Certain symptoms should ring warning bells, so get the 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, vomiting blood)
• Symptoms of an infection (e.g. night sweats, a fever)
• Suspected carbon monoxide poisoning (e.g. headache, dizziness, nausea, breathlessness, raised heart rate)
• Anything that indicates an undiagnosed chronic condition (e.g. depression, breathing difficulties that could suggest COPD)
• Persistent or recurrent tiredness – although not life-long – which might point towards chronic fatigue syndrome.

Tiredness or drowsiness can be a side effect of many medicines, from prescription drugs such as painkillers, sedatives and blood pressure medication, to over-the-counter (OTC) remedies for hayfever and herbal products. Always ask the pharmacist to step in if someone is complaining of tiredness and says they are taking any form of medicine(s).