Script for video:  Chronic Fatigue  - Exhausted, Foggy, and Frustrated? This Is a Deep Dive Into the Solution

 

🧍‍♂️ Section 1: Patient Introduction (3–4 min)

🎬 [Scene: Patient seated in a functional medicine clinic, speaking directly to camera]

“I’m 42. I’ve had persistent fatigue for years. I wake up tired, crash in the afternoon, and feel foggy most of the day. My primary care doctor ran a CBC, thyroid panel, and metabolic screen. Everything came back ‘normal.’ I was told to sleep more, reduce stress, and maybe try an antidepressant. But I know something deeper is off. I want answers—not just symptom relief.”

📚 Section 2: Terminology Made Simple (3–5 min)

🎙️ “Before we dive into testing and protocols, let’s define a few key terms you’ll hear throughout this video.”

• Mitochondria: Tiny structures inside your cells that produce energy (ATP). Think of them as your body’s battery packs.

• HPA Axis: The communication loop between your brain and adrenal glands that regulates stress hormones like cortisol.

• Dysbiosis: An imbalance in your gut bacteria that can lead to inflammation, poor digestion, and fatigue.

• Leaky Gut: A condition where the lining of your intestines becomes permeable, allowing toxins and undigested food to enter the bloodstream.

• Organic Acids Test (OAT): A urine test that shows how well your body is producing energy, detoxifying, and metabolizing nutrients.

• Beta-Glucuronidase: An enzyme produced by gut bacteria that, when elevated, can interfere with hormone detox and contribute to fatigue.

• CD57: A marker of immune function often used to assess chronic Lyme or immune suppression.

• Glutathione: Your body’s master antioxidant and detox molecule. Low levels impair your ability to recover from stress and toxins.

🎙️ “Now that we’ve got the language down, let’s look at what functional medicine actually tests for—and why conventional medicine often misses it.”

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🔬 Section 3: Core Dysfunctions in Chronic Fatigue

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🔋 Dysfunction 1: Mitochondrial Dysfunction

Why it matters: Mitochondria produce ATP, your body’s energy currency. If they’re underpowered, fatigue becomes systemic.

Tests:

• Organic Acids Test (OAT): Krebs cycle intermediates, carnitine, CoQ10

• Lactate/Pyruvate ratios

• Serum CoQ10 and carnitine levels

Symptoms:

• Fatigue after minimal exertion

• Muscle weakness

• Brain fog

• Poor recovery from exercise

Protocols:

• CoQ10, PQQ, NAD+, magnesium

• Red light therapy

• Mitochondrial support diet: polyphenols, omega-3s, sulfur-rich vegetables

What conventional medicine misses: Standard labs don’t assess mitochondrial function unless rare genetic disease is suspected. Subclinical dysfunction is ignored.

Extra explanation: The Krebs cycle is the metabolic pathway inside mitochondria that generates ATP. Elevated intermediates suggest a bottleneck in energy production. OAT reveals this long before conventional labs do.

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NOTES:

-  The Krebs cycle is the part of the chemical reaction inside mitochondria that generates ATP. Intermediates are temporary chemical products formed and consumed during a chemical reaction, and if they are elevated, it suggests a bottleneck in energy production. OAT reveals this long before conventional labs do.

- Carnitine, Lactate, Pyruvate, and CoQ10 are an important chemicals used in the energy production process

- PQQ supports mitochondrial growth and function.

-NAD+ therapy helps with metabolism

-Magnesium is needed for ATP production and function

-Red Light Therapy supercharges your mitochondria by penetrating skin and stimulating enzymes inside the mitochondria

-Good diets to restore mitochondria are keto and mediterranean

- Polyphenols promote the growth of good bacteria in the gut.

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🧠 Dysfunction 2: HPA Axis Dysregulation

HPA Axis: The communications loop between your Hypothalamus, Pituitary gland, and Adrenal glands. It is your body’s stress management system. During stress, the stress hormone cortisol is released to help you face challenges, for example, heart rate and blood pressure goes up, alertness and focus increase, pain and fatigue go down, urgency and anxiety increase. 

 

Why it matters: The HPA axis regulates your stress response. Chronic stress flattens cortisol rhythms, impairing energy, sleep, and immune resilience.

