Tiredness
Investigate some common causes of fatigue: CBC, thyroid, iron, vitamins, glucose, and HbA1c.
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Included Markers
9 markersA multi-system panel designed to explore some of the more common causes of persistent tiredness. It covers blood count, thyroid function, iron stores, vitamins, and blood sugar markers.
Why this test?
Persistent fatigue can have many possible causes, and often multiple factors may contribute at the same time. This panel measures markers across several systems that are commonly associated with tiredness, including thyroid function, iron stores, vitamin levels, and blood sugar regulation. Rather than testing one area in isolation, this approach may help identify which systems warrant further attention.
Who is this test for?
This test may be relevant for women who:
- Experience persistent fatigue that is not explained by sleep or lifestyle factors alone
- Want to explore multiple potential causes of tiredness in one test
- Have noticed a decline in energy levels over time
- Would like data to discuss with their healthcare provider
What is tested?
This panel measures markers across multiple systems:
- Complete Blood Count (CBC): evaluates red and white blood cells and platelets
- Thyroid: TSH, Free T3, Free T4
- Iron: Ferritin
- Vitamins: Vitamin B12, Vitamin D (25-OH)
- Blood sugar: Glucose (Fasting), HbA1c
What can this test tell you?
Fatigue may be associated with low iron stores (ferritin), thyroid imbalance, vitamin deficiencies (B12 or D), blood sugar fluctuations, or changes in the blood count. By testing across these areas simultaneously, this panel may help narrow down which factors could be contributing. It is worth noting that fatigue can also have causes that are not captured by blood testing, and results should be discussed with a healthcare provider.
How is the sample collected?
The test requires a blood draw at a certified sample point (afnamepunt). There are over 750 locations across the Netherlands. Since fasting is required, scheduling a morning appointment is recommended.
When is this test useful?
This test may be considered when:
- You feel persistently tired despite adequate rest
- You want to check multiple systems that may be contributing to fatigue
- You have not had recent blood work and want a broad fatigue-focused panel
- You want data to bring to a healthcare provider appointment
What do the results mean?
Each marker is shown with your value and the reference range. Low ferritin, abnormal thyroid values, low vitamin levels, or blood sugar irregularities may each contribute to fatigue. Sometimes multiple factors are present at once. Results should be interpreted by a healthcare provider who can consider them alongside your full clinical picture.
Preparation
Fasting is required for 8 to 12 hours before the blood draw (water is permitted). Schedule a morning appointment for the most accurate glucose results.
What happens after the results?
Your results are typically available within a few working days. Each marker is presented with your value, the reference range, and an explanation. These results can serve as a starting point for a conversation with your healthcare provider about possible next steps.
Frequently Asked Questions
From order to report in 4 steps
Test when you want, not only when symptoms are severe. No waiting list, no referral needed. Just order and go.
Choose your hormone test
Browse our hormone panels and pick what you want tested. Compare markers and prices, or build a custom test.
Receive your lab referral
Within 2-3 hours you'll receive an email from ZorgDomein with a barcode. Orders outside business hours are processed the next business day.
Get tested at a lab near you
Show the barcode on your phone and bring a valid ID. Done in under 15 minutes.
Receive your report from the doctor
A BIG-registered physician reviews your hormone values and writes a personal report. On your dashboard within a few business days.
Choose your hormone test
Browse our hormone panels and pick what you want tested. Compare markers and prices, or build a custom test.
Receive your lab referral
Within 2-3 hours you'll receive an email from ZorgDomein with a barcode. Orders outside business hours are processed the next business day.
Get tested at a lab near you
Show the barcode on your phone and bring a valid ID. Done in under 15 minutes.
Receive your report from the doctor
A BIG-registered physician reviews your hormone values and writes a personal report. On your dashboard within a few business days.
Always a location near you
With more than 450+ certified phlebotomy points across the Netherlands.
What We Test
This test includes 9 biomarkers to give you a comprehensive health picture.
HbA1c (glycated haemoglobin) reflects your average blood sugar levels over the past 2-3 months. It is the gold standard for long-term blood sugar monitoring and diabetes management.
