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July 1, 2025 18 mins

Feeling exhausted beyond ordinary tiredness? That persistent, debilitating exhaustion that rest doesn't fix might be chronic fatigue—a condition affecting 2.5 million Americans yet frequently misdiagnosed or dismissed by conventional medicine.

Dr. Dolcecore takes us on a comprehensive journey through the five scientifically-validated root causes of chronic fatigue. From post-viral syndromes (including long COVID) to mitochondrial dysfunction, HPA axis dysregulation, environmental toxicity, and circadian disruption—each mechanism explains why standard medical tests often come back normal despite profound symptoms. Most revealing is how these systems interconnect, creating a perfect storm that conventional medicine struggles to address.

The episode highlights the striking limitations of traditional testing while offering hope through functional medicine alternatives. Rather than accepting normal blood work as the end of investigation, Dr. Dolcecore advocates for deeper testing: salivary cortisol rhythms, organic acid panels, comprehensive gut assessments, and environmental toxin screening. The most powerful aspect is his practical, evidence-based approach to recovery—from mitochondrial support (backed by 2022 research showing CoQ10's effectiveness) to nervous system regulation techniques and precise nutritional interventions.

Whether you're personally suffering or supporting someone with chronic fatigue, this episode delivers transformative insights with scientific backing. Chronic fatigue isn't laziness—it's a complex condition with identifiable causes and effective solutions. Ready to move beyond being tired of being tired? Connect with resources at fulllifetampa.com and discover how true healing becomes possible when your body receives the right support.

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
We've all felt tired, but what happens when tired
becomes your normal?
When you wake up exhausted,drag yourself through the day
and feel like no amount of sleephelps?
That's not laziness, it's oftenchronic fatigue.
I've seen patients who've hadevery test come back normal, yet
they could barely function.
Today we're digging into whathappens and what you can do to

(00:25):
reclaim your energy.
Thanks for joining us this week.
I'm Dr Enrico Dolcecori, andwelcome to another episode of
Living a Full Life.
Chronic fatigue is no joke, andit becomes more and more
difficult to deal with as timegoes on.
Chronic fatigue is persistent,debilitating exhaustion that
doesn't improve with rest andlasts for at least six months.

(00:48):
It's often accompanied bycognitive issues like brain fog,
muscle pain or weakness,unrefreshing sleep, sensitivity
to light noise exertion, lightnoise exertion.

(01:09):
The reality to check about isthat it affects up to 2.5
million Americans every year,according to the CDC.
It's often underdiagnosed,especially in women.
Many sufferers are misdiagnosedwith depression, anxiety or
just being run down, and they'releft in the dark afterwards,
which is no fun because thefatigue remains.
So what we're going to do todayis we're going to dive into
chronic fatigue, the medicalportion of it, what it is, how

(01:32):
it happens, how it affects usand maybe even how we can try
and help ourselves to finallyturning the table on the fatigue
issues.
We've got to get down to theroot causes of this.
So there's a few differentthings on here.
I'll give you five that theresearch supports and that I've
seen as a clinician in my officetrying to help people, you know

(01:52):
, with musculoskeletal issues.
But also guess what theirsecondary stuff is Fatigue,
they're just tired.
So number one is the post viralsyndrome.
Chronic fatigue syndrome is nowcalled myalgic
encephalomyelitis, so it'smuscle pain that is inflammatory

(02:13):
.
It falls into the muscularconditions of myelitis and often
triggered by viral infectionslike Epstein-Barr, covid-19, and
these types of viruses thathave happened over long periods
of time.
A 2022 review in Nature ReviewsImmunology found long COVID

(02:34):
shares features with ME CFS,including immune dysregulation
and mitochondrial dysfunction.
So not only can it becomepainful, but the chronic fatigue
definitely wears you down inmany different ways.
So post-viral so viruses thatare affecting us, typically
affecting our mitochondrialproduction of energy within our

(02:57):
cells.
Then there's number two themitochondrial dysfunction.
That can happen not just withviruses, but just for many
different reasons.
The mitochondria is your body'senergy engines.
They're on every single cell inthe human body.
Fatigue often results whenmitochondria can't produce ATP
efficiently due to oxidativestresses or toxin exposures.

