Dr. Steven Noseworthy (00:37.826)
Hey guys, and welcome back to The Inflammation Nation, where we like to stay up to date on how science can help you craft your own wellness journey. And if you haven't done it yet, please take a second to hit subscribe and follow so that you don't miss any new content. And of course, that helps me reach other people with the message of science-informed wellness. In this episode, I am talking about the most common causes of fatigue and why advanced biohacks.
and biohacking fails to fix it. So let's go ahead and just jump right into that. Most of the
Dr. Steven Noseworthy (01:18.956)
Hey guys, welcome back to The Inflammation Nation, where we like to stay up to date on how science can help you craft your own wellness journey. And if you haven't done it yet, please take a second to hit the follow or subscribe button right now so that you don't miss any new content. And of course, that helps me reach other people with the message of science-informed wellness. If you're listening on Apple and Spotify, I appreciate you being here. But if you like the visual side of things, I do from time to time.
Put things up on the screen that you can only see if you're watching video. So you can check us out on YouTube. Now, in this episode, I am going to be talking about the most common causes of fatigue and more importantly, why biohacking strategies quite often fail to fix that. So let's just jump right into that. First thing to know is that most of the, let's say, top 10 reasons why people go to see a medical doctor.
They're related to medical issues like having a sore throat. I believe upper respiratory infections are the number one cause why people go see their medical doctor. But sitting at number 10 in that list, it might change depending on which year you look at, but somewhere around number 10 is fatigue. It's a very common reason why people go to see their doctor. But unlike a cough or a respiratory infection, which are almost always like transient viral infections.
Fatigue is a it's a nebulous creature, right? Sometimes it's hard to describe fatigue if you're describing it from the patient side. And on the doctor side, sometimes it's hard to find or define the root cause. And of course, that's the name of the game. That's why so many people use words like root cause medic medicine, root cause disruptors is a term that I use quite often myself. But inevitably,
Any research that you do on your own about your own fatigue is probably going to land you in one of a few different places. You're going to learn about how your low thyroid, perhaps Hashimoto's or chronic infections like Epstein Barr, how they are
Dr. Steven Noseworthy (03:34.041)
But inevitably, any research you do on your own about your own fatigue is going to land you in one of a few places. You're going to be learning about low thyroid, perhaps Hoshimoto's, maybe how chronic infections like Epstein Barr end up affecting your mitochondria. And that's that little energy factory that lives in all of your cells. And your mitochondria are usually described as maybe your cellular batteries.
or more commonly the powerhouse of your cells. And they are. And if you are following wellness trends online, you have seen a heavy push for mitochondrial biohacking of one form or another. Influencers will tell you to take high dose NAD + precursors like NMN or NR. they will tell you to sit in cold plunges, to use red light panels and
Maybe even get IV drips to charge up your mitochondria, to charge up these cellular batteries. And maybe you've tried some of these shortcuts. Maybe you got some benefits. For some people, actually, it is going to help. But for most of us, we're going to feel a brief surge of stimulation. But then hours, days, maybe weeks later, your baseline fatigue returns. Or worse, you end up pushing through.
To the point where you eventually crash and things get worse. And so the question is: if all these biohacks are supposed to be so good for us, why do these high-tech or semi-high-tech shortcuts so often fail to address fatigue, particularly in complex and chronic cases? Because mitochondria do not downregulate energy production simply because they lack a trendy supplement.
Or because you're not doing cold plunges. When cells encounter persistent oxidative stress or stealth infections like Epstein Barr, or even heavy metals, or live in an environment of low thyroid hormones or poor tissue oxygenation, the mitochondria intentionally shift out of a mode of abundant energy production into a dysfunctional state of biological defense.
Dr. Steven Noseworthy (06:00.258)
This is a well-documented pathobiological phenomena that's called the Cell Danger Response. And trying to force energy output with supplements like high-dose NAD or precursors or different thermal stressors like cold plunges, while your cells are locked in a cell danger response, it's like slamming the gas pedal on your car while your transmission is locked in place.
