Patient presents with chief complaint of tiredness or fatigue.  Symptoms include persistent exhaustion, lethargy, low energy levels, and difficulty concentrating.  Onset of fatigue is reported as gradual or sudden, with duration described as chronic fatigue syndrome, persistent fatigue, or prolonged tiredness.  Patient reports experiencing physical fatigue, mental fatigue, or both.  Severity of fatigue is documented as mild, moderate, or severe, impacting daily activities, including work productivity and social functioning.  Associated symptoms may include sleep disturbances such as insomnia or hypersomnia, muscle weakness, pain, difficulty concentrating, decreased motivation, irritability, and depression.  Review of systems includes questions regarding sleep patterns, dietary habits, exercise routines, and stress levels.  Differential diagnosis includes anemia, hypothyroidism, depression, anxiety, infections such as mononucleosis or Lyme disease, autoimmune diseases, and sleep disorders such as obstructive sleep apnea.  Diagnostic workup may include complete blood count, thyroid panel, metabolic panel, and further testing as indicated by patient presentation and clinical suspicion.  Treatment plan may include lifestyle modifications such as improving sleep hygiene, regular exercise, stress management techniques, and nutritional counseling.  Pharmacological interventions may be considered based on underlying causes and symptom severity.  Patient education provided regarding fatigue management strategies, importance of follow-up care, and symptom monitoring.  Follow-up appointment scheduled to assess treatment response and adjust plan as needed.