(03:20):
Another research study in 2023from Frontiers in Physiology
linked chronic fatigue symptomswith reduced mitochondrial
respiration and increasedinflammation.
Another one is adrenal fatigueAPA axis dysregulation.
You may have heard of adrenalfatigue, but I don't think we

(03:41):
address it very well.
Adrenal fatigue, but I don'tthink we address it very well.
Chronic stress alters yourbrain's messaging to your
adrenal glands, leading to lowcortisol output and poor energy
mobilization.
It's often referred to asadrenal fatigue, but more
accurately, hpa axis dysfunction.
This is one we're going to diveinto a little bit through the
podcast.

(04:02):
Number four is toxins, molds andheavy metals.
Environmental toxicity canburden the liver and
mitochondria, suppressing energysymptoms.
So this one, I think, is theunderlying cause for some not
all People.
They're being chronicallyexposed to something in their
environment, typically theirhome or their workplace.

(04:23):
Toxins can be anything.
It can be chemicals fromcleaning supplies, it can be
construction material, it can bepaint material, it can be
whatever Flooring, it can be awhole bunch of carpet.
It can be a whole bunch ofthings there Dust, bunnies,
dander, mold, heavy metals andif we're chronically exposed to

(04:43):
this stuff.
Some of us may have mildallergies to some types of
animals and we have them as petsin our home and don't even know
it.
We don't have the classicalitch or rash allergic reactions
to the dogs, cats, birds,bunnies, whatever we have, but
we may have this underlyingcondition there too.
And then, lastly, sleepdysfunction and circadian

(05:06):
disruption.
And then, lastly, sleepdysfunction and circadian
disruption even if you're asleep.
Poor sleep architecture meansno true restoration and over
time can lead to chronic fatigue.
So I think those are the bigfive pinpoints to fatigue and
chronic fatigue in general, andwe're just going to go over
these and see medically what wecan do for ourselves and the
ones we love to help them maybeget out of this, which is pretty

(05:28):
amazing.
Part one is the diagnosis howfatigue is medically evaluated.
We need to really just reviewthis.
It's kind of lackluster.
You're not going to get tooexcited on this portion of the
podcast because we really don'tdo much for it, but we need to
and you need to advocate foryourself.
So traditional medical testingis, you know, blood testing,

(05:49):
thyroid panel.
We check the TSH, the T3, theT4, come back normal CBC to look
for anemia or infections.
We look at these centophils,the lymphocytes, the monocytes,
see if you're finding a chronicinfection typically come back
normal CMP.
We want to look at the liver,kidney function, vitamin D, b12,
iron, ferritin.
Now these tests for some peopledo come back with some stuff.

(06:12):
People are either vitamin Ddeficient, low B12, maybe have
some ferritin issues, red bloodcell size issues, almost like an
anemic issues where thosethings can be worked on.
And then autoimmune markerslike ANA, crp, checking these
things.
That's the typical medicalblood work that sets out come

(06:34):
back.
But what happens if that allcomes back normal?
These do mostly come back normal, making patients feel dismissed
, saying, hey, this justhappened to me a month ago.
I went for my testing.
I told him, hey, I'm feeling alittle fatigued, can we run some
tests?
She said nothing about thefatigue, sent me for the same
exact panels and came back.
But luckily I can help myselfand go dive deeper into that and

(06:55):
order some other panels thatmay be useful.
A 2021 article in the Lanceturges more comprehensive
metabolic and inflammatoryprofiling for fatigue patients.
So when patients come in withfatigue, medical providers
should be diving a little bitmore deeper into the metabolic
and inflammatory panels, doingmore than just the ANA and CRP.

(07:18):
So we want to get into more of afunctional medical approach to
this.
We need to dig deeper, and it'sfunny how functional medicine
has become a word in medicinewhere if you do more for the
patient to dig deeper, it'scalled functional medicine.
It's no longer medicine.
So medicine is not even reallya thing that you go for for your

(07:38):
wellness anymore.
It's really to look forpathology.
And if pathology doesn't pop upright away, like cancer, heart,
heart disease, diabetes rightoff the bat, then you need to
look into functional medicineand I think that's the majority
of people need to find afunctional medical provider that
looks at their overall wellnessto keep them well.
I think that's the best part ofit.
And then if a pathology isfound, guess what?

