Certain symptoms should ring warning bells, so get your pharmacist involved if a customer reports any of the following alongside tiredness:

• Significant and unintentional weight loss
• Signs that could indicate a neurological problem (e.g. loss of vision or coordination)
• Symptoms of malignancy (e.g. a lump, rectal or post-menopausal vaginal bleeding, difficulty swallowing or vomiting blood) or an infection (e.g. night sweats or a fever)
• Suspected carbon monoxide poisoning (symptoms would include headache, dizziness, nausea, breathlessness and a raised heart rate)
• Anything that indicates an undiagnosed chronic condition (e.g. breathing difficulties suggest COPD, while tiredness that is worse in the morning hints at depression)
• Persistent or recurrent fatigue (although not life-long), which might point towards chronic fatigue syndrome.

Tiredness can be a side effect of many medicines €“ from prescription drugs such as painkillers, sedatives and blood pressure medication to over-the-counter remedies for hayfever and herbal products. So always ask your pharmacist to step in if someone is complaining of fatigue and tells you that they are taking any medicines at all.