Conditions We Treat · One Tree Integrative Medicine
Fatigue that doesn’t respond to rest isn’t a lifestyle problem — it’s a signal. The body doesn’t exhaust itself without reason. And yet chronic fatigue is one of the most routinely dismissed presentations in conventional medicine, because standard labs rarely reveal what’s actually depleting energy at the cellular level.
At One Tree we run the panels that actually matter — full thyroid, adrenal function, mitochondrial markers, viral reactivation, nutrient status, gut health — and we build the investigation around your specific history rather than a standard checklist.
On this page
What chronic fatigue actually is
Why standard testing misses it
How One Tree investigates it
Treatments we use
Conditions in this category
“My TSH was normal. My iron was normal. Every panel came back fine. But I could barely get through the day.“
What It Is
Chronic fatigue isn’t tiredness. It’s a persistent, often debilitating depletion of energy that doesn’t improve with sleep and frequently worsens with physical or mental exertion — a pattern known as post-exertional malaise.
It can stem from many sources: mitochondrial dysfunction (the cells aren’t producing energy efficiently), thyroid dysregulation, adrenal imbalance, viral reactivation such as Epstein-Barr, nutrient depletion, chronic low-grade infection, or gut dysfunction affecting absorption and systemic inflammation. Often more than one of these is operating simultaneously.
It is a real physiological process. The frustration of being told otherwise — that it’s depression, deconditioning, or stress — is one of the most common experiences patients bring to One Tree.
Why Testing Misses It
Standard blood panels are designed around population averages and acute disease thresholds. They catch serious dysfunction reliably. They frequently miss the more subtle but clinically significant patterns that drive chronic fatigue.
TSH alone misses thyroid dysfunction — A TSH in ‘normal range’ doesn’t evaluate T3 conversion, reverse T3, or thyroid antibodies — all of which can produce severe fatigue while TSH looks fine.
Ferritin cutoffs are too low — Standard labs flag ferritin deficiency well below the level at which fatigue and cognitive impairment typically appear. Many fatigued patients are told iron is ‘normal’ at levels that are clinically insufficient.
Adrenal function isn’t tested — Standard panels don’t assess cortisol patterns across the day or the HPA axis function that governs energy regulation and stress response.
Viral reactivation is rarely checked — Epstein-Barr reactivation, HHV-6, and other chronic viral contributors to fatigue aren’t part of routine panels — even when the clinical picture strongly suggests them.
Our Approach
The investigation starts with your history — not just the labs. When did the fatigue start, what was happening at that time, what makes it worse, what helps even temporarily. These details guide which testing is most likely to reveal what’s driving the depletion.
From there, we use a targeted combination of advanced labs and functional testing — going significantly beyond the standard CBC and metabolic panel. We look at the systems most commonly implicated in chronic fatigue, in the depth that actually matters.
What We Investigate
Full thyroid panel (TSH, Free T3, Free T4, Reverse T3, TPO antibodies) · Adrenal function and cortisol patterns · Viral reactivation (EBV, HHV-6, CMV) · Mitochondrial function markers · Comprehensive nutrient status (B12, D3, iron, ferritin, magnesium, zinc) · Gut health and absorption capacity · Inflammatory markers (beyond standard CRP) · Sleep architecture and quality factors
Conditions in this category
ME/CFS (Myalgic Encephalomyelitis)
Long COVID fatigue
Adrenal fatigue & HPA axis dysfunction
Post-viral fatigue syndromes
Thyroid-driven fatigue
Exhaustion unrelieved by rest
Brain fog & cognitive fatigue
Post-exertional malaise
How We Treat It
What’s used depends entirely on what the investigation finds. These are the tools most commonly relevant for chronic fatigue at One Tree — often used in combination because the underlying drivers typically interact.
Thyroid Optimization
When thyroid dysfunction is contributing — even at TSH levels considered ‘normal’ — addressing it is often the most direct path to restoring energy. This may involve optimizing T3 conversion, addressing thyroid antibodies through gut and immune work, or using bioidentical thyroid support where clinically appropriate. Dr. Jamie evaluates the full panel, not just TSH.
Peptide Therapy
Specific peptides support mitochondrial function, cellular energy production, and recovery from chronic stress at the physiological level. BPC-157 addresses gut-driven inflammation that depletes energy systemically. PT-141 and other peptides may be relevant depending on the specific pattern found. Used when the investigation identifies them as appropriate.
Gut Restoration & Nutrient Repletion
Gut dysfunction impairs absorption of the nutrients energy production depends on — B12, iron, magnesium, zinc, D3. Addressing the gut often resolves deficiencies that supplementation alone can’t correct. We combine microbiome mapping, permeability testing, and targeted repletion based on what your specific labs show.
Biofeedback
The QUEX-ED biofeedback system identifies autonomic nervous system patterns contributing to fatigue — particularly in cases where dysregulation of the HPA axis and stress response is maintaining the depletion cycle. Useful for adrenal fatigue patterns, post-viral presentations, and ME/CFS where nervous system dysregulation is a primary driver.
What to Expect
Most people who arrive at One Tree with chronic fatigue have already seen several providers, had labs reviewed multiple times, and been told everything is normal. That history — what was tested, what wasn’t, what was tried — is the starting point of the investigation.
Free 40-Min Consultation
A direct conversation about your fatigue history — when it started, what’s been ruled out, and what hasn’t been looked at. Dr. Jamie will tell you honestly whether One Tree is likely to be useful for your situation.
Deep-Dive Intake (60+ min)
A full history covering onset, timeline, symptom patterns, prior labs and what they showed, current medications, diet, sleep, and anything that correlates with better or worse periods. This is where the gaps in prior workups typically become visible.
Targeted Lab Investigation
The specific panels chosen based on your history — full thyroid, adrenal patterns, viral markers, nutrient status, gut function, mitochondrial markers — not a standard fatigue checklist.
Your Individualized Protocol
A plan built around what the labs actually show. Most chronic fatigue protocols at One Tree address two or three contributing systems simultaneously, because they typically compound each other.
Honest expectations
Chronic fatigue that has built over months or years doesn’t resolve in weeks. Meaningful improvement typically takes one to three months once the protocol is underway.
Not every case of chronic fatigue has a single clear driver. Some are multifactorial and require working through several contributing systems in sequence.
If your fatigue has a cause that falls outside what integrative medicine can address — a serious underlying condition requiring specialist management — Dr. Jamie will identify that and tell you directly.
Bringing prior labs to the consultation is useful. Seeing what was tested — and what wasn’t — is often the fastest way to identify where to start.
“
“After three years of being told my labs were normal, Dr. Jamie found the root cause of my fatigue in two appointments. My ferritin was at the bottom of the ‘normal’ range, my T3 conversion was poor, and I had active EBV reactivation. For the first time in years I actually feel like myself.”
One Tree Patient · Denver, CO · Chronic Fatigue & Thyroid Dysfunction
*Patient experience. Results vary. This is not a medical claim.
The free consultation is a 40-minute conversation about your history and whether One Tree’s approach makes sense for your situation. Bring whatever labs you have. No forms, no commitment beforehand.