Tests:

• DUTCH test: Cortisol curve, DHEA, melatonin

• 4-point salivary cortisol

• HRV tracking

Symptoms:

• “Wired but tired”

• Afternoon crashes

• Poor sleep

• Anxiety and emotional volatility

Protocols:

• Adaptogens (ashwagandha, rhodiola)

• Phosphatidylserine

• Breathwork, vagal toning, circadian retraining

What conventional medicine misses: Cortisol is usually tested once in the morning. This misses the full rhythm. DHEA and melatonin are rarely evaluated.

Extra explanation: A flat cortisol curve means your body isn’t producing enough cortisol in the morning to energize you, nor enough melatonin at night to help you sleep. It’s a circadian collapse.

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NOTES:

- the cortisol curve should be higher in the morning which means you have higher energy and lower at night which means your energy is going down. If it’s flat that means cortisol is low all day or high all day.

-Vagal Toning refers to improving the function of the vagus nerve which is the longest cranial nerve in the body. This nerve is a central part of the parasympathetic nervous system which is responsible for “rest and digest” functions. This is important in recovering from stress and maintaining emotional balance.

-4-point salivary cortisol is where using saliva, your cortisol is measured at 4 times during the day and night

-HRV Tracking is measuring the slight fluctuation of time between your heartbeats

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🦠 Dysfunction 3: Gut Dysbiosis and Leaky Gut

Dysbiosis:  An imbalance in your gut bacteria that can lead to inflammation, poor digestion, and fatigue.

Leaky Gut:  Also called increased intestinal permeability, it’s a condition where the intestinal lining becomes damaged allowing harmful substances to enter the bloodstream.

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Why it matters: The gut regulates nutrient absorption, immunity, and neurotransmitter production. Dysbiosis and leaky gut impair all three.

Tests:

• Stool analysis: microbiome diversity, beta-glucuronidase, SCFAs

• Zonulin and secretory IgA

• Calprotectin

Symptoms:

• Bloating, constipation, diarrhea

• Brain fog after meals

• Food sensitivities

• Skin issues

Protocols:

• Probiotics, prebiotics, polyphenols

• Gut lining repair: glutamine, zinc carnosine, collagen

• Elimination diet and reintroduction

What conventional medicine misses: Microbiome diversity and permeability are rarely evaluated unless there’s overt IBD or celiac disease.

Extra explanation: Beta-glucuronidase is an enzyme produced by certain gut bacteria. Elevated levels can interfere with hormone detox and contribute to estrogen dominance and fatigue.

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NOTES:

- beta-glucuronidase: An enzyme produced by gut bacteria that, when elevated, can interfere with hormone detox and contribute to fatigue.

- SCFA’s:  Short chain fatty acids are produced by gut bacteria and help maintain the integrity of the barrier

- Zonulin: Protein regulating the permeability of the intestinal barrier

- Secretory IGA:  Antibody defending against pathogens and toxins that are trying to enter the bloodstream

- Calprotectin:  Protein indicating the level of intestinal inflammation

- Polyphenols:  Promotes the growth of good bacteria in the gut.

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🧬 Dysfunction 4: Nutrient Deficiencies

Why it matters: Nutrients like magnesium, B vitamins, iron, and amino acids are essential for energy production and detox.

Tests:

• Serum and RBC magnesium

• B12, folate, iron panel

• Plasma amino acids

• Vitamin D, zinc, omega-3 index

Symptoms:

• Fatigue with exertion

• Poor concentration

• Muscle cramps

• Hair thinning

Protocols:

• Targeted repletion: magnesium glycinate, methylated B vitamins, iron bisglycinate

• Nutrient-dense diet

• IV nutrient therapy (if needed)

What conventional medicine misses: Subclinical deficiencies are rarely tested unless there’s anemia or neuropathy.

Extra explanation: RBC magnesium reflects intracellular levels—where magnesium actually works in energy production. Serum magnesium can appear

normal even when tissue levels are depleted.

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NOTES:

-  If it’s not Mitochondrial or HPA Axis or dysbiosis or leaky gut problems causing your fatigue, maybe it’s this fourth dysfunction:  nutrient deficiency

- Serum vs RBC Magnesium: Serum magnesium is the amount of magnesium in the blood whereas RBC magnesium is the amount of magnesium inside red blood cells.  RBC Magnesium is where most magnesium is, so it’s a better measure of magnesium. Magnesium plays a key role in cellular respiration.

