oxygen transport. It sits inside iron-sulfur clusters in three of the mitochondria's electron-transport complexes, so a shortage can blunt cellular energy production directly, not only by thinning the blood. That biochemistry is settled. Whether replacing iron reliably lifts fatigue in someone who is not anaemic is a narrower, less settled question: some trials in selected women show a benefit, and Australian Prescriber still calls the evidence limited.
Australian cut-off: under 30 µg/L
Australian Prescriber, GESA, and Australian Red Cross Lifeblood use ferritin under 30 µg/L as the working adult threshold (about 92% sensitive and 98% specific against marrow iron). The WHO well-population cut-off is under 15 µg/L, rated low-certainty in the 2020 guideline. A ferritin of 20 is already below the floor most Australian labs print.
How common this is
About 22.3% of Australian women and 3.5% of Australian men have ferritin under 30 µg/L, per the ABS Australian Health Survey: Biomedical Results for Nutrients (2011-13). A separate 2020 survey found 34.8% of women aged 18 to 39 below that cut-off. Those are two studies, not one dataset split two ways.
Inflammation can hide a low store
Ferritin rises with infection, inflammation, and some liver disease regardless of iron. Australian guidance is to read it with CRP. When inflammation is present, ferritin under 100 µg/L plus transferrin saturation under 20% is the usual working rule, not the 30 µg/L floor used in a well person.
Do not start iron because you are tired. Confirm the store first. Unnecessary iron does not reliably improve energy when stores are already adequate, and it is unsafe in iron overload conditions such as haemochromatosis.
For thresholds, inflammation, and how to read iron studies on an Australian report, see the ferritin and iron studies guide.
Thyroid
Thyroid
An underactive thyroid slows the body's idle speed. That can feel like tiredness, cold intolerance, weight gain, dry skin, or hair change. It can also be silent on symptoms and obvious only on a blood test.
How thyroid hormone makes energy
The thyroid releases T4, which tissues convert to T3. T3 raises basal metabolic rate by increasing the work of ion pumps (including Na+/K+-ATPase), supporting mitochondrial biogenesis, and changing how leaky those mitochondria are. Low T3/T4 lowers that energy expenditure. The mechanism is settled physiology, not a wellness claim.
TSH first, then free T4
RCPA advice is that TSH is the first-line test for suspected primary thyroid disease. Free T4 and free T3 must not be requested in isolation. Add free T4 when TSH is abnormal. Add free T3 if TSH is suppressed and free T4 is still in range. Measure both TSH and free T4 together if pituitary or hypothalamic disease is on the table.
How common in Australia
Overt hypothyroidism is about 0.5% of Australians, subclinical hypothyroidism about 5%, and thyroid autoimmunity about 12%, per Walsh in the MJA (2016). Tiredness is a common reason TSH is ordered; it is not a reason to skip the history.
Subclinical is not the same as a treatment decision
A high TSH with a normal free T4 is common biochemistry. Whether treating it will lift fatigue is not automatic. That decision sits with a clinician, using the number, the antibodies if measured, and the rest of the picture, not with a page.
High-dose biotin, the kind sold for hair and nails, can interfere with the immunoassays many labs use for thyroid tests. Mention it before the draw.
For TSH, free T4, free T3, antibodies, and Medicare detail, see the thyroid blood test guide.
B12
Vitamin B12
B12 deficiency can cause fatigue, anaemia, and neurological symptoms, and the neurological disease can appear without anaemia. That is why a normal FBE does not close the question if the history still points here.
Two reactions, two kinds of harm
Vitamin B12 is a cofactor for methionine synthase, which feeds DNA synthesis and myelin through the folate cycle, and for methylmalonyl-CoA mutase, which handles odd-chain fatty acids. When the second enzyme stalls, methylmalonic acid rises. The result can be megaloblastic anaemia, demyelination, or both. That pathway is settled.
Total B12 is a screen, not the last word
About 80% of circulating B12 is bound to haptocorrin and is not available to cells. Active B12 (holotranscobalamin) is the usable fraction. Australian labs use active B12 when total B12 is in the grey zone, and may add MMA or homocysteine if the picture is still unclear.
Who is actually at risk
Australian Prescriber (2026) lists vegan or vegetarian diets, older age, metformin, PPIs or H2-blockers used for more than two years, bariatric or ileal disease, pernicious anaemia, and nitrous oxide. In Australians over 50, deficiency prevalence is cited at 5.2% to 6.3%. A whole-population adult rate has not been published in a form worth quoting.
Medicare is frequency-capped
From 1 July 2025, item 66838 funds total B12 and/or active B12 once per 11 months in most people. Item 66842 allows more frequent testing only in defined risk groups. Fatigue alone is not one of those listed groups.
