Are you getting a full blood count? My fatigue last year was extreme. I had low energy for many years, but last year was bad. I was seeing a new doctor, who sent me for a full blood count. The results indicated something was not quite right, but before this could be followed up, I had a virus, which in turn became a chest infection, complicated by asthma, which necessitated a shirt stay in hospital, copious amounts of antibiotics, etc. When I eventually recovered, I was better and suspect I had a low lying infection before, which was sorted out by the antibiotics, but HRT has lifted me higher in the energy stakes. The trouble is you have to be persistent and assertive, when you haven't got the energy for this. The fatigue was blamed on the IBS before. I really appreciate the trouble and care that my current GP has taken.