What Can You Do for Chronic Fatigue?
Last Updated: October 2025
TL;DR
Chronic fatigue is rarely caused by one single issue. Functional medicine looks for the root causes—such as inflammation, nutrient depletion, hormonal imbalance, poor sleep quality, viral reactivation, blood sugar swings, mitochondrial dysfunction, or chronic stress. At Insight Functional Health in Silver Spring, MD, Dr. Anna Sattah, MD, IFMCP, uses a systematic, critical-care-informed approach to uncover why your energy is depleted and build a tailored plan to restore stamina, clarity, and daily function.
Key Points
- Chronic fatigue often has multiple contributing factors, not just sleep or stress.
- Functional medicine identifies underlying drivers using targeted, evidence-based testing.
- Common root causes: thyroid changes, nutrient deficiencies, chronic infections, metabolic dysfunction, inflammation, cortisol imbalance, gut issues.
- Treatment focuses on personalized nutrition, sleep repair, stress physiology, movement strategy, and mitochondrial support.
- Dr. Sattah emphasizes essential testing only, avoiding unnecessary expenses.
- Most patients notice early improvements within 4-8 weeks, with deeper progress over 3-6 months.
What This Means in Plain English
If you're exhausted no matter how much you rest, you're not alone, and it’s not “just in your head.” Chronic fatigue is usually a sign that something deeper is disrupting your energy systems. Functional medicine works by understanding how your hormones, gut, immune system, sleep patterns, brain function, and metabolism interact.
Instead of chasing symptoms, we map out what’s draining your energy and what’s blocking your body from recovering. This approach is especially helpful for people who feel dismissed by previous doctors or have been told, “Your labs are normal.”
What Functional Medicine Can Do for Chronic Fatigue
We investigate and address the most common contributors to long-term fatigue:
1. Thyroid and Hormone Imbalances
Even mild shifts in thyroid function, cortisol rhythm, or sex hormones can dramatically affect energy, sleep, and brain clarity.
2. Nutrient Deficiencies
Low iron/ferritin, B12, folate, magnesium, or vitamin D often go undetected and can lead to fatigue, mood changes, and cognitive slowing.
3. Metabolic Issues
Blood sugar instability, insulin resistance, and mitochondrial dysfunction can drain energy throughout the day.
4. Gut and Immune Dysfunction
IBS, dysbiosis, food sensitivities, and chronic inflammation can all contribute to fatigue.
5. Chronic Infections or Reactivations
EBV, Lyme, long COVID, and other viral or inflammatory patterns can trigger long-lasting fatigue.
6. Sleep Disturbances
Sleep apnea, circadian disruption, and poor sleep architecture often require deeper evaluation—not just “sleep hygiene.”
7. Stress Physiology & Burnout
Chronic stress alters cortisol rhythms and autonomic balance, affecting energy and cognition.
What the Process Looks Like at Insight Functional Health
With Dr. Sattah, the evaluation and care plan typically include:
- Comprehensive history: A detailed review of symptoms, triggers, medical history, stress, sleep, and daily patterns.
- Evidence-based testing: Thyroid panel, iron/ferritin, B12/folate, vitamin D, inflammatory markers, metabolic labs, sleep assessment, and advanced functional lab testing when clinically indicated.
- Personalized plan:
- Nutrition for stable energy and reduced inflammation.
- Mitochondrial support when appropriate.
- Sleep optimization and circadian alignment.
- Stress-regulation tools that fit real life.
- Gentle, progressive movement.
- Follow-up and refinement: Adjustments every 4-8 weeks as symptoms shift and labs improve.
Dr. Sattah’s background in critical care shapes a structured approach: precise, thoughtful, data-aware, and always centered on the patient’s goals.
Who Benefits Most
Functional medicine is especially helpful if you:
- Feel exhausted despite normal basic labs.
- Experience brain fog, unrefreshing sleep, or unpredictable crashes.
- Have fatigue connected to long COVID, autoimmune conditions, thyroid issues, or chronic stress.
- Have been told "everything looks normal" but still don’t feel like yourself.
- Want a collaborative, investigative model rather than quick symptom management.
When to Seek Urgent Care
Seek immediate medical attention if you experience:
- Chest pain, severe shortness of breath, or fainting.
- Rapid heart rate with dizziness.
- Sudden weakness, vision changes, or confusion.
- Severe abdominal pain or persistent vomiting.
Chronic fatigue needs thoughtful evaluation, but emergency symptoms should always be treated urgently.
Sources
- Institute for Functional Medicine — https://info.ifm.org/
- National Center for Complementary and Integrative Health (NIH) — https://www.nccih.nih.gov/
- Centers for Disease Control and Prevention (Chronic Disease) — https://www.cdc.gov/chronic-disease/about/index.html
- JAMA Network Open (Functional Medicine Outcomes) — https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520
- PubMed (Fatigue, mitochondrial dysfunction, chronic inflammation) — https://pubmed.ncbi.nlm.nih.gov
Medically reviewed by Dr. Anna Sattah, MD, IFMCP
Insight Functional Health — serving patients in Silver Spring, MD
Ready to restore your energy? Book your visit here.
Learn more about our Functional Medicine approach or explore Cognitive Decline support.
About Dr. Sattah
This content is for educational purposes only and does not substitute personalized medical advice.