Right? It doesn't move the car forward. It just overheats the engine, maybe breaks the transmission, and it certainly wastes a lot of fuel. And so today we're going to look past the biohacking hype. We're going to break down the actual cellular mechanics of mitochondrial fatigue and why something called the pyruvate blockade or pyruvate bottleneck drives things like post-exertional fatigue or soreness or even brain fog.
And what actually does it take to restore metabolic and mitochondrial capacity? Now, before we dissect the advanced cell signaling of the mitochondria, I want to address something under the heading of what I'm going to call Too Simple, Often Overlooked. In functional functional medicine, you know, we love to dive into like postdoctoral and PhD level physiology. We like to look at enzyme kinematics and
Things like microglial priming and genotypic and phenotypic expressions and so on. But sometimes people spend so much time searching for a complex, hidden root cause that they step right over the most basic and fundamental laws of human physiology. Now, you may have heard me use the Big Rock's first analogy in other episodes, and I'm not going to b re bore you by repeating.
Now, you may have heard me use the Big Rock's first analogy in other episodes, and I won't bore you by repeating it, but the core message of that story is that when it comes to human health and wellness, there is a set of physiological priorities that have to be handled first before you can expect advanced strategies to succeed. In other words, you need to handle, you know, like step one and step two before you go to steps three and step four. And when it comes to fixing fatigue,
Dr. Steven Noseworthy (08:22.986)
One of those foundational rocks is basic energy balance and calorie deficits. And again, this falls on the under the heading of too simple, often overlooked. When you are dealing with chronic fatigue, your baseline calorie mechanics matter immensely. And if you understand that your cells make energy in their mitochondria for the most part, the next question we have to ask is actually, where does the fuel source come from? Right? So at the at the
30,000 view level, it works like this. You eat food, which contains energy in the form of calories, and a calorie is a unit of energy. Your body digests that food and converts it into energy sources like glucose or fats and even amino acids from protein. And these food sources travel from your gut into your bloodstream to your cells.
And then your cells have two major systems that use glucose, fats, and amino acids to create energy. One of those systems uses the mitochondria to burn all of those. So your mitochondria can burn glucose, fats, and amino acids in the presence of oxygen to make energy. And we call energy in this context ATP. You've sure you've heard that before. And the other system your cell uses does not happen in the mitochondria.
And does not use oxygen, and it's an energy producing pathway that sits outside of the mitochondria. Again, it doesn't require oxygen, but it can only use glucose. It does not use fats, and it does not use amino acids. And if you have any background in biology at all, you'll probably recognize that description at the end there as a very basic explanation of the differences between aerobic and anaerobic metabolism.
And if not, then just know that the word aerobic refers to making energy in the mitochondria, using oxygen plus an available fuel source, glucose, fats, and amino acids. And the word anaerobic means creating ATP or energy outside of the mitochondria without oxygen using only glucose. And so for this first two simple, often overlooked reason as to why people are tired, keep this in your mind.
Dr. Steven Noseworthy (10:48.066)
Right? You eat food. Food contains fuel sources like glucose, fats, amino acids, and your cells use that to make energy. The more food you eat, the more calories that you supply for your cells to make energy. And the opposite is also true. The less food you eat, the fewer calories you supply to your cells, which means their energy production capacity is limited, even if the cell in those systems are healthy. And if you're eating fewer calories,
than the amount of energy that you expend in a day, you will be tired at some point. So, in this too simple, often overlooked example, the solution is really as simple as this: eat more food. Now, I have used this example before in the podcast, and I use this story in seminars that I teach to doctors to illustrate how simple, stupid this issue is. And the story, which is a real story, goes like this.
Back in about probably about 2013, I had a middle-aged woman come to see me who had MS. And she was so weak and tired that she had been in a wheelchair for the past couple of years at this point. And I'll I'll give you the very short version of the story, but based on her size and weight and her lack of physical activity being wheelchair bound, she only needed about 1200 calories per day. And contrast that to, say, the average active woman.
