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Sometimes comprehensive blood work comes back essentially normal. That's useful information - it rules out major physical causes - but it's not the end of the investigation.

If bloods are normal, we then focus on: sleep architecture (do you need a sleep study?), chronic pain or hidden inflammation, mental health (depression and anxiety often masquerade as fatigue), medication side effects, overtraining or under-recovery from exercise, and whether a referral to a chronic fatigue specialist is appropriate. The absence of obvious pathology doesn't mean there's nothing to address.