Conditions · Telehealth

Functional medicine for chronic fatigue

You sleep, but you wake up tired. Coffee gets you to noon; willpower gets you to dinner. Your labs are "fine," your checkup was "normal," and yet you know something is wrong. Fatigue is a signal — the work is finding what's sending it.

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Sound familiar?

  • Waking unrefreshed no matter how long you sleep
  • Afternoon crashes that steal your day
  • Exercise leaving you wiped out for days
  • Brain fog — words, names, and focus slipping
  • Wired-but-tired evenings and 3 a.m. wake-ups
  • Needing caffeine to function like a normal person

Why it so often gets missed

Fatigue is one of the most common complaints in medicine and one of the least investigated. A standard workup checks a blood count and a TSH; if both look acceptable, many patients are told they're fine — or offered an antidepressant — and the search ends there.

But persistent fatigue usually has layered contributors: subtle thyroid dysfunction, disrupted cortisol rhythm, iron or B12 insufficiency, blood sugar swings, unrecognized sleep disorders like apnea, and mitochondrial strain. Each is findable. None of them shows up if nobody looks.

How Heal approaches it

A systematic fatigue investigation

We work through the drivers in order — thyroid in full, cortisol rhythm across the day, iron and nutrient status, blood sugar stability, sleep quality and apnea risk — instead of stopping at the first "normal."

Energy at the cellular level

Your energy is produced in mitochondria, which depend on specific nutrients and are sensitive to inflammation and stress load. We evaluate and support the machinery itself, not just the symptoms around it.

Rebuilding, step by step

A personalized protocol sequenced so wins compound: sleep and rhythm first, then fuel and nutrients, then graded activity — reviewed and adjusted with your physician in follow-up visits.

Testing we may use

  • Full thyroid panel (not just TSH)
  • Cortisol rhythm across the day
  • Ferritin, iron studies, B12, folate, vitamin D, magnesium
  • Fasting insulin, glucose, HbA1c
  • Inflammatory markers; sleep apnea screening where indicated

Testing is personalized — your physician recommends only what your history and symptoms call for. Lab fees are billed separately by the lab.

From the journal

Common questions

Every test I've had comes back normal. What could you possibly find?
Standard fatigue workups are narrow — typically a blood count and TSH. A functional evaluation adds the full thyroid picture, cortisol rhythm, ferritin and nutrient status, blood sugar dynamics, and sleep quality. It's common to find several modest contributors that add up to significant fatigue.
Is this chronic fatigue syndrome (ME/CFS)?
Not necessarily — persistent fatigue has many causes, and ME/CFS is a specific diagnosis with its own criteria. Either way, the evaluation is similar: identify every contributing system, treat what's treatable, and pace the plan to your capacity.
How long until I feel better?
It depends on what we find — no honest physician can promise a timeline. What we can promise is a systematic search, a clear plan, and adjustments at every follow-up based on how you actually respond.

Start with a conversation.

A free 15-minute call to share what's going on and see if Heal is the right fit — no commitment, entirely by telehealth.

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