Unexplained fatigue
Always tired — but supposedly everything is fine.
“Everything’s fine” often just means: too little measured. We look at 85+ markers instead of 5 and read them in context — iron, thyroid, vitamins, metabolism, cortisol, silent inflammation. Usually there is an explainable cause. And if not, we tell you honestly.
Why this matters
You function, but you are constantly running on empty. And no one takes it seriously.
You sleep enough and still your energy never lasts. Focus crumbles, the afternoon feels like wading through fog. At the GP you get a small blood count and the verdict “unremarkable”. So it must be you. That is how it feels.
The problem is usually not your resilience, but the scope of the examination. A standard check measures few values against broad reference ranges. There, “normal” means statistically unremarkable, not right for you. Exactly in this gap the common, treatable causes of fatigue often stay undetected.
The usual check
5
A small blood count, TSH, maybe iron. Viewed individually, all “within range”. Result: “unremarkable” — and you are none the wiser.
The YEARS approach
85+
Comprehensive markers plus functional diagnostics, read in context by a physician. Not one value but the pattern behind it — and a plan for what to do.
Why YEARS for you
When “everything’s fine” is no answer, you need a better question.
Too little measured is not the same as “healthy”
“Everything’s fine” often just means too little was looked at. A standard check covers a handful of values. We measure 85+ markers — ferritin and the full iron status, the complete thyroid with fT3, fT4 and antibodies, vitamin D, B12, folate, HbA1c and insulin, cortisol and silent inflammation (hsCRP).
Values in context, not isolated numbers
A low-normal ferritin on its own looks fine. Together with a borderline thyroid and a vitamin D deficiency it forms a pattern that each single value misses. A physician connects the dots and tells you what belongs together.
Physical co-causes are examined too
Fatigue is rarely just lab work. We also look at your cardiovascular system and capacity (ECG, echo, VO₂max), metabolism, lung function and indicators of sleep quality. That way no physical cause stays in the blind spot.
Usually an explainable, actionable cause
In the most common cases there is a concrete lever: an iron or vitamin deficiency, a subclinical thyroid function, an early metabolic shift. You leave with an interpretation and a clear plan, not with another “unremarkable”.
What we examine in you
The most common causes that slip through a standard check.
Not a data pile for its own sake, but the markers behind which fatigue most often hides.
Iron status (ferritin, transferrin)
Ferritin can be low while your “normal” haemoglobin still looks fine. Iron deficiency without anaemia is one of the most commonly missed causes of fatigue.
Thyroid (TSH, fT3, fT4, antibodies)
TSH alone is often not enough. We measure fT3, fT4 and antibodies, because a subclinical dysfunction can clearly affect energy, sleep and mood.
Vitamin D, B12 & folate
A deficiency in vitamin D, B12 or folate is among the most common and most easily corrected causes of fatigue — if it is measured at all.
Blood sugar & metabolism (HbA1c, insulin)
Fluctuating blood sugar and early insulin resistance cause fatigue long before diabetes is diagnosed. HbA1c and the HOMA index show it early.
Stress axis & cortisol
A chronically overloaded stress axis is draining. We look at cortisol across the day and interpret it together with sleep, recovery and your workload.
Silent inflammation & cardiovascular (hsCRP)
Low-grade, silent inflammation (hsCRP) can leave you tired and flat. Together with ECG, echo and VO₂max we see whether your heart and capacity also play a role.
How we work
Physician-led, evidence-based, accompanied across the year.
Intro call
Free and without obligation. We listen to your situation and honestly clarify whether and which program makes sense for your case.
One day of diagnostics
85+ markers plus functional tests (including VO₂max, ECG, echo) in one day in Berlin, physician-led throughout, following established protocols.
Medical results consultation
A physician reads the values in context, interprets the pattern and translates it into a concrete, prioritised plan. No data pile, but clear next steps.
Follow-up across the year
We stay involved and check over time whether the measures are working. Prevention is a path, not a one-off snapshot.
Internal medicine assessment
Doctor-medic Alexandru Ardelean
Specialist in Internal Medicine
„True prevention begins when we stop waiting for symptoms.“
View profileChoose the right checkup for you
All programs include comprehensive diagnostics and individual consultation
Core®
A medically guided baseline check that shows you where you stand and which topics need priority now.
Evolve®
Comprehensive diagnostics plus annual plan, follow-ups and adjustments — turning insight into lasting change.
Ultimate®
Personal health management with close medical guidance, Europe's most comprehensive diagnostics and continuous oversight.
Frequently asked questions about constant fatigue
This is rarely about lack of care, it is about the framework. Standard statutory care often covers only a handful of values, and “normal” means reference range, not optimal. A low-normal ferritin, a borderline thyroid and a mild vitamin D deficiency are each “unremarkable” on their own and still form a picture together. We measure 85+ markers, read them in context and take the time to walk through the pattern behind them with you.
That is a result too, and a reassuring one. If everything is organically fine, we narrow things down further: sleep quality, recovery, workload, lifestyle. We tell you honestly if the cause lies more there, and give you concrete next steps instead of another “unremarkable”. We promise no miracles and no diagnosis at any cost. Prevention can also overdiagnose, and we deliberately keep an eye on that.
For most people clarifying unexplained fatigue, Core is the right entry point: 85+ markers, functional diagnostics and the medical interpretation in one day, from €1,900. Evolve (from €7,600) makes sense if you want an even broader picture, for example with added depth in imaging and procedures. In the free intro call we honestly clarify beforehand which scope fits your case. Often the smaller route is enough.
The diagnostics take place in one day at the clinic in Berlin. Some values are available quickly, the full lab analysis takes a few days. After that comes the detailed medical results consultation, where we do not just read out the findings but translate them into a concrete plan. From there we accompany you across the year, so you can see whether the measures are working.
Yes. Exhaustion, stress and mental strain are closely linked to the body, and we do not pretend they are separate. We check the physical causes thoroughly, interpret cortisol and the stress axis, and speak openly if much points to a psychological or stress-related component. We are a preventive medicine clinic, not a psychotherapy practice, but we refer you clearly if that is the more sensible route.
Yes, for the blood and glucose tests you should fast for at least 12 hours, so that HbA1c, insulin and metabolism can be assessed cleanly. Water is allowed, and breakfast is provided right after the blood draw. You will receive further preparation instructions in good time before your appointment.
Find out what is really behind it.
Book a free intro call or give us a ring. We honestly clarify whether a check-up makes sense for your case.
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