Chronic Fatigue

Chronic Fatigue services offered in Portland, OR

Chronic fatigue - persistent exhaustion that does not resolve with rest and significantly
impairs daily function - is one of the most complex and underserved conditions in
conventional medicine. Whether you are dealing with chronic fatigue syndrome
(ME/CFS), post-viral fatigue including long COVID, or fatigue driven by overlapping
metabolic, immune, and hormonal dysfunction, naturopathic physicians Rebecca Sand
ND and Elizabeth Emrick ND at Open Wellness PDX take this condition seriously and
investigate it thoroughly. Call the Portland office, request a telehealth visit, or book
online.

Chronic Fatigue Q&A

What causes chronic fatigue?

Chronic fatigue is rarely caused by a single factor. Common root causes and contributing conditions seen at Open Wellness PDX include viral or post-infectious drivers such as EBV reactivation, long COVID, and enteroviral infections; mitochondrial dysfunction and impaired cellular energy production; HPA axis dysregulation and cortisol pattern disruption; thyroid dysfunction including subclinical hypothyroidism and poor T4-to-T3 conversion; nutrient deficiencies impacting energy metabolism including B12, folate, iron, magnesium, CoQ10, and carnitine; gut dysbiosis, SIBO, and intestinal permeability; MCAS and histamine-immune overactivation; hormonal imbalances including sex hormone and adrenal dysfunction; chronic inflammation and immune dysregulation; and disordered sleep architecture.

Many patients with chronic fatigue have been told their labs are normal. A naturopathic evaluation uses a broader and more targeted testing framework to find what standard workups miss.

How does naturopathic medicine treat chronic fatigue?

At Open Wellness PDX, Dr. Sand and Dr. Emrick begin with individualized advanced lab testing - including inflammatory markers, nutrient levels, hormone panels via DUTCH testing, expanded thyroid assessment, and gut evaluation - to identify the specific pattern of dysfunction driving fatigue for each patient.

Treatment is paced and individualized. It may include mitochondrial support with CoQ10, carnitine, B vitamins, magnesium, and D-ribose; targeted amino acid therapy and nutrient optimization; adrenal and cortisol support using adaptogens and targeted nutrients; thyroid optimization including T3 support when indicated; gut healing including dysbiosis, SIBO, and intestinal permeability treatment; MCAS and histamine treatment when present; antiviral support and immune modulation for post-infectious presentations; sleep restoration protocols; nervous system regulation and pacing strategies; and pharmaceutical support including LDN when appropriate.

Chronic fatigue is real, it is physiological, and it is treatable. Progress often requires patience and a layered approach - but meaningful improvement is possible.

To get started, call 503-770-0670, request a telehealth visit, or book online.