Functional Medicine · Waltham, MA · Serving Greater Boston
Chronic Fatigue: Finding and Treating the Root Cause
If you’re exhausted no matter how much you sleep, and you’ve been told your labs are “normal,” you’re not imagining it, and you’re not out of options. At Inner Healing Medical in Waltham, about 20 minutes from downtown Boston, our providers take a functional medicine approach to persistent fatigue: a longer, deeper investigation into why your energy is gone, followed by a personalized plan to rebuild it.
A full care team. Your fatigue workup at Inner Healing Medical is led by our providers: board-certified family medicine physicians Dr. Marianela Lavena, MD and Dr. Stephen Roberts, MD, and functional-medicine-trained nurse practitioners, each caring for their own patient panel. Medical visits may be billed to insurance. Call 781-614-7800 or email info@innerhealingmedical.com.
Why standard workups often miss the cause of fatigue
A typical primary care visit has time to check a basic panel (CBC, a single thyroid marker, maybe iron) and rule out emergencies. That matters, but persistent fatigue usually lives in the layers a rushed visit can’t reach: subclinical thyroid dysfunction, depleted iron stores with a “normal” hemoglobin, disrupted cortisol rhythm, poor sleep quality (including undiagnosed sleep apnea), gut dysfunction that limits nutrient absorption, chronic low-grade inflammation, post-viral changes, mood, and the cumulative load of stress. Functional medicine is designed for exactly this territory: extended appointments, a detailed timeline of your health history, and broader targeted testing, so that treatment addresses causes rather than masking symptoms.
Root causes we investigate
Hormonal & metabolic
- Full thyroid evaluation (TSH, free T4/T3, antibodies)
- Cortisol rhythm and stress physiology
- Sex hormone changes, including perimenopause
- Blood sugar regulation and insulin resistance
Nutritional
- Iron stores (ferritin), B12, folate
- Vitamin D and key micronutrients
- Absorption problems tied to gut health
- Diet patterns that drive energy crashes
Gut, immune & inflammatory
- Microbiome imbalance and gut dysfunction
- Food sensitivities and inflammatory triggers
- Post-viral fatigue (including after EBV or COVID)
- Autoimmune and inflammatory conditions
Sleep, mind & lifestyle
- Sleep quality and sleep apnea screening
- Anxiety, mood, and nervous system regulation
- Overtraining or deconditioning
- Environmental exposures
How treatment works at Inner Healing Medical
There is no one fatigue protocol, because there is no one cause. After your evaluation and testing, your provider builds a sequenced plan that may combine conventional treatment where it’s indicated, targeted nutritional repletion, gut restoration, hormone and thyroid optimization, sleep interventions, stress-physiology work drawn from our mind-body medicine programs, and, when appropriate, supportive therapies from our Waltham clinic such as physician-supervised IV nutrient therapy.
Because we practice membership-based integrative primary care, your plan is followed up on, visit after visit, by the same care team rather than handed to you as a one-time report.
A note on ME/CFS — we take the distinction seriously
Not all chronic fatigue is chronic fatigue syndrome. If modest physical or mental activity reliably triggers a delayed crash lasting a day or more (post-exertional malaise), that pattern points toward ME/CFS, which deserves careful, conservative management (pacing first, no pushed exercise) and coordination with conventional specialists where needed. Our providers will tell you honestly which parts of your presentation fit a functional-medicine workup, which need conventional specialty care, and how we can coordinate both. That candor is part of practicing real medicine.
Tired of being tired?
Reach out to our team in Waltham to learn whether our approach is right for you. Serving Boston, Lexington, Newton, Belmont, and Watertown.
781-614-7800 · info@innerhealingmedical.com
465 Waverley Oaks Rd, Suite 201, Waltham, MA 02452
Contact UsFrequently asked questions
What can cause chronic fatigue?
Common contributors include thyroid dysfunction, low iron stores or B12, disrupted cortisol and chronic stress, poor sleep or sleep apnea, gut and microbiome problems, chronic inflammation, post-viral changes, blood sugar dysregulation, hormonal shifts such as perimenopause, and mood conditions. Most people with long-standing fatigue have more than one contributor, which is why single-fix approaches often fail.
How is a functional medicine fatigue workup different from a standard one?
The main differences are time and depth. Your initial evaluation involves an extended visit and a detailed health timeline, and testing goes beyond a basic panel: full thyroid markers, ferritin, vitamin D, B12, inflammatory markers, cortisol patterns, and gut or hormone testing when your history points there. Treatment then targets the specific causes found, rather than offering a generic “eat better and rest” plan.
What testing do you run for fatigue?
Testing is individualized. It typically starts with comprehensive blood work (thyroid panel with antibodies, ferritin and iron studies, B12/folate, vitamin D, metabolic and inflammatory markers) and may add cortisol rhythm testing, gut/microbiome analysis, food sensitivity evaluation, or sleep apnea screening depending on your presentation. Standard labs can often be billed through insurance; specialty functional labs are quoted before anything is ordered.
Do you take insurance?
We accept most major insurance plans for medical visits (not MassHealth or MassHealth-affiliated plans). Membership fees, specialty functional laboratory testing, and certain wellness services are separate from insurance. We’ll explain exactly what’s covered before you enroll.
Can Inner Healing Medical be my primary care provider?
Yes. Our physicians and nurse practitioners can serve as your primary care provider, handling preventive care, prescriptions, and referrals, with functional and integrative medicine built into the same relationship. Each provider cares for their own patient panel.
Where are you located? Do you see patients from Boston?
We’re at 465 Waverley Oaks Rd, Suite 201 in Waltham, MA, about 20 minutes from downtown Boston with free on-site parking and minutes from Lexington, Newton, Belmont, and Watertown. Telehealth visits are available for patients across Massachusetts.
This page is for educational purposes and is not a substitute for medical advice. If you have chest pain, severe shortness of breath, or other alarming symptoms with your fatigue, seek urgent care immediately.