- Iron panel is a series of tests to determine how well your body stores and uses iron

- The terms glycinate, methylated, and Bisglycinate means it has higher bioavailability than other iron supplements

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🧫 Dysfunction 5: Toxic Burden

Why it matters: Heavy metals, mold, and environmental toxins impair mitochondria and immune function.

Tests: Urine provocation for metals, *mycotoxin panels, *glutathione levels

Symptoms:  Fatigue, headaches, *chemical sensitivity, brain fog

Protocols: *Binder rotation, *sauna therapy, glutathione support, air/water filtration

What conventional medicine misses: Rarely tests or treats environmental toxicity

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NOTES:

-Urine provocation for metals is a test involving a chemical that moves metals from tissues to urine.

-Mycotoxins are toxic compounds produced by mold.

-Glutathione is your master antioxidant and detox molecule.  Antioxidants protect against cell damage. Low levels of Glutathione impair your ability to neutralize toxins.

-   Chemical sensitivity is when the body starts reacting adversely to low levels of chemicals that are typically tolerated by others.

-A binder is a substance that grabs toxins in the gut and helps elimination through stool.  Binder rotation is alternating different types of binders like activated charcoal, chlorella, and many more.

-A hot sauna can support the release of certain toxins through sweat, circulation, and lymphatic flow.  The lymphatic system is your body’s silent draining network in which waste and toxins and removed.

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🧪 Dysfunction 6: Immune & Infection Problems

Why it matters: Latent infections like EBV (Epstein Barr), CMV (Cytomegalovirus), or Lyme can drain energy and trigger immune exhaustion

Tests:

EBV IgG/IgM (Epstein Barr antibodies), HHV-6 (Herpes), CMV

Lyme and co-infection panels

Immunoglobulin levels (antibodies)

CD57 count (shows immune system activation or immune system stress)

Symptoms: Flu-like symptoms, swollen lymph nodes, post-viral fatigue, temperature dysregulation

Protocols:  Antiviral or antimicrobial support, immune modulation with mushrooms, vitamin D, and zinc, and mitochondrial repair and detox.

What conventional medicine misses: Reactivated viruses and stealth infections are often dismissed as “past exposure.”

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🌙 Dysfunction 7: Sleep and Circadian Rhythm Disruption

Why it matters: Sleep is when your body repairs mitochondria, balances hormones, and clears brain waste through the glymphatic system. Without deep, restorative sleep, fatigue compounds and recovery stalls.

Tests:

• Melatonin levels (salivary or urinary)

• Cortisol rhythm (via DUTCH or 4-point salivary test)

• HRV (Heart Rate Variability) tracking for autonomic balance

• Sleep tracking via wearables or validated questionnaires

Symptoms:

• Non-restorative sleep despite adequate hours

• Difficulty falling asleep or waking frequently

• Daytime fatigue and poor focus

• Mood swings, irritability, or emotional flatness

Protocols:

• Sleep hygiene: consistent bedtime, dark room, no screens before bed

• Nutraceuticals: melatonin, magnesium threonate, glycine, L-theanine

• Circadian retraining: morning light exposure, meal timing, breathwork

• Vagal toning: humming, cold exposure, resonance breathing before bed

What conventional medicine typically misses: Unless sleep apnea is suspected, sleep quality is rarely evaluated. Most providers don’t assess melatonin production, cortisol rhythm, or autonomic nervous system tone. Sleep is often reduced to a binary: “Are you sleeping or not?”—ignoring architecture, depth, and timing.

Extra explanation: The glymphatic system is a waste clearance pathway in the brain that activates during deep sleep. It flushes out metabolic debris like beta-amyloid. If sleep is fragmented or shallow, this system doesn’t function properly—leading to cognitive fatigue and neuroinflammation.