B12 is worth adding when the history fits. It is not a default first-line fatigue test, and a low-normal total B12 with neurological symptoms still needs a clinician, not a supplement guess.
For the current interpretive bands, causes including metformin and PPIs, and how to read active B12, see the vitamin B12 test guide.
Vitamin D
Vitamin D
Vitamin D is the test commercial fatigue pages love, and the one Australian guidelines are most cautious about.
Deficiency is common. That is not the same as a cause.
The ABS National Health Measures Survey 2022 to 2024 found 20.6% of Australian adults had vitamin D deficiency, down from 23.8% in 2011 to 2012. Association with tiredness is reported. Causation is weak. One small randomised trial in otherwise healthy people with 25-OH D under about 50 nmol/L found a single high dose improved a fatigue score at four weeks. Other signals sit in disease-specific groups, not the general tired patient. Narrative reviews call the data conflicting.
Australian adequacy is 50 nmol/L, not 75
ANZBMS, the Endocrine Society of Australia, and Osteoporosis Australia set adequacy at 50 nmol/L or above at the end of winter. They have said the evidence is insufficient to recommend 75 to 80 nmol/L for extra-skeletal outcomes. The 2011 US Endocrine Society 75 nmol/L framing is the source of a lot of "insufficient" language on the internet. That society's 2024 guideline no longer endorses the 75 nmol/L target or routine screening in healthy adults.
Medicare does not fund this test for tiredness
Item 66833 lists osteoporosis, abnormal bone biochemistry, malabsorption, deeply pigmented skin or chronic severe sun lack, certain drugs, chronic kidney disease, and a short paediatric list. Unexplained fatigue is not an indication. RACGP First Do No Harm advises against routine vitamin D testing.
The evidence that supplementation reliably lifts unexplained fatigue is thin, especially once 25-OH vitamin D is already at or above 50 nmol/L. If the result is low, that is a bone and muscle conversation with a clinician, not proof that vitamin D was the tiredness.
For units, ANZBMS thresholds, and when testing is actually indicated, see the vitamin D blood test guide.
Glucose
Glucose and HbA1c
High glucose and the insulin resistance that often precedes it can both present as low energy. They do it through different, overlapping mechanisms, and they do not always show up on the same test.
What high glucose does
When blood glucose stays high, the kidneys spill glucose into urine and water follows it. That osmotic diuresis causes thirst, dehydration, nocturia, and broken sleep. The tiredness can be the sleep as much as the sugar. This is standard pathophysiology, clearest once diabetes is established.
What insulin resistance can do while glucose still looks "normal"
Muscle cells take up glucose through GLUT4 transporters that insulin has to recruit. In insulin resistance the pancreas compensates by making more insulin, so fasting glucose and HbA1c can sit inside the reference interval for years while fasting insulin is already high. That pattern is settled biochemistry. It is not, on its own, proof that a high fasting insulin is why you feel tired; it is a reason not to stop at a normal HbA1c if the metabolic history still looks off.
Which test belongs where
Australian fatigue guidelines use fasting glucose as the first-line glucose test. HbA1c estimates average glucose over roughly two to three months and does not need fasting. Diabetes is diagnosed at HbA1c 48 mmol/mol (6.5%) or above, confirmed on a second test; prediabetes is 42 to 47 mmol/mol (6.0% to 6.4%), per the Australian Diabetes Society. Fasting insulin is not a first-line fatigue test. It is the earlier metabolic marker once you are looking past a normal glucose.
How common diabetes is
The ABS National Health Measures Survey 2022 to 2024 found about one in fifteen Australian adults had diabetes: 6.6% by the fasting-glucose algorithm and 6.4% by HbA1c. Use that range. A single headcount is not printed on the ABS release.
HbA1c can also mislead when red cell survival changes. Iron deficiency anaemia is one of the conditions discussed as pushing the number up, though that direction is not fully settled. If the glucose story and the iron story are both open, read them together rather than as two separate verdicts.
For mmol/mol vs %, diagnostic thresholds, and when HbA1c misleads, see the HbA1c test guide. Fasting insulin and HOMA-IR are the earlier metabolic pair if glucose still looks ordinary.
Limits
What blood tests cannot show
A normal fatigue panel is not an empty result. It is a shorter list of what is left. These are the common remaining causes that blood cannot diagnose.
Sleep apnoea
Obstructive sleep apnoea is a RACGP probability diagnosis for fatigue, and it is common. The Busselton Healthy Ageing Study (adults aged about 46 to 69, 2010 to 2015, two-channel home sleep studies) found moderate-to-severe OSA in 20.2% of men and 10.0% of women. AJGP 2023 summarises that as about 20% of the Australian general population having at least moderate OSA; that is a middle-aged community sample, not a census of every adult. Doctor-diagnosed rates are much lower, which is the gap, not a contradiction. Blood cannot show this. A sleep history, and sometimes a sleep study, can.