Learn moreTSH, or thyroid-stimulating hormone, is produced by the pituitary gland and controls the thyroid. It is the most commonly used blood value to assess thyroid function. An abnormal TSH level can indicate an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism). Thyroid problems are common — especially in women — and can cause a wide range of symptoms, from fatigue and weight gain to palpitations and nervousness.
Learn moreGlucose is the primary energy source for your body. Your fasting glucose level (measured after at least eight hours of fasting) indicates how well your body can regulate blood sugar. An elevated fasting glucose can indicate prediabetes or type 2 diabetes, while a low value (hypoglycaemia) can cause symptoms such as trembling, sweating, and difficulty concentrating.
Learn moreFree T4 (thyroxine) is the main hormone produced by the thyroid gland. It may serve as a precursor that your body converts into the more active T3. Healthcare providers often consider Free T4 a primary indicator of thyroid gland output.
Learn moreVitamin B12 is considered essential for red blood cell formation, neurological function, and DNA synthesis. Deficiency may develop gradually and is sometimes associated with dietary patterns. Healthcare providers can help interpret your results.
Learn moreVitamin D is a fat-soluble vitamin that plays a key role in calcium absorption, bone health, and immune function. It is primarily produced in the skin through sunlight exposure and can also be obtained from certain foods and supplements.
Learn moreFree T3 (triiodothronine) is considered the most active thyroid hormone. It may play a key role in regulating metabolism, energy production, and body temperature. Healthcare providers often assess Free T3 alongside other thyroid markers for a comprehensive picture.
Learn moreFerritin is the primary storage protein for iron in your body. It reflects your iron stores more accurately than iron levels themselves, which can fluctuate considerably throughout the day. Low ferritin is the earliest sign of iron deficiency — often measurable before your haemoglobin drops and anaemia develops. High ferritin can indicate iron overload but is also a widely used inflammation marker. Interpretation always depends on the clinical context.
Learn moreA complete blood count (CBC) is a comprehensive blood test that evaluates the major components of your blood: red blood cells, white blood cells, and platelets. It is one of the most commonly ordered blood tests and provides a broad overview of your overall health.
Learn moreHbA1c (Glycated Hemoglobin)
MetabolicHbA1c (glycated haemoglobin) reflects your average blood sugar levels over the past 2-3 months. It is the gold standard for long-term blood sugar monitoring and diabetes management.
HbA1c provides a long-term view of blood sugar control, unlike fasting glucose which reflects a single point in time. It is essential for diabetes diagnosis and management. Consult your healthcare provider.
TSH (Thyroid Stimulating Hormone)
ThyroidTSH, or thyroid-stimulating hormone, is produced by the pituitary gland and controls the thyroid. It is the most commonly used blood value to assess thyroid function. An abnormal TSH level can indicate an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism). Thyroid problems are common — especially in women — and can cause a wide range of symptoms, from fatigue and weight gain to palpitations and nervousness.
The thyroid affects virtually every organ in your body. The hormones it produces (T3 and T4) regulate your metabolism, heart rate, body temperature, energy level, and even your mood. When thyroid function is disrupted, the effects can be wide-ranging. Hypothyroidism (underactive) is the most common thyroid condition, affecting an estimated 5% of adults, with a clear predominance in women. It is often caused by the autoimmune condition Hashimoto's disease. Symptoms develop gradually and are therefore often recognised late. Hyperthyroidism (overactive) is less frequent but can be more serious. Graves' disease is the most common cause. Untreated, it can lead to heart rhythm disorders and bone loss. For women trying to conceive, the TSH value is particularly relevant, as suboptimal thyroid function can affect fertility and pose risks during pregnancy. A TSH below 2.5 mU/L is often used as a target in this context.
Glucose (Fasting)
MetabolicGlucose is the primary energy source for your body. Your fasting glucose level (measured after at least eight hours of fasting) indicates how well your body can regulate blood sugar. An elevated fasting glucose can indicate prediabetes or type 2 diabetes, while a low value (hypoglycaemia) can cause symptoms such as trembling, sweating, and difficulty concentrating.
