Fatigue

Persistent fatigue could have more than one cause. Clara reads your chart to help find it.

Clara reads your labs, medications, and wearable data together to surface what may actually be driving your fatigue. A licensed physician reviews every clinical finding before any action is taken.

Get started See possible causes
I've been exhausted for months. I sleep 8 hours and still wake up tired. My doctor ran a TSH and said it was normal. What else could it be?
Clara
A normal TSH doesn't rule everything out. Your ferritin was 11 ng/mL eight months ago and hasn't been rechecked, and your B12 was low-normal at 247. I'll order a full panel to check the most common causes and send it to our physician for review.

Values and scenarios shown are illustrative examples only. Clara identifies patterns for physician review — it does not diagnose from symptoms alone.

How it works

Connect your records. Clara reads the full picture. A physician reviews every clinical action.

1

Connect your records

Clara auto-syncs your medical records from 150,000+ doctors' offices, hospitals, labs, and pharmacies: every prior lab, every prescription, every diagnosis. Wearable data syncs automatically on Standard and Concierge plans. Free to start, no credit card.

2

Clara reads the context behind the fatigue

Fatigue is the starting point, not the conclusion. Clara reads your full chart — recent labs, medications, wearable trends, prior diagnoses — and surfaces the most likely contributors rather than anchoring on the first plausible explanation. Many cases of fatigue involve more than one contributing factor.

3

Labs ordered, physician-reviewed findings

When the chart points at something worth investigating, Clara orders the relevant labs and prepares a clinical summary for physician review. Every lab order is reviewed and signed by a licensed physician. Plans start at $25/mo. Labs on Standard and Concierge plans include the most common fatigue workup in one pass.

Your chart already has most of the context. Clara reads it so you don't have to start from scratch.

Get started Free to connect records. HSA and FSA eligible.
Possible causes

Persistent fatigue can come from several different places. Clara reads your chart to help identify which.

Many cases of persistent fatigue are caused by something treatable once identified. The conditions below are the most common causes Clara looks for — reading them together in context rather than evaluating each in isolation.

Iron deficiency and anemia

Low ferritin (iron stores) is one of the most commonly missed causes of fatigue, particularly in women of reproductive age. Ferritin can be depleted well before hemoglobin falls into the anemia range, meaning a standard CBC can look normal while iron stores are significantly low.

Hypothyroidism

Fatigue is the most common presenting symptom of an underactive thyroid. A TSH in the "normal" reference range doesn't always mean the thyroid is optimally functioning — particularly in patients with Hashimoto's, where antibody levels and Free T4 add important context.

How Clara manages hypothyroidism →

Vitamin D deficiency

Low 25-OH vitamin D is widespread and directly associated with fatigue, muscle weakness, and low mood. It is frequently missed on standard annual panels because it is not always included by default.

B12 deficiency

B12 deficiency causes fatigue, brain fog, and neurological symptoms. It is particularly common in patients on metformin, proton pump inhibitors, or those with reduced dietary intake. Low-normal B12 levels (200–400 pg/mL) can still be functionally insufficient for some patients.

Perimenopause and menopause

Hormonal changes during perimenopause frequently cause fatigue, sleep disruption, and cognitive fog — often years before periods stop. These symptoms often go unrecognized or are attributed to stress or depression rather than the hormonal transition driving them.

Depression and anxiety

Fatigue is a core symptom of both depression and anxiety. Clara runs a PHQ-9 screen and reads your symptom picture alongside your labs to distinguish mood-related fatigue from metabolic fatigue — the distinction matters for what comes next.

Insulin resistance and prediabetes

Fatigue is a common early sign of insulin resistance, often appearing years before HbA1c moves into the prediabetes range. Fasting insulin is a more sensitive early marker that a standard annual panel typically doesn't include.

How Clara manages diabetes and prediabetes →

Obstructive sleep apnea

Sleep apnea is significantly underdiagnosed, particularly in women and in people without classic risk factors. Fatigue despite adequate sleep duration, wearable data showing fragmented sleep or elevated resting HR, and a BMI above 25 are all signals Clara watches for. Clara can queue a home sleep study when the pattern warrants it.

Medication side effects

Fatigue is a side effect of many common medications including beta blockers, SSRIs, antihistamines, statins, and blood pressure medications. Clara reads your full medication list before concluding that fatigue is unexplained.

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When to seek emergency care

If your fatigue is accompanied by chest pain or pressure, shortness of breath at rest, sudden severe headache, fainting or near-fainting, one-sided weakness or slurred speech, or coughing or vomiting blood, call 911 or go to your nearest emergency room immediately. Clara is not an emergency service. For life-threatening symptoms, always call 911.

How Clara reads it

Why reading the full picture together matters more than any single test.

A normal TSH with low ferritin and low-normal B12 is a different clinical picture than a normal TSH alone. Clara reads every result in your chart against your current medications and wearable trends rather than evaluating each lab in isolation.