Depression, anxiety, and stress
Australian primary-care reviews treat these as the most common non-somatic diagnoses in fatigue. There is no AIHW figure that cleanly answers "what share of tired Australians have depression," and this page will not invent one. The practical point is simpler: a normal blood report does not make the tiredness imaginary, and it does not replace a mental-health conversation.
Post-viral illness and long COVID
Post-viral fatigue is on the Australian probability list independently of COVID-19. For long COVID, published Australian figures are a range, not a single national rate: an AIHW 2022 review put then-available estimates at 5% to 10% of COVID-19 cases with symptoms beyond 12 weeks, and an MJA 2024 Western Australian Omicron survey found 18.2% of respondents reporting symptoms consistent with long COVID at 90 days, with fatigue in 70.6% of that group. Blood can exclude some other causes. It cannot confirm this one.
Medicines, alcohol, and sleep debt
Australian fatigue guidelines ask about prescription medicines, complementary and over-the-counter products, alcohol, and sleep. They do not publish a named drug list, and this page will not invent one. Bring the box, the bottle, and an honest week of sleep to the appointment. Those details often matter more than a third add-on assay.
ME/CFS is a separate clinical diagnosis with its own criteria. It is not a default label for unexplained tiredness, and it is not something a standard fatigue panel can prove or rule out.
How to order
How Australians get these tests
| Approach | Best for | Typical cost | What it covers |
|---|---|---|---|
| GP-ordered, Medicare-funded first-line set | Unexplained tiredness after history and examination, especially if it has lasted beyond a short watchful wait | Often bulk-billed or low gap when the GP judges the tests clinically indicated | Typically FBE (MBS 65070), TSH (66716), iron studies (66596), fasting glucose, EUC, LFT, and CRP or ESR |
| GP-ordered add-ons | A history that points to B12, diabetes risk, or (less often) a funded vitamin D indication | B12 is frequency-capped (66838, once per 11 months for most people). Diagnostic HbA1c is item 66841 when eligible. Vitamin D is item 66833 and does not list tiredness. | B12, HbA1c, or vitamin D only when the indication fits, not as a default fatigue bundle |
| Private standalone tests | Preventative or extra markers outside MBS criteria | Iron studies about $62 to $75; TSH about $20 to $50; TSH plus free T4/T3 about $60 to $150; vitamin D about $40 to $80; HbA1c about $45 to $65 | Whatever is written on the request. You still need an authorised GP request. |
| Membership platforms (e.g. Hemexa) | A full preventative panel with the first-line markers and the useful add-ons on one draw, then a six-month retest on the fast-moving ones | ~$1,199/year (full membership) | Ferritin and iron studies, TSH/free T4/free T3, B12, vitamin D, FBE, HbA1c, fasting glucose, and fasting insulin among 76–80 signature markers |
Pathology in Australia requires an authorised request from a registered medical practitioner. Collection for Hemexa members is through Healius Pathology, with regional brands that differ by state. A request form is not a diagnosis, and a membership is not a substitute for seeing a GP about red flags.
FAQ
Frequently asked questions
- What blood tests should I ask for if I am always tired?
- Start with FBE, fasting glucose, TSH, EUC, liver function tests, and ESR or CRP. Add ferritin or iron studies (the eTG figure and the current RCPA Manual include them). Add B12 if diet, metformin, age, or gut history points there. Add HbA1c if diabetes risk is on the table. Vitamin D is not a first-line fatigue test and is not Medicare-funded for tiredness alone.
- Can my ferritin be low if my haemoglobin is normal?
- Yes. That is iron deficiency without anaemia: stores are down, the red cell count has not fallen yet. Australian practice treats ferritin under 30 µg/L as depleted in a well adult. The WHO well-population cut-off is under 15 µg/L, so a result between the two can be read two ways.
- Will Medicare pay for a vitamin D test if I am just tired?
- Not under item 66833 as written. That item lists bone disease, certain biochemistry, malabsorption, limited sun or deeply pigmented skin, specific drugs, kidney disease, and a paediatric list. Unexplained fatigue is not on it. A private vitamin D test typically costs about $40 to $80.
- Are B12 and vitamin D first-line tests for fatigue in Australia?
- No. Australian guidance puts FBE, fasting glucose, TSH, EUC, liver function, and ESR or CRP first, with ferritin or iron studies on the eTG figure and in the current RCPA Manual. B12 and vitamin D are add-ons when the history fits.
- Can my HbA1c be normal if I still have a glucose problem?
- Yes. Fasting insulin can be high for years while fasting glucose and HbA1c stay inside the reference interval. That pattern is compensated insulin resistance. Fasting glucose is still the first-line glucose test in a fatigue workup; fasting insulin and HbA1c answer different questions.
