Fatigue & Energy Optimization
Chronic fatigue isn't normal—it's your body's signal that key systems need support. By identifying and addressing root causes, we can restore your natural energy production.
Beyond 'Normal' Labs and Generic Advice
If you've been struggling with fatigue, you've probably heard 'your labs are normal' or 'try sleeping more and reducing stress.' You know it's not that simple. When you're exhausted despite adequate sleep, when brain fog clouds your thinking, when you don't feel like yourself—something is wrong, even if standard testing doesn't show it.
Fatigue is a symptom with many possible causes: thyroid dysfunction, cortisol imbalances, nutrient deficiencies, mitochondrial problems, hidden infections, gut issues, hormonal changes, and more. The key is identifying which factors are contributing to your fatigue specifically, not applying a one-size-fits-all solution.
I use comprehensive testing that goes beyond standard panels, interpret results using optimal ranges (not just disease-detection cutoffs), and investigate the systems most commonly involved in energy production. Then we address what we find with targeted, evidence-based treatment.
Conditions I Treat
Common Root Causes of Fatigue
Thyroid Dysfunction
Even 'normal' TSH can hide thyroid problems. Poor T4-to-T3 conversion, high reverse T3, or Hashimoto's autoimmunity all cause fatigue with normal standard labs.
Cortisol Dysregulation
Chronic stress disrupts cortisol patterns—too high, too low, or flat-lining. This causes morning fatigue, afternoon crashes, and 'wired but tired' at night.
Blood Sugar Instability
Insulin resistance causes energy crashes after meals and makes cells less efficient at producing ATP. Many fatigued patients have hidden metabolic dysfunction.
Nutrient Deficiencies
Iron, B12, vitamin D, and magnesium deficiencies are common and directly impair energy production. Optimal levels are different from 'normal' lab ranges.
Mitochondrial Dysfunction
Your mitochondria are your cellular power plants. When they're not functioning optimally due to oxidative stress, toxins, or nutrient deficiency, energy suffers.
Gut Issues
SIBO, dysbiosis, and leaky gut impair nutrient absorption, create inflammation, and drain energy. Many fatigue patients have underlying gut dysfunction.
Comprehensive Fatigue Evaluation
I investigate multiple systems to find what's actually causing your fatigue:
Thyroid Assessment
- • TSH, free T4, free T3
- • Reverse T3
- • Thyroid antibodies (TPO, TG)
- • T3 uptake
Adrenal & Stress
- • 4-point salivary cortisol
- • Cortisol awakening response
- • DHEA-S
- • HPA axis assessment
Metabolic & Nutrient
- • Fasting insulin & glucose
- • Iron panel (ferritin, TIBC)
- • B12, folate, homocysteine
- • Vitamin D, magnesium RBC
Other Systems
- • Complete blood count
- • Inflammatory markers
- • Organic acids (mitochondrial)
- • Gut testing if indicated
My Approach to Restoring Energy
I investigate multiple systems simultaneously—hormones, nutrients, mitochondria, gut health, and stress response—because fatigue rarely has a single cause. Most patients have several contributing factors that compound each other.
Treatment addresses all identified factors at once. This might include thyroid optimization, nutrient repletion, blood sugar stabilization, mitochondrial support, cortisol rhythm restoration, and gut healing—depending on what testing reveals.
I also look for 'quick wins'—issues that can be rapidly addressed for fast improvement—while working on deeper root causes. Many patients notice meaningful improvement within weeks once we correct significant deficiencies or imbalances.
What to Expect
Detailed History
We'll spend time understanding your fatigue pattern, when it started, what makes it better or worse, and everything you've already tried. Context matters.
Comprehensive Testing
Based on your history, we'll order targeted labs to evaluate thyroid, adrenals, nutrients, metabolic function, and any other relevant systems.
Multi-System Treatment
We'll address all identified issues—not just one. This typically includes targeted supplements, dietary changes, hormone optimization if needed, and lifestyle support.
Progressive Improvement
Many patients notice improvement within 4-8 weeks. We'll continue optimizing and addressing deeper issues until your energy is restored.
Frequently Asked Questions
Why am I tired all the time even though my labs are 'normal'?
Standard lab testing is designed to detect disease, not identify suboptimal function. Your thyroid could be struggling within 'normal' range. Your iron could be low-normal but not optimal. Your cortisol pattern could be off. Your mitochondria could be underperforming. I use different lab ranges—optimal ranges, not just disease-detection ranges—and test markers that conventional medicine often skips, like fasting insulin, reverse T3, and comprehensive nutrient panels.
What is adrenal fatigue and is it real?
The term 'adrenal fatigue' isn't recognized in conventional medicine, but the underlying concept—HPA axis dysfunction—absolutely is. Chronic stress doesn't exhaust your adrenal glands, but it does dysregulate the communication between your brain and adrenals, leading to abnormal cortisol patterns. This is measurable through salivary cortisol testing. Symptoms include fatigue (especially in the morning), difficulty handling stress, cravings for salt and sugar, and feeling 'wired but tired.' Treatment involves addressing the stressors and supporting the HPA axis.
Could my fatigue be from my thyroid?
Possibly. Thyroid dysfunction is one of the most common causes of fatigue, and it's frequently missed because conventional testing only checks TSH. I run complete thyroid panels including free T4, free T3, reverse T3, and thyroid antibodies. Even with 'normal' TSH, you could have poor T4-to-T3 conversion, high reverse T3 (which blocks thyroid function), or autoimmune thyroid disease. Many patients with fatigue have subclinical thyroid issues that respond well to treatment.
What's the connection between gut health and fatigue?
Your gut affects energy through multiple mechanisms: nutrient absorption (you can't make energy without B vitamins, iron, and other nutrients), inflammation (gut inflammation causes systemic inflammation that drains energy), and the gut-brain connection (gut dysfunction affects neurotransmitters and stress hormones). SIBO, in particular, is a common hidden cause of fatigue because bacteria in the small intestine steal nutrients and produce toxins that impair energy production.
How long does it take to get my energy back?
It depends on the underlying cause and how long you've been fatigued. Some patients notice improvement within weeks once we address a clear deficiency or imbalance. Others with complex or longstanding issues may take 3-6 months to feel significantly better. I always look for 'low-hanging fruit'—issues that can be quickly addressed for rapid improvement—while also working on deeper root causes. I'll give you a realistic timeline based on your specific situation.
What supplements do you recommend for energy?
I don't recommend supplements without testing first. Random energy supplements often don't work because they're not addressing your specific issue. That said, common nutrients I assess and potentially recommend include B vitamins (especially B12 and folate), iron, vitamin D, magnesium, CoQ10, and adaptogenic herbs. The key is identifying what you're actually deficient in and addressing that specifically, rather than throwing everything at the wall.
Tired of Being Tired?
Get comprehensive testing that actually finds the cause—not just another 'your labs are normal.'
Schedule Free CallSigns to Investigate
- Tired despite sleeping 7-8+ hours
- Need caffeine to function
- Afternoon energy crashes
- Brain fog or difficulty concentrating
- Exercise makes you more tired
- "Wired but tired" at bedtime
Get Your Energy Back
Chronic fatigue isn't something you have to accept. With the right testing and treatment, most patients can significantly improve their energy and feel like themselves again.
Schedule Your Free Discovery Call