Fatigue may manifest in a number of ways. It may be:
• general feeling of tiredness
• physical fatigue (lack of physical energy, weak or heavy limbs, difficulty engaging in physical activities)
• mental fatigue (fogginess, and lack of clarity of thought)
• low motivation to participate in activities
• inability to perform at ones expected level
 
Following a typical medical work up including a detailed history with an appropriate physical exam and standard blood work and imaging as indicated, we will look at a variety of factors that have been implicated in the origin of fatigue . This includes, but is not limited to the investigation of:
• insomnia and sleep quality
• thyroid function
• nutrient depletion – iron, B12, and more
• mental health challenges – stress, anxiety, depression
• diet and food sensitivities
• physical activity, and other lifestyle routines
 
More in-depth investigation may sometimes be necessary. In instances of un-resolving fatigue or fatigue that is bordering on exhaustion, we are likely to investigate:
• Lyme disease and common co-infections
• Chronic viral infections (EBV, CMV, HHV, etc.)
• Environmental factors (toxicity, medications, etc.)
• Chronic fatigue syndrome
• Fibromyalgia
• Metabolic and mitochondrial health
• and more…
 
Treatment plans are based upon a thorough assessment and the exact strategy is determined in consultation with each patient. Different options may be presented to provide choice as to the exact nature of the undertaken program.
 
• We will aim to have markers of progress to follow, including self-reported symptom levels, fatigue questionnaires and measurable biomarkers to quantify your progress.
• The recommended therapies will depend on our assessment and our discussion as to the most appropriate strategy for you, but may include any of the following:
– Sleep support recommendations
– Diet and nutrient recommendations
– Appropriate adrenal support recommendations
– Hormone supporting recommendations
– Intravenous therapies, as appropriate