Might need 1800 calories or 1600 calories or something like that. But when I had her do a diet diary for me, on average she was eating only about 400 calories per day. She needed roughly 12. She was only consuming one-third of that, which is a massive, massive calorie deficit. And this had been going on for years. Now remember, she had MS. And fatigue, of course, is a classic symptom of that. And so for about two years,
She had been told that she couldn't get out of her wheelchair because of her fatigue. And that was due to the MS. But wouldn't you know it that once her calories got up to about 900 calories per day, she was able to get out of her wheelchair for the first time in years. Well, how about that? And that's not because I cured MS, because I didn't, but because she was simply low on fuel and we topped off her tank.
Dr. Steven Noseworthy (13:12.212)
Simple, maybe stupid simple, but all of her medical doctors and specialists overlooked it. Now, ever since that case, the very first thing that I always ask myself and sometimes the person I'm consulting with, when they have a complaint of fatigue, my first question is, Well, how much food do they eat? And if their answer is, Well, I don't know, that's quite often the answer actually. And and
I honestly I've noticed this alarming trend over the last 15 years. And this trend has two different dimensions. The first is that most of my clients don't know how many calories they need and how many calories they eat, let alone how to optimize those calories as they're coming from carbs and fats and proteins. And this is literally the first thing that I do with every single new client. It's a comprehensive diet review.
To make sure that we get that part right, because I don't care what supplement you take or what the brand of your cold plunge tank is, if you're not eating enough food to fuel fundamental systems, those things are not going to work. And in fact, they might make things a little bit worse. The second dimension is that in the last decade or so, ever since intermittent fasting and other calorie restriction standard strategies have become the thing to do, especially in the longevity space. I've seen
Client after client after client, trying to push through the misery of intermittent fasting, despite the massive mismatch between what they need and what intermittent fasting does to them. That does not mean to say, and I do not mean to say that intermittent fasting is bad across the board. It's certainly not, and it has its place. But to think that every single person is going to benefit from doing it just kind of ignores physiological reality.
Like when your core symptomatology and your lack of quality of life is being driven by a lack of fuel, And if you don't fix the problem, you don't fix the problem by lowering your fuel intake.
Dr. Steven Noseworthy (15:13.474)
When your core systems are being driven by a lack of fuel, you don't fix the problem by lowering your fuel intake. That would be like having your gas gauge on empty. And instead of pulling into the gas station and filling up, you cut your fuel line. Those two things don't go together. So sometimes the answer to fatigue is simply eat more food. And ideally, you would know how much and what type of food is best for you to get those extra calories.
And if you can't figure that out on your own, you know, you can reach out to me and we can set up a consult and we can do a diet review. Never step over a simple foundational rock like calorie balance just to chase a complex, expensive, trendy biohack or supplement protocol. You have to fix the fundamentals first. And in the world of too simple, often overlooked, there is a second problem that deserves mention.
And that is anemia. Anemia of any kind can create fatigue. But I want to chat quickly about iron deficiency anemia specifically, because it's probably statistically the most common one and it tends to hit women of reproductive age more so than men. And here's the bottom line with iron deficiency anemias and why they contribute to fatigue. The very simple fact that our most efficient energy production system
Requires the use of oxygen in the mitochondria. This begs the question: how do we get oxygen into our mitochondria? Well, of course, we have this apparatus called our lungs where we breathe oxygen in from our environment. But we have to get a way, we have to have a way to get oxygen from our lungs into our cells. And that's accomplished by a molecule inside your red blood cells called hemoglobin. And again, I know you've heard all these names before. Well, hemoglobin is an
Iron-based protein. And if we don't have enough iron for whatever reason, but the most common cause is going to be menstruation, if you don't have enough iron, you can't make enough hemoglobin, which means you can't carry enough oxygen that even though your lungs might be perfectly healthy and fine, if you're not extracting and carrying oxygen through your bloodstream in these iron-based proteins called hemoglobin, then your cells will have a reduced amount of oxygen available to them.