(08:00):
You're bounced back to medicineand they get to do what they do
best and help with pathology.
So that's the thing.
Most of these conditions we dealwith most of the time are not
pathological.
They're not going to end upwith death being the final
result of it, but they can leadus down a road, like chronic

(08:20):
fatigue can lead us down a roadto other conditions and diseases
that could become pathologicalMake sense.
So a functional medicalapproach is the way to do this.
We have to dig deeper.
Salivary cortisol rhythmslooking at cortisol rhythm can
give us a real test on what'sgoing on.
If it's hormonal, cellular ordigestive causing the chronic

(08:40):
fatigue can tell us.
If it's hormonal, it can besleep related.
We can try and affect sleep.
If it's gut related, we thencan try and help heal the gut.
Organic acid testing formitochondrial markers, gi
testing for dysbiosis or candida, so having a stool test to see
the biosis of bacteria andviruses in the gut, mycotoxin

(09:03):
testing for mold exposure andnutrient depletion panels to see
if we're truly depleted.
Usually that's done lastbecause we want to fix the
underlying things first.
When we fix the diet and allthese things, if we're still
having nutrition depletion thenwe've got an absorption issue
with the gut and it all leadsback to the gut.
So doing the gut stuff first isreally the primary panel.

(09:25):
For majority of patients withfatigue and chronic fatigue is
the gut.
That's typically number one, Iwould say 80% of the patients.
The other 20% is what I justmentioned here the salivary
cortisol rhythms and looking atother deeper markers to see what
is going on.
So what truly helps?
What truly helps these patientsget better and I've seen it in

(09:46):
my practice.
My wife, dr Haver.
She does a lot of this in-depthwork with patients and we see
the people who do it get better.
It's amazing the ones that arelike yes, I'm in, tell me what
to do, let's do it.
They dive in, they do it, theyget better.
They all do.
There's no failures.

(10:07):
Uh, you heal the mitochondria.
That's what needs to happen.
Nutrients coenzyme q10,magnesium b complex nad nad
precursors.
Um.
This podcast in no way, shapeor form, is a solution to any of
your issues.
If you're listening right now,you do not take this information
and go like, okay, he saidcoenzyme q10, magnesium b
complex and you go buy this andyou take this stuff.
You don't know the dosages, youdon't know the medications that

(10:28):
you're taking.
Do not take this as any adviceto heal yourself If the only
advice is it's who to go to todive deeper so that they can
manage your blood work and helpyou in the right way.
That's just a side note, justso you guys know, because I know
you're writing things downAntioxidants, glutathione, alpha

(10:52):
lipoic acid and then removemitochondrial toxins like
alcohol, mold and heavy metalsimmediately you got to get out
of those environments in orderto heal.
So another research study fromthe Journal of Clinical
Biochemistry in 2022.
Coenzyme Q10 supplementation wasshown to improve energy and
mitochondrial markers in fatiguepatients almost everyone.
That is something you probablygo out and take just by

(11:12):
listening to this podcastbecause it's pretty safe.
But again, dosage we want toknow that, based on your age,
height, weight, all those thingsGet the right help for that for
sure.
If you need any help info atfulllifetampacom you reach out
to us saying, hey, can you helpme?
No matter where you are in theUnited States, no matter where

(11:32):
you are in the world, this canbe done virtually as long as we
can get you the right things atthe right time.
These things can be donevirtually by any good doctors
and if it comes to fatigue orgut, dr Hafer is probably one of
the best.
And if it comes to fatigue orgut, dr Hafer is probably one of
the best.
Reset the circadian rhythm.
So we want to reset our circuit.
Wake up with sunlight, limitscreens one to two hours before

(11:54):
bed, keep consistent sleep andwake times.
Use magnesium, glycinate,l-theanine or GABA for nervous
system support.
We've got to go back to oursleep.
I think we've done threepodcasts on sleep.
Go to the search bar on Spotify, put in sleep under living a
full life podcast and you'll seetwo or three episodes pop into

(12:14):
there.
One is called the circadianrhythm.
Listen to that one.
We dive deep into what thecircadian rhythm is and then how
we can regulate that and whatthings we can do to improve our
sleep.
On that one, that's a greatpodcast as well.
Support the HPA access that wetalked about.
The adaptogens rhodiola,ashwagandha, holy basil these

(12:35):
are adaptogens that we can take.
You can take an all-in-one mix.
Again, this is stuff you wantto be advised with Balance blood
sugar, no skipping meals orsugar spikes.
We want to support this axis.
So sometimes in weight lossprograms you'll hear like
fasting.
If you're in chronic fatiguemode, fasting is horrible.

