You've had your blood checked. You were told it's fine. You're still exhausted by mid-afternoon, and coffee isn't fixing it.
That experience is common, and it is real. We can't promise to find a single cause. What we can do is look more widely than a routine panel, and explain plainly what we see.
Fatigue has many possible causes, and the cause is often not hormonal. When it isn't, we say so.
An underactive thyroid slows energy, mood and metabolism.
Low iron stores can cause tiredness before anemia shows up.
Fewer red blood cells means less oxygen reaching your tissues.
Breathing pauses at night can leave you unrefreshed after a full night in bed.
Short, broken or late sleep adds up over weeks.
In men, low levels can affect energy, mood and muscle.
Shifting hormones in women's forties can disrupt sleep and energy.
Low energy is one of the most common signs of depression.
Blood pressure medications, antihistamines and others can cause fatigue.
Common in winter and linked with tiredness and aches.
Less movement lowers fitness, which makes everyday tasks feel harder.
These are the tests we would typically run when someone comes in for fatigue. We choose from this list based on your history.
Kidney and liver function, electrolytes and fasting glucose.
Complete blood count to check for anemia and other blood changes.
Ferritin, serum iron, TIBC and transferrin saturation, which show iron stores, not just hemoglobin.
A full view of thyroid function, not TSH alone.
Drawn in the morning, when levels are highest and most reliable to interpret.
Where relevant, for women whose symptoms suggest a hormonal change.
Two common deficiencies that can contribute to fatigue.
Your three-month average blood sugar, plus cholesterol and triglycerides.
Fat mass, lean muscle mass and phase angle, measured in about a minute.
A structured screening at your visit. We refer you for a sleep study when it's indicated.
What follows depends entirely on the results. If a deficiency shows up, we may start with targeted supplements. If thyroid or sex hormones are out of balance, we discuss whether treatment makes sense for you. If sleep apnea is likely, we refer you for a sleep study.
If nothing abnormal shows up, we tell you that, and we work through sleep, activity, nutrition and medications together.
Initial evaluation
$250
Self-pay
Follow-up visit
$150
Self-pay
We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare. HMO plans are not accepted. Lab and treatment costs depend on what is ordered.
See full pricing →A routine panel usually covers a handful of markers. It often leaves out ferritin, free T3 and free T4, morning testosterone, vitamin D and B12. We look at a wider set, and we read results against how you feel, not only against the reference range.
Sometimes, but often not. Iron deficiency, poor sleep, sleep apnea, medication side effects, low fitness and depression are all common causes. If your hormones are not the problem, we tell you that, and we don't prescribe hormones.
We screen for it at your visit. When the screening points to sleep apnea, we refer you for a sleep study, which can often be done at home.
Then we say so plainly. We look again at sleep, activity, nutrition, stress and medications, and agree on what is worth changing and what to recheck later. Sometimes the honest answer is that nothing needs treating.
Most blood results return within a few days. The InBody 970 body composition scan is done during your visit and takes about a minute. We go through the results with you at your follow-up.
For many markers, yes. We offer at-home capillary collection from the upper arm, which is self-pay. Medically necessary labs can be ordered through Quest or Labcorp, where insurance may apply.
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