Anemia, blood sugar, adrenals, neurological??? Any number of metabolic conditions can lead to fatigue.
Is the anemia related to iron, B12, Folic acid? Is the blood sugar high or low? Are the adrenals overproducing cortisol or underproducing? If the adrenals are low, is it due to chronic stress causing a feedback problem turning off the pituitary control of those glands? Is the thyroid low? Is it an autoimmune condition called Hashimoto’s?
If there are brain based issues related to inflammation, what is causing that?
These are questions that need to be answered if you want to address the CAUSE of your fatigue.