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NOTES:

-If it’s not Mitochondrial or HPA Axis or dysbiosis or leaky gut or nutrient deficiency or detox overload or infection and immune problems causing your fatigue, maybe it’s this final dysfunction:  sleep & Circadian rhythm disorder

-Circadian rhythms are 24 hour cyclical processes like the sleep-wake cycle

-The glymphatic system are vessels in the central nervous system where waste is sent through

-Cortisol is a stress hormone and are highest around 8 am and is needed for energy. As the day progresses, it should get lower and be at the lowest during sleep

-Autonomic balance refers to how balanced is your nervous system.  A low score signals chronic stress or fatigue

-Nutraceuticals are supplements that comes from the words nutrient and pharmaceutical. 

-Cold exposure triggers feel good hormones like endorphins.  It can also lower cortisol which is the stress hormone.

-Vagal toning refers to improving the function of the vagus nerve which plays a crucial role in regulating bodily functions and emotional well-being

Sleep apnea is a sleep-related breathing disorder

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Dysfunction 8: Methylation Imbalance

Methylation is a chemical reaction that happens billions of times per second in every cell

Methylation modifies target DNA, RNA, proteins, neurotransmitters, hormones and toxins. Methylation is accomplished by chemically tagging the target with another chemical called a methyl group.

For DNA and RNA, methylation will turn on or turn off whether certain genes gets translated into a protein. This is called gene expression.

For proteins, methylation will turn them on or off, guide them to the right location, and influence how they interact with other molecules.

For neurotransmitters, methylation will help the body break them down and keep their levels balanced.

For hormones, methylation will help the body break them down and clear them out once they’ve done their job.

For toxins, methylation will help the liver neutralize and prepare them for elimination via urine, bile, or stool.

Methylation can run too slow or too fast: 

If it’s too slow, it’s called undermethylation and can cause anxiety, poor detox, fatigue inflammation, cardiovascular risk, cognitive & mood issues, fertility & pregnancy risks.

If it’s too fast, it’s called overmethylation and can cause irritability, poor digestion, fatigue, brain fog, blunted immune response, and sensitivity to supplements.

Why it matters: Both undermethylation and overmethylation can cause chronic fatigue.

Tests:  *Homocysteine, *SAMe/SAH ratio, *MTHFR gene variants

Symptoms:  Flu-like symptoms, swollen lymph nodes, post-viral fatigue, temperature dysregulation, fatigue

Protocols:  B12 (*methyl or hydroxy), methylfolate, *betaine, lifestyle modulation

What conventional medicine misses: Genetic variants often ignored

 

NOTES:

-Homocysteine and SAMe are both a part of the methylation cycle and their levels show how well methylation is occurring the body. 

-MTHFR is a gene that produces an enzyme involved in the final step of converting dietary folate into its active form, methylfolate. This active form is essential for methylation, detoxification, and neurotransmitter balance. The MTHFR gene variant test checks for changes in the MTHFR gene that may affect how efficiently methylation occurs.

-Methyl and Hydroxy B12 are 2 forms of B12

Betaine supports efficient methylation.

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Dysfunction 9: *Low-Grade Inflammation

Why it matters: Chronic inflammation hijacks energy and impairs recovery by rerouting your body’s                        resources toward a perpetual state of defense. This demands a lot of energy from the body                         leaving you in chronic fatigue.

Tests:  *hs-CRP, *IL-6, *TNF-alpha, *fibrinogen.

Symptoms:  Fatigue, joint pain, brain fog, weight gain.

Protocols:  *Anti-inflammatory diet, *omega-3s, *curcumin, *sleep optimization.

What conventional medicine misses: Inflammation is often overlooked as a cause of chronic fatigue

 

NOTES:

-  low-grade inflammation is a chronic, subtle activation of the immune system, without the heat, redness, and swelling of acute inflammation

-hs-CRP is high sensitivity C-reactive protein.  It is a blood marker used to detect low-grade inflammation

-IL-6 is Interleukin-6 which is a tiny signal or chemical alarm your body sends out when it’s stressed or fighting something. It tells your body to stay in alert mode.

-TNF-alpha is a chemical your body uses to trigger inflammation

-Fibrinogen is another marker of inflammation

-Anti-inflammatory diet means eliminating foods containing refined sugar, processed foods, processed grains, dairy, artificial sweeteners & preservatives, food dyes, and synthetic chemicals. The Mediterranean diet is a good diet.

-Omega-3 and curcumin both help reduce inflammation.

