Thirty-four yr old female. always tired/extreme fatigue. labs are good. help!!! what can be the cause?

Medications: I see that you take oral antihistamines such as Benadryl. This can have the side effect of drowsiness. If you are still experiencing fatigue after discontinuing the med, then I would think about your lifestyle and optimize it. Things like stress, lack of exercise, poor diet, and poor relationships can cause you to feel fatigued. I see you have pain, this can also cause fatigue.