Hello. It s sometimes difficult to decipher the needs of our children. On the one hand, we hesitate to race to the doctor with every new complaint; on the other, we re fearful of ignoring anything that might signify a serious medical problem. In your daughter s case, her fatigue, pallor and complaints of being cold could be signs and symptoms of anemia, which isn t unusual in young people. Young women who are menstruating are particularly susceptible to anemia, because their diets often don t furnish enough iron to replace that lost during their periods. (Even if your daughter isn t menstruating yet, she could still be at risk for anemia by virtue of rapid growth and low iron stores.) This is one of those issues that warrants further investigation. It s an easy matter to rule out anemia (a simple blood test is all it takes). If your daughter isn t anemic, her doctor can decide if a more thorough workup is needed. I hope things go well!