Does it make sense to have my hormones tested if I feel listless and fatigued?

Yes, targeted hormone testing makes sense for persistent listlessness. But the key word is targeted: the goal is to identify a specific cause, not simply to 'check everything'. Which test is useful depends on your symptoms, age and medical history.

The best first step is a thyroid test (TSH and free T4). An underactive thyroid is a well-known cause of fatigue and affects roughly 1 in 300 people, more commonly women and older adults. You cannot feel or see this yourself; only a blood test gives a definitive answer. This is the best-supported hormonal test for complaints of listlessness.

Another possible cause is that your adrenal glands produce too little cortisol. Fatigue occurs in 50 to 95 percent of people with that condition. However, it is rare, affecting fewer than 279 per million people, unless you have taken high doses of cortisone medication for a prolonged period. In that case, testing is certainly worthwhile.

If the pituitary gland produces too few hormones, that too can cause persistent fatigue. This affects 300 to 455 cases per million people. It is not a routine check, but consider it if, in addition to listlessness, you also experience low blood pressure, sensitivity to cold or fertility problems.

In athletes with persistent fatigue and a drop in performance, hormone measurement is being studied as a diagnostic tool, but no reliable standard test for overtraining syndrome yet exists. Hormone values alone are insufficient here. In dialysis patients, it turned out that standard hormone values could not explain the fatigue at all. This shows that hormone testing does not always provide the answer, especially when the cause lies elsewhere, for example in depression or a chronic illness.