- How much do fatigue blood tests cost in Australia?
- A GP-ordered first-line set is often bulk-billed or low gap when clinically indicated. Private standalone prices already published on Hemexa marker guides are about $62 to $75 for iron studies, $20 to $50 for TSH, $60 to $150 for a fuller thyroid panel, $40 to $80 for vitamin D, and $45 to $65 for HbA1c. Memberships that include these markers on a panel of 76–80 signature markers start around AU$1,199 per year.
- Do I need to fast?
- Fasting glucose and fasting insulin need an overnight fast, water only. FBE, TSH, ferritin, B12, vitamin D, and HbA1c do not, on their own. If they are drawn on the same form as a fasting test, you fast for the visit. Morning collection is preferred for TSH and serum iron.
- What if every blood test is normal?
- That is a common and useful result. Australian data put a significant clinical diagnosis from fatigue testing at about 4%. The next conversation is often sleep (including apnoea), mood, medicines, alcohol, and whether this followed an infection. Blood cannot close those questions.
- Is being tired all the time the most common reason Australians see a GP?
- No. It presents at 1.4 per 100 Australian GP encounters. It is the most common unexplained complaint, which is a narrower claim. Most GP visits are for something more specific.
- Should I test cortisol or reverse T3 if I am tired?
- Not as a first-line fatigue test. Australian guidelines do not include cortisol or reverse T3 in the opening set. "Adrenal fatigue" is not a recognised medical diagnosis. True adrenal insufficiency is a different, uncommon condition and is a specialist workup, not a commercial fatigue-panel add-on.
- Should I take iron, B12, or vitamin D without a test?
- No. Iron is unsafe to self-start if you have iron overload. B12 and vitamin D are not harmless just because they are vitamins, and a symptom guess is a poor way to choose a dose or a duration. Confirm the deficiency, then treat the cause with a clinician.
- How long should I wait before asking for tests?
- If there are no red flags, Australian guidelines often support about four weeks of watchful waiting. If you are older and this is new, if you have lost weight, if you are short of breath, if you are bleeding, or if you have a fever or new lumps, do not wait on a page. See a GP.
- Does Hemexa test the markers in a fatigue workup?
- Yes. The annual baseline includes ferritin and iron studies, TSH, free T4, free T3, vitamin B12, vitamin D, a full blood count, HbA1c, fasting glucose, and fasting insulin, among 76–80 signature markers. HbA1c, glucose, insulin, and hs-CRP also repeat on the included six-month retest. Collection is through Healius Pathology. A membership does not replace a GP visit for red flags.
How Hemexa fits
How Hemexa can help
Tiredness has many causes. The useful product move is to put the first-line markers and the honest add-ons on one panel, then read them together instead of as a stack of PDFs.
Iron studies, thyroid, B12, vitamin D, and the FBE on one baseline
Hemexa includes ferritin, iron, transferrin, TSAT, TSH, free T4, free T3, vitamin B12, folate, 25-OH vitamin D, and haemoglobin on the annual baseline, part of 76–80 signature markers. That is the fatigue-relevant set, not a claim that the panel diagnoses tiredness.
HbA1c, glucose, and insulin twice a year
HbA1c, fasting glucose, fasting insulin, and hs-CRP run on both the annual baseline and the included six-month retest, so a normal glucose this year is not the end of the metabolic story.
Clinical safety review on the results that cannot wait
Hemexa flags ferritin below 15 or above 1000 µg/L, TSH below 0.1 or above 10 mIU/L, HbA1c of 48 mmol/mol or above, and haemoglobin below 90 or above 190 g/L for follow-up with a doctor, rather than leaving those numbers in a PDF.
Collection through Healius Pathology
Healius Pathology is Hemexa's collection partner, with regional brands that differ by state. Results from other Australian labs can be imported after your first baseline. The partner is the network, not one state brand.
Sources
References
Wilson, J., Morgan, S., van Driel, M., & Magin, P. (2014). Fatigue: a rational approach to investigation. Australian Family Physician, 43(7). Cites Britt et al., General practice activity in Australia 2011-12 (BEACH), and Gialamas et al., Aust Fam Physician 2003, for the 1.4 per 100 encounter rate and the 16%/4% yield figures. View source ↗
Balendran, S., & Forsyth, C. (2021). Non-anaemic iron deficiency. Australian Prescriber. View source ↗
World Health Organization. (2020). WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. View source ↗
Zhang, C., et al. (2024). Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing of blood donors by Australian Red Cross Lifeblood. Medical Journal of Australia, 221(7). View source ↗
Australian Bureau of Statistics. Australian Health Survey: Biomedical Results for Nutrients, 2011-12. View source ↗