Functional medicine — chronic fatigue
Chronic Fatigue Treatment in St. Louis
Chronic fatigue that has not been solved by routine medical workup is one of the most common and most frustrating presentations. At Simply Health Integrated Medical in St. Louis, chronic fatigue is approached as a multi-system problem: thyroid, HPA-axis, mitochondrial, gut, blood sugar, hormones, sleep, inflammation, and infection-related contributors are all considered. Dr. Bryan Deloney, DC, MS-Functional Medicine, leads the evaluation.
What to expect
Simply Health Integrated Medical helps patients understand symptoms, goals, and options before recommending a care path.
The next step is a consultation request or direct call so the team can determine whether the clinic is a good fit for your needs.
Why chronic fatigue is hard to diagnose
Routine medical workups screen for the most common diagnosable causes — anemia, hypothyroidism (by TSH), sleep apnea, depression — and stop there if those are normal. But chronic fatigue often comes from contributors that routine screening misses: T4-to-T3 conversion problems, HPA-axis dysregulation, mitochondrial dysfunction, SIBO, low-grade inflammation, post-viral patterns, hormone shifts, and combinations of all of the above. The default 'everything is normal, must be stress' is the result.
How chronic fatigue evaluation actually works here
Evaluation starts with a structured intake that maps the fatigue pattern — when did it start, what made it worse, what gives relief, what worsens it, what is the post-exertional response, what is sleep like, what is the cognitive component. Labs are then targeted to the pattern rather than a one-size-fits-all panel. The goal is to identify the dominant contributor first, then layer the rest as the picture clarifies.
Common contributors to unresolved fatigue
Subclinical or autoimmune thyroid dysfunction missed by TSH-only screening. HPA-axis dysregulation (what patients call adrenal fatigue). Mitochondrial dysfunction from chronic inflammation, infection, or toxin exposure. SIBO or other gut issues affecting energy and nutrient absorption. Post-viral patterns including post-COVID syndrome. Sleep disorders beyond OSA. Iron, B12, vitamin D, magnesium, or other nutrient deficiencies. Hormone shifts (perimenopause, low testosterone). Blood sugar instability. Often there is more than one contributor.
Mitochondrial function and chronic fatigue
Mitochondria are the energy production units of the cell. Chronic inflammation, oxidative stress, certain infections, and other stressors can impair mitochondrial function — and the downstream symptom is profound fatigue, particularly post-exertional fatigue (feeling worse the day after exertion). Mitochondrial support (CoQ10, B vitamins, nutritional support, sometimes peptide therapy) can be a meaningful part of recovery when this is part of the picture.
Post-viral and post-COVID fatigue
Chronic fatigue following viral illness — including post-COVID — has become a more common presentation. The pattern often involves HPA-axis disruption, mitochondrial dysfunction, gut microbiome changes, and immune dysregulation. The functional medicine workup is well-suited to evaluating these contributors alongside conventional medical referral when appropriate.
Realistic expectations for chronic fatigue recovery
Recovery is rarely fast and rarely linear. Most patients see meaningful improvement within 3 to 6 months of structured care. Severe or long-standing fatigue can take 6 to 12 months for substantial recovery. The plan is iterative — labs and symptoms are tracked, and the plan adjusts as the picture clarifies and the body responds. The point is sustained energy, not a temporary stimulant.
Request a chronic fatigue evaluation
If you have chronic fatigue that has not been resolved by routine workup — and you are tired of being told 'everything is normal' when you feel terrible — request a chronic fatigue evaluation. The next step is a comprehensive workup that takes the symptom cluster seriously and considers contributors most routine workups miss.
Frequently asked
Common questions
▸Where can I get chronic fatigue treatment in St. Louis?
Simply Health Integrated Medical at 12977 N Forty Dr, Suite 105, St. Louis, MO 63141 offers comprehensive functional medicine chronic fatigue evaluation. Led by Dr. Bryan Deloney, DC, MS-Functional Medicine. By appointment 24/7. Call (636) 590-4686.
▸Why am I tired all the time when my labs are 'normal'?
Routine labs screen for the most common diagnosable causes and miss subclinical thyroid dysfunction, HPA-axis dysregulation, mitochondrial dysfunction, SIBO, low-grade inflammation, post-viral patterns, and nutrient deficiencies that drive chronic fatigue. A comprehensive functional medicine workup looks at these contributors.
▸What does a chronic fatigue workup include?
Evaluation typically includes complete thyroid panel, cortisol pattern testing, comprehensive metabolic and nutrient labs (iron studies, B12, vitamin D, magnesium), inflammatory markers, blood sugar evaluation, gut function context, hormone panel when relevant, and infection screening depending on history. The panel is targeted to the pattern rather than ordered blindly.
▸Is chronic fatigue syndrome the same as chronic fatigue?
Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) is a specific diagnostic category with strict criteria. Many patients with chronic fatigue do not meet full CFS/ME criteria but still have a real, multi-system fatigue problem. The functional medicine workup is useful in both cases.
▸Can post-COVID fatigue be treated?
Post-COVID fatigue / long COVID fatigue is a recognized pattern often involving HPA-axis disruption, mitochondrial dysfunction, gut changes, and immune dysregulation. Functional medicine evaluation can identify which contributors are dominant in a specific patient and structure a recovery plan accordingly.
▸How long does chronic fatigue recovery take?
Most patients see meaningful improvement within 3 to 6 months of structured care. Severe or long-standing fatigue can take 6 to 12 months for substantial recovery. The plan is iterative — labs and symptoms are tracked, and the plan adjusts as the body responds.
▸Will I need supplements for chronic fatigue?
Targeted supplements based on lab findings often have a role — mitochondrial support, nutrient repletion, adaptogens, B vitamins — but the broader plan addresses sleep, blood sugar, hormones, gut function, and the contributors driving the fatigue. Supplements alone rarely resolve chronic fatigue.
▸Is chronic fatigue treatment covered by insurance?
Some labs and prescriptions may be covered depending on the plan. The functional medicine evaluation and bundled programs are often not insurance-billed. Cost is reviewed during the evaluation.
Next step
Ready to find the right next step?
If this page sounds like what you are looking for, request a consultation or call the office so the team can help you choose the right starting point.