Fatigue–A Functional Medical Doctor Perspective by Svetlana Kogan, M.D.

It’s the subject of energy in its various expressions has always piqued my interest. I have authored numerous articles and posts about Masaru Emoto’s experiments with frozen water crystals to document how invisible energy changes the structure of water, and, since we are mostly water, how energy affects every aspect of our livelihood. Today I wanted to expand this discussion to include the most common complaint we hear as doctors when patients come into the office: fatigue or lack of energy.

To a functional physician, fatigue represents a loss of energy balance. The most challenging to treat are those patients who have Chronic Fatigue Syndrome (CFS). By the time they come to see a functional doctor, most of them have been evaluated already, and no medical or psychiatric reason was found for their chronic tiredness. Classically, for the diagnosis of CFS to be made, the fatigue must be present for at least 6 months continuously and at least 4 out of these 8 symptoms should be present:

• Tender neck lymph nodes
• Sore throat
• Joint pain
• Muscle pain
• Headaches
• Unrefreshing sleep
• Impaired memory or concentration
• Unusual malaise after exertion

An extensive list of medical diseases should be ruled out before someone receives a diagnosis of CFS. This means that a thorough laboratory and diagnostic radiology workup has been done first. Most patients with CFS who have come to see me, desperate for holistic solutions, already tried either antidepressants, analgesics, or antivirals, and for most of them these conventional treatments did not hold much promise. I feel that what was missing for these folks was a functional medicine approach, because it considers all the subtle, often missed possibilities underlying chronic non-specific fatigue. Special attention is paid to antecedent contributors, which could have been at play beyond the patient’s own control, like their mother’s prenatal stress levels, their genetic predispositions via testing, detailed family history of fatigue or other functional symptoms.

Close consideration is also given to the triggering events in the patient’s life like infections, allergic reactions, physical or emotional trauma, exposure to new medications or supplements, exposure to environmental toxins or mold, or abrupt dietary and/or lifestyle changes.

Functional doctors will take time “digging” for the above and other perpetrators of fatigue, like family and job environment, alcohol or drug use, or nutrient deficiencies. We need to understand and build a solid doctor-patient relationship to understand our patient’s experience, and this cannot be a rushed process. We then identify and remove the obstacles to the body’s normal functioning.

Fatigue is often a result of imbalanced relationships between various body systems, and the treatments often involve a detailed modification of lifestyle and routine. I also collaborate with my patients on optimizing their sleep, breathing, heart rate variability, tweaking their exercise routine, and putting together a customized dietary plan chock full of nutrients and vitamins. I see one of my healing roles as that of a holistic coach who works with my patients regularly on helping them to balance their interpersonal relationships, and sometimes deal with stress, isolation, or grief. These especially important attributes of our consciousness are essential to how we perceive fatigue or pain.

In treatment of CFS, the supplements which I recommend are customized to each patient, to provide metabolic support, maintain cellular membrane integrity, mitigate effects of oxidative stress on the body, and to provide the detoxification or inflammation reduction if necessary. These supplement recommendations are uniquely tailored in their composition, dosage, and duration for each patient, because I believe that a cookie-cutter approach to supplements, where people just take those supplements they see being promoted on TV, can often be detrimental rather than helpful.

By empowering patients with the tools to manage the pieces of the healthy energy puzzle, functional doctors heal the person as a whole energetic being, rather than just treating their disease.

The author of ‘Diet Slave No More!’, Svetlana Kogan, M.D. is a Board-Certified Internal Medicine, Holistic & Functional Medical Doctor with 25 years of experience. Her website is CustomLongevity.com Office Phone: 239-676-6883