Chronic Fatigue
When the Body and Brain Simply Don’t Recover
When Is Fatigue Already Chronic and Not Just a “Phase”?
When energy levels remain low over time and everything feels heavier, it is not always a matter of rest. Chronic fatigue is a symptom, not a diagnosis.
If you feel a lack of energy almost every day, have difficulty functioning at work and at home, fall asleep or feel drained after a meal, wake up tired even after a full night’s sleep, or feel that your body does not recover after physical activity, it is a sign that it is worth stopping and investigating more deeply.
What Can Cause Chronic Fatigue?
Prolonged fatigue can result from a variety of factors — and sometimes from several of them together:
An undiagnosed sleep disorder
Ongoing overload and chronic stress
Hormonal imbalance
Nutritional deficiencies or an unbalanced metabolic state
A reaction to medications or certain foods
Chronic infections that have not been fully treated
Environmental exposure — mold, dampness, and toxins
Habits that drain energy over time
When we understand what is behind the fatigue — it becomes possible to start treating it rather than just coping with it.
What Do People Usually Describe?
Difficulty getting up in the morning even after sleep
An “energy crash” after eating
Reduced concentration and patience throughout the day
A feeling of heaviness or overload in the body
Difficulty maintaining physical activity or slow recovery
A feeling of ongoing burnout with no “single explanation”
Our Approach
At the clinic, we combine neurological assessment with a broad mapping of medical background, lifestyle, and environment in order to understand what may be affecting energy, concentration, and functioning.
In appropriate cases, environmental and biological factors such as mold and dampness, biotoxins, heavy metals, environmental sensitivities, and chronic infections are also examined. When the overall picture is appropriate, treatments from the fields of CIRS and environmental health may be integrated, particularly the approaches of Dr. Ritchie Shoemaker (Shoemaker, MD) and Dr. Neil Nathan (Nathan, MD), with careful and personalized adaptation.
Based on the findings, a personalized and gradual plan is developed, which may include adjustments to lifestyle and environment, additional testing, supplements, or medication as needed.
Alongside her clinical work, Dr. Karin Elman-Shina founded Enviro Health Israel, an initiative to promote awareness, knowledge, and research in the field of environmental health and CIRS in Israel.
From the Clinic
Frequently Asked Questions
How Do You Know If It’s “Fatigue” or a Medical Issue That Requires Evaluation?
When fatigue persists over time, keeps recurring, affects functioning, or does not improve despite rest, it is worth undergoing a comprehensive evaluation. During the consultation, we organize the information and decide what is important to investigate.
Can Fatigue Be Related to Sleep Even If I “Sleep Enough”?
Yes. And more often than people think. The number of hours of sleep is only part of the picture. What happens during sleep is no less important.
Non-restorative sleep can look like this:
Fragmented sleep — awakenings that are not always remembered
Abnormal breathing during sleep that prevents entering deep sleep
Mental or physiological overload that the body is unable to “release” at night
The result is the same — a morning that does not feel like a beginning.
Therefore, when evaluating chronic fatigue, sleep is one of the first things we examine — not only how much, but how.
Can Nutrition Really Affect Energy Levels Throughout the Day?
Absolutely. For many people, there is a connection between nutritional composition, meal timing, sensitivities, deficiencies, blood sugar stability, and energy. At the clinic, recommendations are not general, but personalized.
How Long Does It Take to Feel a Change?
It varies from person to person and depends on the causes of the fatigue and how long they have been present.
Sometimes improvement can be felt within the first few weeks, while in other cases a longer process is required. The goal is to identify the factors affecting functioning and energy, and to build a personalized, practical, and gradual plan, accompanied by follow-up and adjustments as needed.
Is It Still Worth Coming If I Have Already Had Tests and Everything Came Back Normal?
Yes. Many patients come after undergoing an extensive medical evaluation that did not find a clear explanation for the fatigue, brain fog, or decline in functioning.
In some cases, the symptoms may be related to factors that are not routinely tested, such as exposure to mold and dampness, heavy metals, chronic infections, or other environmental exposures that may affect brain function, energy levels, and quality of life.
The approach at the clinic combines a neurological perspective with an assessment of environmental, biological, and lifestyle factors, with the aim of identifying relevant factors that can be influenced and building a personalized and practical plan for the next steps.
In Summary
If you feel that fatigue, brain fog, or reduced functioning are controlling your day, it may be time to investigate what is behind them.
The goal is not only to cope with the symptoms, but to understand their possible causes — including environmental, biological, and lifestyle factors — and to build a personalized and practical plan to improve energy, functioning, and quality of life over time.
Ready to Invest in Your Brain?
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