Dr. Steven Noseworthy (17:36.675)
Now, I'm going to come back to the idea of why is it important to be able to burn energy in the presence of oxygen versus not? But know for right now that if you have a physiological bias or tendency towards low iron states, if you're a woman in her reproductive years and you've got either increased bleeding time or very heavy flow during your cycle, and you're not compensating for that or
Better yet, figuring out why those things are the case, then it's very likely that you're in a state of low tissue perfusion, which means low tissue oxygen, and that by itself will produce fatigue. That is the core presentation, the hallmark presentation of anemia is fatigue. Right? So just consider that as we continue to go further. Now, I want to move beyond this because that, you know, those two things fall into the too simple, often overlooked category.
And let me just say this before I move on. There are many different types of anemias. Iron deficiency is just one. So if someone says you're the you're anemic, your next question should be: well, what kind? Is it iron deficiency? Is it a B12 deficiency? Is it the anemia of inflammation? And there are a host of other non-nutritional, more metabolic and disease states, like for example, chronic kidney disease can lead to anemia states.
Could go off and talk on that one for quite a while. So let's just cut that conversation here. Let me move on to something else called the cell danger response. Once you ensure that energy balance is established, meaning calories in and calories out, we can look at what mitochondria actually do at the cellular level. And as I mentioned before, most of us were taught in high school biology that mitochondria are simply the powerhouse of the cell, these tiny little biological engines.
Whose sole purpose is to convert fuel sources from your diet into ATP, which is the currency of energy. But modern bioenergetics research shows that mitochondria have a second, equally important job, and they interlink, those two interlinks. The first job is to make energy, the second job is to act as an environmental sensor and a security guard for the cell. It's your own personal security detail.
Dr. Steven Noseworthy (19:58.851)
When mitochondria sense persistent danger signals in the forms of oxidative stress or some kind of chronic infection or certain heavy metal toxicities, poor oxygen delivery, like we just talked about, they s they shift out of energy producing mode into self-defense mode. And this is called the cell danger response. They intentionally reduce energy production.
Especially in the context of chronic infection, because many intracellular pathogens, like an Epstein-Barr virus, as one example, and other viruses and other things that infect and invade the cells, they actually require energy to replicate. And if you listen to my episode a couple of episodes ago where I talked about Epstein Barr and other stealth infections, you realize that when you have a chronic virus, which many of us do.
That those viruses hijack the cell metabolism and DNA structures. And so they basically rob all the energy for themselves and leave none for the cell. And so the cell says, no, we're going to shut that down. And so in the cell defense response, or cell, yeah, cell defense response, cell danger response, I should say, they go into a state of low energy production to starve the enemy. So by downregulating ATP production, the mitochondria starves the threat.
And at the same time, it releases its own signaling molecules, like it releases some of the energy into the extracellular space, the space outside the cell. They create reactive oxygen species or what are called oxidants. And they alert the surrounding immune cells that they are under siege so that the immune system can come in and take care of business. And that sometimes might involve damaging or destroying the cell just to get rid of the threat that's inside it.
And so when you are in a state of self-defense with your cells and your mitochondria, the cell damage response, when you take any nutritional support for the mitochondria, like an NAD or an AD plus boosters, or maybe you do cold plunges and you're trying to get your mitochondria to engage. And if you do that while your cells are locked in self-defense mode, you're attempting to force the cell
Dr. Steven Noseworthy (22:19.394)
To generate ATP when its own internal innate intelligence is saying, no, we need to not do that and we need to fight against the enemy. And what's worse, part of the cell danger response profile is the production of inflammation. And if all you do is force the mitochondria to make more ATP without resolving the factors that drove the cell danger response to begin with, you just provide more fuel to make more inflammation.