-   When sleep is deep, consistent, and aligned with circadian rhythms, it helps the body shift from defense mode to repair mode

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Dysfunction 10: Neurotransmitter Imbalance

Why it matters: Dopamine, serotonin, and GABA regulate mood and motivation

Tests:  Urinary neurotransmitter panels, *amino acid precursors

Symptoms:  Apathy, anxiety, poor focus, fatigue

Protocols:  Tyrosine, tryptophan, GABA, *adaptogens, gut healing

What conventional medicine misses: Neurotransmitter issues seen as a mental health problem instead of as biochemical.

 

NOTES:

-Amino acid precursors are the raw ingredients that go into making neurotransmitters

-Adaptogens help the body adapt to stress

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Dysfunction 11: Neuroinflammation

Why it matters: Inflammation in the brain disrupts cognition, mood, and energy regulation. It’s often triggered by infections, toxins, or immune mis-signaling.

Tests:

*Cytokine panels, *CRP, *homocysteine

*Neurotransmitter metabolites and *organic acids

Symptoms:

Brain fog, poor memory, mood swings

Fatigue that worsens with mental effort

Protocols: 

*Omega-3s, *curcumin, *magnesium threonate ç Calms neuroinflammation

*Breath Pacing, red light therapy, and vagal activation

Gut repair and immune modulation

What conventional medicine misses: Sees cognitive fatigue as psychological, not as an inflammatory signal

 

NOTES:

-Cytokines are signaling proteins that regulate inflammation and other processes in the body. Elevated cytokines in the blood suggest that the immune system is in an activated or inflamed state—either fighting, repairing, or misfiring.

-CRP is C-reactive protein which is a marker of systemic inflammation produced in the liver in response to immune activation.

-Homocysteine is another inflammatory signal.

-Instead of testing neurotransmitters themselves, we can test for their chemical byproducts formed when neurotransmitters are broken down. Neurotransmitters themselves are hard to test because they are confined to the central nervous system and are not freely in the blood.  The metabolites are more stable and measurable in blood or urine.

-Breath pacing is a type of breathwork which focuses on controlled, rhythmic breathing. It helps the body out of a chronic stress state.

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Dysfunction 12: *Autonomic Nervous System Imbalance

Why it matters: *Dysregulated sympathetic/parasympathetic tone affects energy and digestion

Tests:  *HRV, *tilt-table test, pupillary response ç Give clues about autonomic nervous system

Symptoms:  Fatigue, dizziness, poor digestion, anxiety

Protocols: Vagal toning, breathwork, *cold exposure, biofeedback

What conventional medicine misses: Often misdiagnosed as anxiety

NOTES:

-The autonomic nervous system runs background operations of the body like heart rate, breathing, digestion, blood pressure, and temperature control.

-Sympathetic activates fight or flight functions in the body and parasympathetic activates rest and digest functions in the body

-HRV is heart rate variability test.

-Tilt-table test measures how your heart rate and blood pressure react when your move from lying down to upright.

-Cold exposure activates the fight-or-flight response followed by the rest and digest response. This is like hitting the reset button for the nervous system.

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NOTES:

-The autonomic nervous system runs background operations of the body like heart rate, breathing, digestion, blood pressure, and temperature control.

-Sympathetic activates fight or flight functions in the body and parasympathetic activates rest and digest functions in the body

-HRV is heart rate variability test.

-Tilt-table test measures how your heart rate and blood pressure react when your move from lying down to upright.

Cold exposure activates the fight-or-flight response followed by the rest and digest response. This is like hitting the reset button for the nervous system.

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Dysfunction 13: Oral Infection

Why it matters: Chronic oral infections release inflammatory cytokines, endotoxins, and stealth   pathogens directly into circulation. The pathogens can trigger *immune confusion,   mitochondrial dysfunction, and neuroinflammation.  These can cause chronic fatigue.

Tests:  *Oral microbiome mapping (OralDNA, Bristle), *Cone Beam CT Scan, *Lymphocyte Response   Panels, *Organic Acid Tests, *CRP, *IL-6, *TNF-alpha

Symptoms:  Fatigue, brain fog, memory lapses, mood swings, post-exertional malaise, jaw tension,   facial pain, unexplained headaches, metallic taste, bleeding gums, bad breath

Protocols: *Biological dental consult, extraction of infected root canal or cavitations, *ozone therapy or   *laser disinfection

What conventional medicine misses: Oral terrain is overlooked

NOTES:

-Immune confusion is where the immune system loses its ability to clearly distinguish between friend and enemy leading to misfires

-Oral microbiome mapping is the process of mapping the bacteria living in the mouth

-A cone Beam CT scan can help detect potential inflammation sources in the mouth like cavitations, root canals, and hidden infections.

