The 11-Point Diagnostic Roadmap to Chronic Fatigue

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If you’re like most of the people that I’ve had the pleasure of dealing with over the past several years regarding chronic fatigue, I bet you’re pretty frustrated.

You’re tired, you’re probably overweight, you don’t feel like yourself and your life is taking a hit because of it.

The worst part of it is that you’ve probably gone to numerous doctors (the most I’ve heard so far is 15) and you’ve gotten nothing but maybe, empty diagnoses, like Chronic Fatigue Syndrome or Fibromyalgia.

If you’re struggling to figure out what’s at the root of your chronic fatigue, I’m going to lay out my 11-point diagnostic roadmap that I use when helping folks get to the bottom of their chronic fatigue.


You’re probably aware that hormones can have an incredible effect on the body and can drive chronic fatigue and other chronic disease states.

What you probably didn’t know is that nearly all hormones are interconnected in a tangled web of signaling and that if one of your hormone pathways is out of whack, others are probably of whack too.

Ultimately, your sex hormones (testosterone, estrogen, etc), your stress hormones (cortisol, etc), and your thyroid are all related and will tend to feed off of each other.

It’s important to look at hormone status as a whole rather than simply looking at thyroid health or adrenal health individually.

Chronic Infection

“Chronic infections” is quite the broad category, but suffice it to say that this includes well-known infections such as Lyme or Epstein Barr, and lesser well known, HHV-6 and the like.

This needs to be a part of your workup if you’re suffering from chronic fatigue.

These infections can cause serious symptoms and sadly, are often overlooked by conventional medicine.

In fact, there are many conventional medicine practitioners out there that believe infections such as Lyme cannot persist in the body for long periods of time.

So, this obviously needs to be looked at with great scrutiny.

Chronic Inflammation

This section kind of ties back into chronic infections.  For example, in people with certain genetic pre-disposition, Lyme has lasting inflammatory effects even after the bug has been squashed, so to speak.

There are also, non-infectious causes of chronic inflammation, such as exposure to toxic mold or contaminated waterways.

It all boils down to a very similar disease process.  Your body is exposed to toxins of some sort (either from infection or an external source) and because of genetic predisposition, you cannot get those toxins out of your body, so they just stay as long as they’d like and keep making you sick.

This is due to an ongoing activation of inflammation.

Environmental Toxicity

I just wrote an article talking about heavy metals and metals fall into this category of environmental toxicity.  Metals can come from dental fillings, contamination of drinking water, fish that we eat, etc.

There are other sources of environmental toxicities as well, such as exposure to chemicals at a job or maybe the farmer next door to you is spraying pesticides and herbicides on his crops several times a year.

All of these can lead to toxic situations and to you being sick.


Autoimmunity can be precipitated by many factors including, genetics, inflammation, etc., but in the end, it’s an inappropriate immune response.

This immune response yields increased amounts of inflammation and tissue damage that can cause chronic fatigue and a number of other symptoms.

Recognizing autoimmunity and taking action to correct the autoimmunity is going to be critical to overcoming chronic fatigue.

Gut Problems

A lot of people don’t really consider the gut being an issue unless they’re having gut-related symptoms, like constipation, diarrhea, nausea, vomiting, etc., but research has shown that the gut is related to many different body systems including the brain, the skin, and hormones.

If you’re suffering from a silent (or not so silent) gut issue and it is not recognized and fixed, then you’re going to have a very hard time getting the upper hand on your chronic fatigue.

That’s why this is a huge part of my diagnostic roadmap and why I have spent many blog posts talking about the gut and its effects on health.

Food Intolerances

Along those same lines, food intolerances are an often-overlooked problem in people with chronic fatigue.

Food intolerances have been associated with “leaky gut,” which is a breakdown in the protective barrier function of the gut.

I wrote about the functions of a healthy gut and you can read about that here, but in the cases of food intolerances, these functions are compromised and can lead to many symptoms, including chronic fatigue.

Nutritional Imbalances

Not having enough of key nutrients in your diet can be a huge issue and cause a number of symptoms.

On the other hand, having too much of certain nutrients can be an issue as well.

It’s important when you’re going down this roadmap and determining the underlying causes of your chronic fatigue, that you make sure you’re hitting the sweet spot of vitamins, minerals and other phytonutrients… It’s kind of a Goldilocks thing…

Liver or Detox Insufficiency

Your liver acts as a filter for your entire blood stream.

If you have something in your blood stream that shouldn’t be there, your body is pretty smart and will do its best to get rid of it.  That usually is taken care of by the liver and to a lesser extent the kidneys.

Now, there is only a certain amount of work that these detox channels can handle and if they are overloaded they won’t be able to perform at a high enough level to keep you healthy.

That’s when this becomes an issue and can lead to chronic fatigue.

Regulation of Blood Pressure

I’m afraid this is going to be a chicken and egg situation.

It’s not clear yet, whether, poor regulation of blood pressure is a contributing cause of chronic fatigue or a result of other factors that contribute to chronic fatigue, but I do feel that this an important thing to address.

Some of you may be experiencing high blood pressure, some low, and some may have normal blood pressure, until they stand or go from a lying to seated position.

Regardless of which group you fall into, it’s important to address this as it can put you at increased risk of a stroke, syncopal episode (passing out), etc.

Energy Production Dysfunction

This is still a new area of study for me, but I do feel that it’s worth mentioning as it can have some major implications to chronic fatigue.

Mitochondria are the power-house of our cells and if they are not working properly, our bodies are unable to use the food that we give it, efficiently and we get fatigue and a number of other symptoms as a result.

Dave Asprey at Bulletproof is all about some mitochondria and his research into the subject has been quite fruitful.  I will continue to look into this and report back with more information soon.

How to Make the Most of this Information

I like to think that this 11-point roadmap is useful information… maybe I’m a little biased.

But the fact is, all the information in the world is useless if you don’t take action upon that information.

You could try systematically going through this yourself, researching for hours on each individual modality, then trying to convince your healthcare provider to run the appropriate tests and treat any issues that are found.  But that sounds like a lot of work, don’t you think?

You don’t have to do all that.  I’ve done all the research for you.  I already know what tests are necessary, and more importantly, which ones are not.  I have the ability to help you correct these abnormalities and maybe most importantly, I WANT TO HELP YOU GET BETTER.

Being sick and tired, sucks.  You lose your life to this illness and next thing you know, you’re in a prison that is your illness.  If you’re okay with the way things are and don’t want to do anything about it, please just click that X in the top right of your screen.  But if you’re sick of living like this and are ready to do something about it, click here and book an appointment with me now.

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