Type 2 diabetes affects more than one million people in the Netherlands, and an estimated 1.1 million more have prediabetes without knowing it. Untreated, diabetes significantly increases the risk of cardiovascular disease, kidney damage, eye problems, and nerve damage. Prediabetes is a reversible stage. With lifestyle adjustments — weight loss, more exercise, less sugar and processed carbohydrates — more than half of people with prediabetes can prevent developing diabetes. This makes early detection through a fasting glucose test or HbA1c very valuable.
Free T4 (Thyroxine)
ThyroidFree T4 (thyroxine) is the main hormone produced by the thyroid gland. It may serve as a precursor that your body converts into the more active T3. Healthcare providers often consider Free T4 a primary indicator of thyroid gland output.
Free T4 may help your healthcare provider determine whether your thyroid gland is producing adequate hormone levels. Some experts consider it one of the most informative markers for detecting both overactive and underactive thyroid conditions early.
Vitamin B12
VitaminsVitamin B12 is considered essential for red blood cell formation, neurological function, and DNA synthesis. Deficiency may develop gradually and is sometimes associated with dietary patterns. Healthcare providers can help interpret your results.
Vitamin B12 is believed to be vital for healthy nerve cells, red blood cell formation, and DNA synthesis. Low levels may be associated with anaemia, fatigue, and neurological symptoms. Early detection through testing may help prevent long-term complications.
Vitamin D (25-OH)
VitaminsVitamin D is a fat-soluble vitamin that plays a key role in calcium absorption, bone health, and immune function. It is primarily produced in the skin through sunlight exposure and can also be obtained from certain foods and supplements.
Adequate vitamin D levels are essential for strong bones, a well-functioning immune system, and overall well-being. Low levels may be associated with an increased risk of bone disorders, mood changes, and weakened immunity. Consult your healthcare provider for personalised advice.
Free T3 (Triiodothyronine)
ThyroidFree T3 (triiodothronine) is considered the most active thyroid hormone. It may play a key role in regulating metabolism, energy production, and body temperature. Healthcare providers often assess Free T3 alongside other thyroid markers for a comprehensive picture.
Free T3 may help your healthcare provider evaluate how well your thyroid is functioning at a cellular level. Some experts suggest it can reveal conversion issues that other thyroid tests might miss, potentially offering a more complete understanding of thyroid health.
Ferritin
MineralsFerritin is the primary storage protein for iron in your body. It reflects your iron stores more accurately than iron levels themselves, which can fluctuate considerably throughout the day. Low ferritin is the earliest sign of iron deficiency — often measurable before your haemoglobin drops and anaemia develops. High ferritin can indicate iron overload but is also a widely used inflammation marker. Interpretation always depends on the clinical context.
Iron deficiency is the most common nutritional deficiency worldwide and one of the leading causes of fatigue. Ferritin detects iron deficiency at an early stage, before haemoglobin drops. This makes it a valuable preventive marker. In women of childbearing age, iron deficiency is particularly common due to menstrual blood loss. A ferritin below 30 µg/L with symptoms such as fatigue, concentration problems, or hair loss is often already reason to supplement, even if haemoglobin is still normal. On the other hand, significantly elevated ferritin (above 500 µg/L) can indicate haemochromatosis, a hereditary condition in which the body absorbs too much iron. Untreated, this can lead to liver, heart, and joint damage. Haemochromatosis occurs in 1 in 200 people of European descent and is often discovered late.
Complete Blood Count (CBC)
HematologyA complete blood count (CBC) is a comprehensive blood test that evaluates the major components of your blood: red blood cells, white blood cells, and platelets. It is one of the most commonly ordered blood tests and provides a broad overview of your overall health.
The CBC is a cornerstone of preventive healthcare and diagnostic medicine. It can help detect a wide range of conditions including anemia, infections, immune disorders, blood cancers, and clotting problems. Regular CBC testing supports early detection and ongoing health monitoring.
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