-Lymphocytes are white blood cells that detect and remember threats.

-IL-6 stands for Interleuken-6 and triggers the immune system when an infection is present.

-TNF-alpha alerts immune cells to infection

-Biological dental consult is specialized dental evaluation done by a dentist who practices holistic dentistry. They do in-depth scanning and tests for infections.

-Ozone is a supercharged form of oxygen that destroys bacteria, viruses, and fungi that may be thriving in gum pockets, root canals, and cavitations.

-Lasers can penetrate deep into tissues where bacteria hide.

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5 Archetypical Profiles of Chronic Fatigue

1. The Wired Sleeper

Description:

HPA axis dysregulation + cortisol collapse.

Stuck in a loop of core exhaustion and insomnia.

Feels “tired and wired” – unable to rest and constantly fatigued

Traits:

Difficulty falling asleep despite exhaustion

Morning fatigue, afternoon crashes, nighttime alertness

Often misdiagnosed as anxiety or depression

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2. The Foggy Thinker

Description:

Mitochondrial collapse + *neuroinflammation

Struggles with memory, focus, and motivation.

Feels like their brain is wrapped in cotton

Traits:

Brain fog, poor recall, slow processing

Fatigue worsens with exertion or stress

Often dismissed as “burnout” or “getting older”

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3. The Gut-Derailed Reactor

Description:

Dysbiosis + malabsorption.

Experiences bloating, food sensitivities, and post-meal crashes.

Feels like their gut is sabotaging their energy.

Traits:

Fatigue after meals or infections

Brain fog, mood swings, and digestive discomfort

Often misdiagnosed as IBS or psychosomatic

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4. The Detox Blocker

Description:

Mycotoxin overload + sluggish detox pathways

Sensitive to smells, chemicals, and environments.

Feels like their body is holding onto invisible toxins.

Traits:

Fatigue, headaches, chemical sensitivity

Poor recovery and emotional flatness

Often told “it’s all in your head”

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5. The Nutrient Starved Achiever

Description:

Micronutrient depletion + poor absorption

Eats well, supplements often, but still feels depleted.

Feels like their cells are starving despite effort.

Traits:

Fatigue, poor focus, muscle cramps

Symptoms worsen with stress or fasting

Often told “labs are normal

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Myth Busting

Myth 1: People with chronic fatigue are just tired - Chronic fatigue is not ordinary tiredness—it’s cellular collapse and not relieved by rest.  It’s not a motivational issue either.

Myth 2: Fatigue is the only symptom in chronic fatigue patients - It’s a multi-system, *terrain collapse. Other symptoms can include brain fog, muscle pain, sleep disruption, gut issues, and sensory sensitivity.  It’s not one broken wire – it’s a frayed circuit board.

Myth 3: It’s all in your head - Chronic fatigue is a biological illness—not a psychological construct

Myth 4: Exercise will fix it - Pushing through fatigue can worsen symptoms. Exertion can trigger crashes lasting days or weeks.

Myth 5: If your labs are normal, you’re fine - Many patients with chronic fatigue

have normal CBCs and metabolic panels. But deeper testing reveals many issues.

 

 

🎯 Final Thoughts (2–3 min)

Chronic fatigue isn’t a mystery—it’s a message. It’s your body’s way of saying: something is out of sync.

We’ve explored many core dysfunctions. Each one is testable. Each one is repairable.

If your doctor has not been able to make headway with your chronic illness, it’s time to check out functional medicine. There’s no magic to it…it’s all about extensive testing and root cause detective work, NOT SYMPTOM SUPPRESSION. If functional medicine interests you, find a functional medicine practitioner by going to the Institute for Functional Medicine’s website at https://IFM.org, and click on the ‘Find a Practitioner” link.

However, if you’d like to talk with someone directly about your chronic illness issues, consider booking a free, 1 hour call with us at Holistica. Just go to https://Holistica.services.

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