Evaluation of thyroid dysfunction in patients presenting with unexpected fatigue

Submission: 01 November 2025 | Acceptance: 20 January 2026 | Publication: 07 April 2026

Dr Muhammad Zubair¹, Dr Mansoor Musa², Dr Qamar Abbas³, Dr Faiza Maqsood⁴, Dr Marwa Riaz⁵, Dr Qaisar Mumtaz⁶

¹Assistant Professor Medicine, Gomal Medical College, Dera Ismail Khan

²Assistant Professor, Poonch Medical College, CMH Rawlakot

³Senior Medical Officer, Sheikh Zayed Hospital, Rahim Yar Khan

⁴Assistant Professor, Bolan Medical College, Quetta

⁵Senior House Officer, Hope Family Clinic Faisalabad

⁶Assistant Professor, Nishtar University Hospital Multan

ABSTRACT:

Background: Unexpected fatigue is a common yet nonspecific clinical complaint encountered in medical practice. It may be associated with a wide range of underlying conditions, including endocrine disorders. Thyroid dysfunction, encompassing both hypothyroidism and hyperthyroidism, is a well-recognized but often underdiagnosed cause of fatigue. Early identification of thyroid abnormalities in such patients is crucial for timely management and improved quality of life. This study was conducted to evaluate the frequency and pattern of thyroid dysfunction among patients presenting with unexplained fatigue.

Aim: To assess the prevalence and types of thyroid dysfunction in patients presenting with unexpected fatigue.

Methodology: This cross-sectional study was conducted at Pakistan Institute of Medical Sciences from May 2025 to April 2026. A total of 90 patients presenting with unexplained fatigue were included through non-probability consecutive sampling. Patients aged 18–65 years of either gender were enrolled, while those with known thyroid disorders, chronic systemic illnesses, or on medications affecting thyroid function were excluded. Detailed clinical history and physical examination were performed for all participants. Blood samples were collected to assess thyroid function tests, including serum Thyroid Stimulating Hormone (TSH), Free T3 (FT3), and Free T4 (FT4). Based on laboratory findings, patients were categorized into euthyroid, hypothyroid (overt and subclinical), and hyperthyroid (overt and subclinical) groups. Data were analyzed using SPSS version 25, and frequencies and percentages were calculated.

Results: Out of the 90 patients evaluated, 54 (60%) were females and 36 (40%) were males, with a mean age of 38.5 ± 11.2 years. Thyroid dysfunction was identified in 34 (37.8%) patients, while 56 (62.2%) were euthyroid. Among those with thyroid abnormalities, hypothyroidism was the most common, observed in 24 (26.7%) patients, including 15 (16.7%) with subclinical and 9 (10%) with overt hypothyroidism. Hyperthyroidism was detected in 10 (11.1%) patients, with 6 (6.7%) subclinical and 4 (4.4%) overt cases. Thyroid dysfunction was more prevalent in females compared to males and was more commonly observed in the age group of 30–50 years.

Conclusion: A significant proportion of patients presenting with unexplained fatigue were found to have underlying thyroid dysfunction, particularly hypothyroidism. Routine screening of thyroid function tests in such patients was valuable for early diagnosis and appropriate management. Increased clinical awareness can help reduce missed diagnoses and improve patient outcomes.

Keywords: Unexpected fatigue, Thyroid dysfunction, Hypothyroidism, Hyperthyroidism, TSH, Subclinical thyroid disease, Endocrine disorders.