And those things that create the cell danger response tend to deplete the cell's antioxidant status, particularly glutathione. And if the cell's glutathione defenses are depleted, it forces the mitochondrial output to simply generate more amounts of unbuffered free radicals or oxidative stress that further damages mitochondrial membranes and drives severe post exertional crashes. And the cell danger response in that
You know, severe post-exertional crash is most obvious in people who have very low exercise tolerance, where sometimes not only do they have to dial back the amount of or the intensity of exercise they do, sometimes even simple daily tasks like cleaning the house or doing laundry exhaust them.
So that's the next thing is the cell danger response. And quite honestly, there's a rich body of literature on that, which is a little difficult to summarize just in a shorter podcast episode like this. We're just skimming the surface again of the most common causes of fatigue. Now, this brings us to a second physiological obstacle in chronic fatigue. And that relates to how your cells actually process the fuel sources, right? Glucose, fats, and carb or amino acids.
And why so many people experience fatigue and even muscle soreness and certainly brain fog after either exercise or just simple daily tasks that overwhelm their energy production system. We're going to call this section here, I call it the pyruvate blockade or the pyruvate bottleneck. So when you eat carbohydrates in particular, your body breaks that down into glucose, which goes through a
Dr. Steven Noseworthy (24:38.52)
Pathway inside the cell called glycolysis. Glyco meaning glucose, lysis meaning break apart. And so essentially what the cell does is it takes glucose, which is a six-carbon chain, and it breaks it up into smaller pieces. That's called glycolysis. And
When the body does that, when the body uses glycolysis, and again, this is happening outside of the mitochondria. When it uses glycolysis to break up glucose into smaller bits to eventually create energy, it creates a compound called pyruvate. So from glucose, we make pyruvate. And this process, this glycolysis, or what we call the glycolytic pathway, is anaerobic.
We mentioned the word anaerobic before. That's making energy without the benefit of oxygen. And while there are several different distinctions that we can make between aerobic and anaerobic energy, let me point out two that are relevant for this point of the discussion. The first is that making ATP using glucose, but without oxygen, is a relatively inefficient way to make energy. You want to make energy through your mitochondria, through aerobic metabolism with the benefit of oxygen.
Because by doing so, you make on average about 17 times more ATP than if you ran through the glycolytic anaerobic pathway outside of the mitochondria. And these two systems are interlinked. They're not independent or not 100% in independent. As you burn glucose without oxygen outside the mitochondria in this anaerobic pathway, it creates that byproduct that we call pyruvate. And pyruvate is the link between the two systems.
Because pyruvate that's produced outside the mitochondria by breaking down glucose can enter the mitochondria, where now we have oxygen availability and where pyruvate can go into the aerobic system. But just because pyruvate can enter the mitochondria doesn't mean it does. Because this is an active transport mechanism that can fail under certain circumstances.
Dr. Steven Noseworthy (26:54.166)
And while there are many factors that can affect this and essentially create this pyruvate blockade that I'm talking about, let me just mention a few that fall within the scope of functional medicine. First of all, any deficiency, like true deficiency of many of the B vitamins and even magnesium and another compound called lipoic acid, can block pyruvate from getting into the mitochondria. So too can the presence of
Heavy metals like arsenic and mercury. Too much alcohol can do it. But perhaps the most common are metabolic factors like having an iron deficiency anemia or a B12 anemia or insulin resistance or simply inflammation can do the same thing. And again, I just gave you this list. The whole point is that if you have any or
Multiple of these in play at the same time, it can prevent pyruvate from going outside the mitochondria into the mitochondria, which is really where we want to make energy. So, what's downstream of this pyruvate blockade? What's the consequence if we can't get pyruvate into the mitochondria to be used as a fuel source in the presence of oxygen? Well, you're limiting your energy production to what comes before that.
You're limiting your if you can't get into the mitochondria to make energy. You're lim limiting energy production to burning glucose outside the mitochondria without oxygen. And this drops energy production by as much as 1700%. Seventeen hundred percent. And this is why so many chronic fatigue patients report feeling that, you know, they feel like they just ran a marathon after just walking up a flight of stairs or or grocery shopping.