Many cases of fatigue have more than one contributing factor. Iron deficiency and hypothyroidism can coexist. Depression and sleep apnea frequently occur together. Clara looks at the full picture before suggesting what to investigate next.

If your wearable shows fragmented sleep or an elevated resting HR alongside recent labs, that context also factors into what Clara surfaces for physician review.

Clara reads it together 🧪 Lab results 💊 Medications Wearables 📋 Prior history 💬 Symptoms
Why Clara

How Clara approaches fatigue differently.

Clara Symptom checker app General telehealth Your doctor
Reads your full chart before responding ✓ Auto-synced, 150,000+ sources Symptom input only Self-reported history Within a single practice
Evaluates multiple causes at once Algorithm-ranked suggestions Visit-by-visit At visit, depends on time
Orders a full fatigue workup when cause is unclear ✓ Physician-reviewed panel Limited panel
Reads wearable data alongside labs
Monthly cost $25–$150/mo · HSA/FSA eligible Free to use Varies Per-visit copay
Biomarker panel included ✓ Included in Standard and Concierge memberships Extra cost Per-test copay
Physician-approved prescriptions and lab orders

The answers are often already in your medical history. Clara puts them together.

Get started From $25/mo · HSA/FSA eligible · cash-pay.

What an AI that reads your full chart makes possible in primary care.

A clinician in a 15-minute visit reads the last panel. Clara reads every result you have ever had drawn, every medication you have been on, and every wearable reading in a single pass. That is not a time-management difference. It is a category-of-work difference. The AI handles the data; licensed physicians handle every clinical decision.

Reads your entire chart, every time

Clara auto-syncs from 150,000+ medical sources and reads every prior result, medication, and diagnosis together. A ferritin that was low eight months ago and never rechecked is part of the picture. Clara doesn't miss it.

Evaluates the differential, not just the obvious

Clara doesn't anchor on the first plausible cause. It reads fatigue against your full chart and surfaces what the full pattern points to, including combinations that a single-symptom visit is unlikely to catch.

Physician review on every clinical action

Clara drafts; physicians decide. Every lab order and prescription is reviewed and signed by a licensed clinician. The AI handles intake and reasoning. The physician handles sign-off.

An AI that reads your full chart. A physician who signs off on every clinical decision.

Get started Licensed medical providers review every lab order and prescription.
Common questions

Frequently Asked Questions

What does Clara cost?
Connecting your medical records and chatting with Clara is free. Paid plans start at $25/month, which includes physician-approved prescriptions and lab orders but does not include bundled biomarker tests or wearable integration. Standard ($50/mo) adds 74 biomarker tests and wearable integration. Concierge ($150/mo) includes 108 biomarker tests and expanded panels. All plans are HSA/FSA eligible and cash-pay. Medications and ad-hoc lab orders are billed by your pharmacy or lab and may be covered by your insurance.
Can I use my insurance, HSA, or FSA?
Clara's membership is cash-pay and not billed through insurance, but every plan is HSA/FSA eligible. Prescriptions Clara's physicians write go to your pharmacy and may be covered by your plan like any other script. Ad-hoc lab orders may also be covered by your insurance when applicable.
Is Clara a real medical practice?
Yes. Clara operates through affiliated professional corporations licensed in all 50 states. All diagnoses, prescriptions, and lab orders are reviewed and signed off by licensed physicians. Clara's AI handles intake, continuous monitoring, and clinical reasoning. The physician sign-off happens before any clinical action reaches you.
How is this different from my regular doctor?
A 15-minute annual visit can review your most recent results. Clara reads every lab you have had drawn, every medication you have been on, and every wearable data point in a single pass, and does it every time you interact. Your PCP remains the right choice for in-person exams, procedures, and anything Clara refers out. Clara fills the continuous monitoring gap between those visits.
What if I need in-person care?
Clara refers you to an in-person provider when a physical exam, imaging, or procedure is required. For fatigue, this might include a home sleep study for suspected sleep apnea, a specialist referral if the labs suggest something more complex, or an in-person visit for anything that requires examination. Clara prepares a clinical summary for every referral.
Is my data private?
Clara is HIPAA compliant. Your medical records and wearable data are used solely to personalize your care. They are not sold to third parties and are not used to train public AI models.
Will Clara diagnose me from my symptoms?
Clara does not diagnose from symptoms alone. It reads your symptom in the context of your full chart — your labs, medications, and wearable data — and surfaces patterns for physician review. A licensed physician reviews all findings before any clinical action is taken.
My doctor said my labs are normal. Could I still have a problem?
Possibly. "Normal" reference ranges are population averages, not necessarily optimal for every individual. Ferritin can be depleted at levels the lab flags as normal. B12 can be functionally insufficient at low-normal values. TSH can be in range while Free T3 is low. Clara reads the full picture — not just whether each value is above or below the reference line.

Your chart already has most of the context. Let Clara read it.

Free to connect your records and chat with Clara. Standard and Concierge plans include physician-reviewed lab orders and bundled biomarker panels that cover the most common causes of persistent fatigue.

Get started