(12:55):
I was there probably a year anda half ago into fatigue and I'm
like man, I've got to a point.
I put on a lot of muscle.
I was trying to lose a littlebit more fat.
I'm like I'm going to startintermittent fasting.
That was the worst thing Icould have done at that time
with my workouts and work.
I was just crashing really fast.
I'm like what's going on?
I was eating a lot of proteindoing all this stuff, but I was

(13:17):
cramming it between 12 and 8.
And I was like but five yearsago when I did do a 35-pound
weight loss, I was intermittentfasting and I felt fantastic as
I was decreasing inflammation,decreasing, but I wasn't working

(13:37):
out.
I wasn't working out as hard asI was.
So see, timing and where we arein our life all matters on how
we do these things, and that'swhy functional medicine comes in
.
They become your coach, yourdoctor, your sidekick, your
partner, your in health.
It plays a big role becausethey dive into your life.
They're like listen, this iswhat's going to work for you and
how you live.
That's the missing key in allof medicine is having a provider

(14:01):
that sits beside you, notacross a desk from you.
So support the HP access bybalancing blood sugar and
limiting stimulants likecaffeine to avoid cortisol
swings.
So insulin balance that's whatwe're talking about is more of a
hormone balance in there.
And number four is the nervoussystem regulation Daily breath

(14:22):
work, yoga, cold exposure, evenchiropractic adjustments can
reduce sympathetic dominance.
We've seen in our practice thatwhen the spine is adjusted and
the nervous system calms down,energy often rebounds as the
body shifts from survival modeto healing mode.
So even chiropractic gettingput in there can help with
energy and fatigue.

(14:43):
And then nutrition I don't knowwhy this is number five.
It should be number one, butit's here.
Anti-inflammatory diet, wholefood-based diets.
Remove gluten, dairy sugar atleast temporarily, as your body
adapts to you, trying to heal,and then emphasize on healthy
fats, clean proteins andcolorful plants.

(15:04):
It's just a whole food dietthat we always talk about.
That's the big stuff there.
Chiropractic can actually help,I think, because we have
functional medicine andchiropractic in our office and
we integrate them both, we getsuch great success.
Adjustments improve the nervoussystem regulation, it reduces

(15:24):
flight or flight drain onadrenals, it restores the
brain-body communication viaspinal cord alignment and it may
increase heart rate variabilityand parasympathetic tone.
From the Journal of ChiropracticMedicine in 2021, chiropractic
adjustments shown to improvesleep and reduce fatigue
symptoms in patients withchronic pain and tension was

(15:45):
universal across the board forall the patients that came in
with those types of chronic painand tension complaints.
So there is hope.
If you're fatigued and you feellike you're fatigued all the
time, it may be chronic.
If it's been bothering you formore than six months, it could
be adrenal, it could be hormonal, it could be mitochondrial, it
could be a whole bunch ofdifferent reasons, but the point

(16:06):
of this is trying to find outexactly what it is.
Chronic fatigue is real and it'scomplex, but it's not hopeless.
Start by tracking your energypatterns, cleaning up your sleep
and nutrition, and seekpractitioners who look deeper
than just basic blood work, andthen you don't have to.
You don't have to live tired.
Healing is possible, and whenyour body has the right support,

(16:29):
it remembers how to thrive.
Remember that as you're seekingthis stuff, and use not just
this podcast or me or anything,but use the guidance that you
receive in life as beacons oflight to just adapt to and to
respond to.
This might be a calling at theright time for you to just send
that email info atfulllifetampacom.

(16:49):
It may not be us, it may not beDr Hafer, it may not be anyone
that we, you know, practice withor in our network, but we'll
find you the right people thatare experts in the field,
because Instagram is is, youknow, a source of entertainment
and sometimes a source ofinformation, but it's not
exactly the best in the industryout there.
So let us help you.

(17:10):
That's the whole point of thisthis is the whole point of the
podcast is to reach more peopleand help more people.
So come out to us, reach out tous.
Info at Full Life Tampa, anyquestions you have, just send
them to us and we'll be morethan happy to help you.
Stay well, stay healthy, takecare.
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