Their cells cells are limit literally
Dr. Steven Noseworthy (28:48.866)
This is why so many chronic fatigue patients report feeling like they ran a marathon after simply walking up a flight of stairs or carrying their groceries. Their cells are literally accumulating pyruvate outside the mitochondria because they can't get it into the mitochondria and they can't shift to mitochondrial and energy production. And that's where the high yield chemical reaction is that creates abundant energy.
When you try to push through this low energy state with more and more exercise or some of these biohacking nutrients and stimulants, you don't fix the blockade, you don't fix the bottleneck. You simply generate more pyruvate that can't get into the mitochondria, and you consign yourself to not only a low energy state, but here's the kicker. As pyruvate accumulates inside the cell, it shifts the internal state of the cell.
to one of high inflammation and oxidative stress that further impairs cellular energy production and what's worse, causes mitochondrial damage. And you end up perpetuating the very problem that you're trying to fix. And these kinds of strategies often leave people exhausted, sore, brain foggy. And listen to me now, this can't be fixed with simple traditional mitochondrial support nutrients.
Just CoQ10 is not going to do it, NAD is not going to do it, nicotinic riboside is not going to do it, red lights are probably not going to do it. Even providing these deficient nutrients, that's not going to do it because the problem has evolved past the deficiency to a systemic pro-inflammatory, pro-oxidative stress with mitochondrial damage that usually exists in the context of multiple.
Metabolic imbal imbalances compounded by the effects of chronic inflammation, chronic infections, and environmental toxicity. Supplements alone won't do it. You need a personalized and strategic big rocks first approach, right? We stop chasing shiny biohacking shortcuts and we start respecting the hierarchy of function.
Dr. Steven Noseworthy (31:06.018)
Now, having said all that, there is a lot more to say, but I've run out of time for today. Let me make some honorable mentions before I summarize and we close out this episode. The first honorable mention goes to hypothyroidism, especially Hashimoto's, which by definition will cause fatigue for a couple of primary reasons. True hypothyroidism creates a low thyroid hormone environment. And thyroid hormones, free T3 particularly,
Is required to stimulate mitochondria to activate and engage in self-repair. Secondly, Hashimoto's, by its very nature, is pro-inflammatory. And the inflammation itself inhibits energy production on many different levels. Other hormone deficiencies like low progesterone, estrogen, testosterone, can also play a role since your mitochondria have receptors for all of these reproductive type hormones as well.
Not just thyroid hormones. And finally, let's throw in there just being in a deconditioned state. If you don't move your body that much, you don't engage the systems that are responsible for maintaining the right number and the right size of your mitochondria. And exercise is by far the single most potent driver of mitochondrial biogenesis. But too often people find themselves stuck in a self-perpetuating loop.
Something causes poor mitochondrial function and low energy, which impairs your ability to engage in and recover from exercise, which leads to fewer and smaller mitochondria, which results in even lower energy, and the loop just keeps going round and round. And while ultimately one of the ultimate goals that I have with my clients is to have them exercising, not just because it's a good idea and we all know we should, but exercising as a therapeutic tool for recovery.
In cases like this, we often have to do some metabolic restoration and balancing before we can do that. And when we get to the point where adding exercise into a three-stage journey makes sense, we have to do it in a graded and controlled manner. And it's not simply enough to say join a gym or go hire a trainer because your starting point is different than the average person who doesn't struggle with these mitochondrial defects or problems and chronic fatigue.
Dr. Steven Noseworthy (33:33.196)
So if that describes you where somewhere along the way you had to seriously limit exercise or stop altogether and you're at the point where just simple daily tasks exhaust you, just know that there are people out there like me and others who know how to bring you from point A to point B without crashing your system.
So let me summarize. And I'm going to share with you a general step-by-step framework that I've developed. And I've based this on, you know, my almost 30 years now of clinical experience, as well as my understanding of human physiology and how all these different systems integrate and cooperate together. And of course, the precise application of what I'm going to share with you right now is going to vary from person to person, but in general.
