Home / Fatigue
Cincinnati · Fatigue
Tired all the time is a finding, not a personality
Fatigue that survives a full night’s sleep is rarely just a mood. It is usually ferritin, thyroid, fasting insulin, B12, or vitamin D, markers board-certified OB/GYN Dr. Tiffany Hall reads first in The Choosi Read, a comprehensive lab panel, before anyone talks about what comes next.
Before The Read
The tired that sleep does not fix
You get eight hours, sometimes nine, and wake up already behind. Coffee gets you to ten. By three in the afternoon you are running on will, not energy, and by the time you sit down for dinner there is nothing left for the rest of your night. Somewhere along the way you started calling this normal.
It is not normal, and it is not a personality trait. Fatigue like this is a finding waiting to be read, not a stage of life to accept. Ferritin, the thyroid hormone that actually does the work, fasting insulin, B12, and vitamin D are where we look first, and it is common for one or more of the five to come back out of range.
What we check first
The markers that explain it
These are not the whole panel. They are the first places Dr. Hall looks when fatigue is the primary complaint, pulled from the thyroid, metabolic, iron, and vitamin categories inside The Choosi Read.
| Marker | Why we run it | Category |
|---|---|---|
| Ferritin (ng/mL) | Measures iron stores, as low ferritin is a commonly overlooked cause of fatigue in women. | Iron studies and CBC |
| TSH (mIU/L) | The first-line screening marker for thyroid function, and often where routine thyroid testing ends. | Thyroid axis |
| Free T3 (pg/mL) | The active thyroid hormone, which may be suppressed even when TSH appears normal. | Thyroid axis |
| Fasting insulin (uIU/mL) | An early indicator of metabolic dysfunction that is often overlooked in routine testing. | Metabolic and insulin |
| Vitamin B12 (pg/mL) | Evaluated in the context of energy production, neurologic function, and methylation. | Vitamin and micronutrient |
| Vitamin D, 25-OH (ng/mL) | Assesses vitamin D status, as deficiency is common and can affect immune and bone health. | Vitamin and micronutrient |
Every one of these lives inside the same comprehensive lab panel that starts every plan at Choosi.
See the full ReadThe first marker we run
Ferritin, the most-missed cause
Of these, ferritin is the one Dr. Hall checks first when fatigue is the complaint that brought you in. Ferritin is not the iron circulating in your blood. It is the iron your body has banked in reserve, and a standard panel calls almost any number above ten normal.
Most standard panels never run ferritin at all. They run a complete blood count, which only catches anemia, the late stage of the same problem. By the time anemia shows up on a CBC, the fatigue behind it has usually been building for years.
- Fatigue that does not improve with sleep
- Hair shedding at the temples and crown
- Cold hands and feet, restless legs at night
- Brain fog and low motivation that feels like depression
When ferritin comes back low, repletion is usually something Dr. Hall starts that same visit, with a recheck built into your ninety-day follow-up.
“I read ferritin first. It is the single marker that explains the most symptoms in the women who walk in saying they were told their labs were normal.”
Dr. Tiffany Hall
After your results
What happens after the Read
Ferritin, thyroid, fasting insulin, B12, and vitamin D come back as numbers, not a verdict. At your follow-up, Dr. Hall reads them against your history and your symptoms, together with you, and the plan gets built from there.
A low ferritin or vitamin D usually means repletion starts that same visit, with a recheck at twelve weeks. A thyroid picture that is off can bring hormone therapy into the conversation. A fasting insulin that is already climbing becomes part of a broader metabolic conversation, even while glucose alone still looks normal.
Every path starts with the same panel. See what the Choosi Read includes.
Ready when you are
Know why you are tired.
Book The Read and find out which of the five (ferritin, thyroid, fasting insulin, B12, or vitamin D) is behind it. Dr. Hall reads the results against your history, not a generic checklist.