I have severe fatigue that is lowering my quality of life. It started senior year of highschool but it wasn't debilitating yet. Then at 19 I started riding my bike every day. Around that time my face started to atrophy. Its like all the fat and soft looking skin started to melt away making me look older. I kept riding my bike because I didn't really have a choice. Then the fatigue started getting worse and worse. I lost my job and the job after that because I'm so tired its hard to even smile at people. I'm always cold, tired, starving hungry, my hair is thinning in the middle, my skin looks way older than people my age (I'm 22 and female) any idea what could be causing this debilitating fatigue? My thyroid is low but my tsh is also low which makes me think it could be a pituitary problem. But it could just be animia. Do doctors usually test for anemia automatically