One of the first things you have to do is just ensure baseline energy mechanics, proper calorie intake, avoiding both chronic calorie overload and prolonged metabolic starvation. Number two, we have to consider tissue perfusion and oxygen delivery. Before we even touch mitochondrial type supplements, we have to look at your functional blood chemistry analysis. We have to look at your iron or ferritin levels. We have to look at your red blood cell markers and figure out.
Do you have an anemia? And if so, what kind? And what caused that? And how do we fix that portion? Then we have to consider whether or not you have good metabolic flexibility. Can you efficiently use glucose as a fuel source? Can you switch into burning fat as a fuel source on demand based on your activity levels? Or have you lost that to some degree? So if you're not efficient at using glucose and fats equally well, you're going to have problems with energy production.
We look also for evidence of increased oxidative stress. We have to replenish, or I should say we may have to replenish your glutathione levels and other antioxidants and address the root cause disruptors that are driving the increased oxidative stress to begin with. And that might be stealth infections or mold toxins or leaky gut or fill in the blank of all the things that you hear about when you listen to your podcast. They all fall into this category.
Dr. Steven Noseworthy (35:48.835)
We also have to consider this pyruvate blockade. And even though I'm saying it's not as simple as giving targeted nutrient cofactors, sometimes we need to give that, but only in the context of that bigger picture. But we need to make sure that we're doing everything to allow pyruvate to go from outside the mitochondria into the mitochondria, where we have that high-yield energy production system. And then the last thing we do.
is introduced, introduce a graded functional training program. Once the cells can safely generate APT, ATP, without triggering oxidative damage, we reintroduce precise doses of physical activity that are tailored strictly within the patient's individual metabolic capacity to avoid these post-exertional crashes. And there's a whole system that I've developed
That I teach other doctors that we use with my or I use with my own clients. When you ensure optimal calorie intake and you improve tissue perfusion, oxygen delivery, metabolic flexibility, resolve any mismatches between oxidative stress and antioxidant capacity, and you address large-scale metabolic and environmental challenges. Your mitochondria naturally shift out of defense mode and they resume.
Clean sustainable energy production.
Chronic fatigue is usually not a simple nutrient or thyroid hormone deficiency. It is a biological state that demands a systematic evaluation of all of those different hierarchical physiological priorities that we just talked about. You cannot outhell let me say it this way you cannot outhack a cell locked in self defense mode. And crafting wellness, as I say,
Dr. Steven Noseworthy (37:49.384)
every time I close out these episodes is not the same thing as managing diseases or symptoms. Crafting wellness is not the same as just simply employing internet biohacks or protocols to change symptomatic expression, especially if it's not addressing underlying root cause disruption. Crafting wellness requires to identify root cause disruptors, evaluate your foundational systems,
And move strategically and step by step through a personalized, structured, three stage health journey. And that's why I run the practice the way I do, which is low volume, high engagement. I don't take on a lot of new clients every month because I simply want to spend enough time to solve these puzzles. And if I'm trying to see 20 patients in a day, that's not going to happen because I only have 10 minutes, 15 minutes tops with each person. And it doesn't work well for me and for them.
When clients work with me, it's just me. I don't have any staff. And I designed it that way on purpose. I've done that before. I've been in large clinics. I've run as a clinic director, multidisciplinary clinics with medical doctors and nurse practitioners and chiropractors and acupuncturists and so on and so on. So on. I've done that, and I don't, I'll never go back to that because the quality of my care went up immensely when I went out by myself. So if you are
Ready to stop the biohacking madness and to stop majoring in the minors, and you're ready to address, address the root cause or causes that are driving your chronic fatigue, then reach out to me today. You're going to find my direct phone number, my email, a link to an online web request form in the episode description. You can text me, call me, email me, use the web request form.
Reach out and say you want to schedule a one-on-one consultation, which we do over Zoom. And I'd be honored to walk through your options. So thank you for listening to The Inflammation Nation. Remember, put your big rocks in first. Stay rooted and grounded. And I will see you in the next episode.
