The late afternoon crash you’re feeling isn’t just a sign that you need another coffee or a weekend of sleeping in. It’s an important data point. When exhaustion becomes your new normal, your body is telling you that its internal machinery is struggling to keep up with the demands of your life. In my practice here in Charlottesville, I don’t look at fatigue as a character flaw or byproduct of a busy career. I look at it as a physiological breakdown in how you produce and use energy. We’re here to identify why your cellular engine is stalling and get you back to peak function.
Exhaustion is a persistent state of depleted physical and mental energy that does not improve with rest. Biologically, it usually stems from mitochondrial dysfunction, hormonal imbalances, or nutrient deficiencies that prevent your body from converting fuel into usable energy.
When a patient tells me they wake up feeling exhausted, feel tired all the time, or slump in the later afternoon or evening, we start by looking for the root causes. Exhaustion is rarely caused by one thing. It’s usually a combination of biological and environmental factors. I often find an underlying medical condition, like a decrease in testosterone or thyroid levels, that acts as a brake for your metabolism.
But it goes deeper than that. Often it’s mitochondrial dysfunction—the batteries in your cells aren’t converting nutrients into energy efficiently. Other times, it’s chronic inflammation, perhaps starting in the gut, that forces your immune system to use all the resources, leaving little for your brain or muscles. While everyone deals with temporary dips, persistent or severe fatigue is a signal that your body is overtaxed and under-resourced.
Normal labs don’t always mean you’re healthy. Most doctors look for common diseases; I look for inflammation and optimization. I want to see the process of how your body is actually performing. We use advanced blood chemistry to find your optimal zones for hormones and vitamins, the levels where you actually feel alive, not the levels that keep you out of the hospital.
To better understand chronic fatigue and persistently low energy, we measure your Resting Metabolic Rate (RMR)—the amount of energy your body requires at rest to sustain vital functions such as breathing, circulation, cellular repair, and hormone signaling. RMR testing allows us to determine whether your metabolism is functioning appropriately or has become suppressed due to factors such as chronic stress, under-fueling, inflammation, hormonal dysfunction, or prolonged illness. When RMR is lower than expected, it often reflects adaptive metabolic downregulation, a state in which the body conserves energy at the expense of vitality, performance, and recovery. By identifying these patterns, we can tailor nutrition, exercise, sleep, and hormone strategies to restore metabolic efficiency and improve sustainable energy production—rather than relying on stimulants or guesswork.
Think of your hormones as the software for your energy production. If your testosterone or thyroid levels have dipped, no amount of caffeine will fix the underlying tiredness. By restoring these levels to their peak performance state, we can essentially reboot your metabolism.
If your body is struggling with obesity or insulin resistance, your energy levels will always be erratic. Using medications like Semaglutide or Tirzepatide, we can stabilize your blood sugar and reduce systemic inflammation, making it much easier for your body to burn fuel efficiently.
We can’t build a high-performance engine without the right materials. I use high-bioavailability Thorne supplements and a healthy diet to feed your mitochondria directly. We’ll also talk about how alcohol or poor sleep might be sabotaging your well-being.
We utilize targeted metabolic and cellular therapies—including NAD+ support, methylene blue, and select peptide-based interventions such as sermorelin or tesamorelin—to optimize mitochondrial function, cellular energy production, and physiologic recovery. These therapies work at the level of cellular signaling and repair, supporting healthy aging pathways, improving resilience to stress, and enhancing recovery and performance. By restoring efficient energy production and growth hormone signaling, we address the underlying drivers of chronic fatigue rather than masking symptoms with stimulants or temporary fixes.
If you’re a Charlottesville professional or athlete who feels like you’ve lost your edge, you’re likely a candidate. This is for the person who wakes up tired despite a full night’s sleep or someone who has noticed a sense of declining performance that they can’t push through anymore. We’re looking for the specific symptoms that indicate your internal systems need a recalibration.
When we meet, we’re going to have a real conversation about your life, your stress levels, and other symptoms like pain or anxiety. We’ll combine your personal history with hard data from our metabolic and body composition testing to create a blueprint designed specifically for your body.
Since we’re focusing on biological optimization, there’s no surgery or downtime. But we are asking your body to change how it functions. Most of my patients start seeing sleep disturbances clear up, and their mood stabilizes within the first few weeks. By week six, that heavy shroud of exhaustion usually starts to lift, and you’ll find you have the energy to actually enjoy your daily activities again.
This is a long-game strategy. While you’ll likely feel a shift early on, my goal is to fundamentally change your health trajectory. Over the first few months, you’ll see your stamina return and your mental fog evaporate. We do quarterly check-ins to make sure your energy levels stay optimized and that you’re hitting the metrics we’ve set for your long-term health.
I’m a firm believer in transparency. The cost of your treatment reflects the complexity of the diagnostics and the specific therapy your body requires, whether that’s hormone pellets, injectable peptides, or a metabolic reset. Because everybody is different, pricing is customized to your specific needs and longevity goals.
I’m not just an MD/PhD who understands the science of exhaustion; I’m someone who has used these exact treatments to optimize my own health. I know what it feels like to struggle with low energy, and I know exactly what it takes to fix it. In Charlottesville, my clinic is the only place where you get this level of data-driven, personalized care. We don’t just treat symptoms; we optimize you.
If you’re done with feeling exhausted and ready to see what your body is actually capable of, let’s get started. We’ll use the best diagnostics available to identify your hurdles and build a plan to clear them. Contact my office to schedule your vitality assessment.
Longevity Health Clinic 4100 Olympia Circle, Suite 106 Charlottesville, VA 22911 (434) 260-3306 Book Your Consultation Online
Standard labs are designed to find disease, not peak health. You might be “normal” for a sedentary person, but not optimal for the life you want to lead. I find the gaps that standard medicine misses.
Absolutely. Hormones like testosterone and thyroid are the primary drivers of your energy. When they’re out of balance, your body can’t sustain energy levels throughout the day.
Yes. Gut health plays a central role in energy, metabolism, and immune regulation. Disruptions in the gut—such as poor nutrient absorption, chronic inflammation, dysbiosis, or increased intestinal permeability—can impair mitochondrial function, hormone signaling (including thyroid hormones), and neurotransmitter production, all of which are critical for sustained energy. When gut health is optimized, many patients experience meaningful improvements in fatigue, mental clarity, and overall resilience.
Yes. Mental health and physical health are a two-way street. Depression or anxiety can lead to tiredness, and chronic exhaustion can certainly cause a low mood. We look at the whole picture to ensure we’re treating the root cause.
Conditions like rheumatoid arthritis can occur alongside severe fatigue. If you’re experiencing joint pain along with your exhaustion, it’s important we talk about it so I can rule out serious medical conditions or heart disease.
