Header image alt text

Dr. Fred Hui

Helping People Achieve Balance in Life

Chronic Fatique

According to the various health surveys that have been conducted on the general population, “Tiredness” or “Fatigue” seems to always top the list. It could be a relatively new concern or an issue that the patient has been fighting over many years. There could be several reasons for tiredness – like hormonal or nutritional deficiency, adrenal insufficiency, fibromyalgia, depression etc.

When patients approach their physicians about it, they would be checked for the most obvious causes such as anemia, thyroid issues and abnormal kidney or liver function. These tests often come back negative and no further tests are carried out. Being fatigued all day causes a drop in normal functioning, social interactions and outings; and leaves one with symptoms of depression. However, many doctors fail to see the real equation, and end up blaming the fatigue symptoms on “depression”, and put these patients on a lifetime of anti-depressants.


Depending on the cause of your chronic fatigue, there may be other associated concerns that can point to the source of the problem. Here are a few such symptoms:

1) Fatigue all day, especially in the mornings
2) Feeling “under the weather” ( Fluish feeling )
3) Aching muscles and joints
4) Occasional low-grade fever/ chills
5) Low blood pressure
6) Weight gain/ loss over a short period of time
7) Excess/ Deficient/Disturbed sleep
8) Emotionally hypersensitive (cries easily, angry outbursts) etc.


Dr. Jacob Tietelbaum, author of the bestseller “From Fatigued to Fantastic” has a comprehensive approach towards diagnosing and treating fatigue, and its called the “SHIN” protocol. A slightly modified version has been adopted by me. The SHIN protocol rules out the most common causes and lesser known causes, and also allows one to address multiple issues at the same time, because they are often linked to one another.

The SHIN protocol stands for:


A good sleep releases endorphins, which is endogenous morphine, also called the “Feel- Good Hormone”. Poor sleep is one of the simplest but common reasons for tiredness, decreased concentration etc.
An article explaining my approach to improving your sleep in detail will be given to you.

• This is our body’s natural sleep hormone. As we age, our melatonin levels drop. For those patients whose melatonin baseline levels are low, its supplementation would improve the depth and quality of sleep.
• Melatonin is a non-addictive, natural sleeping pill. There is no lingering effect/ daytime drowsiness. Melatonin also has anti-oxidant, anti-aging and immune system boosting properties.

• Start with a 3mg pill on Night 1 ——-> 2 pills on Night 2 ——-> 3 pills on Night 3 and gradually increase the dosage until you discover the right dosage for your body. You can take a maximum of 10 pills a night (30mg).
• USE AN EYE COVER – In order to increase the effectiveness of this hormone, ensure complete darkness over the eyelids because light deactivates the action of melatonin.

• This is another natural supplement for sleep that is composed of herbal ingredients like Valarian root extract, passionflower extract, lemon balm extract and griffonia seed. It also contains 5-HTP, melatonin and GABA, which are known to relax the body and mind. Dosage: 2 caps/ night.

• This is yet another natural supplement that I advise patients to take, if melatonin alone doesn’t help. The dosage prescribed is 2 capsules/ night.

• For those patients who have chronic sleep issues, and for whom medication and supplements are also not helping, I would want to further investigate the cause for sleeplessness by advising the NEUROLAB TEST.

• This test checks the levels of neurotransmitters in the brain – like GABA, serotonin, dopamine etc. An imbalance in these levels often goes undiagnosed, and it can cause several issues like stress, depression, anxiety, sleep issues etc.

• Depending on the results, we can work at creating a balance by supplementing those neurotransmitters that you are deficient in. For example, 5-HTP and GABA are available in capsule form at all my clinics.


Deficiency of certain hormones can also bring about the associated symptoms and hence I would first need to rule out such deficiencies.

– TSH, Free T3 and Free T4 – A routine blood work only checks for TSH but I take a more detailed look into your thyroid function by checking your Free T3 and Free T4 as well.
– Having decreased thyroid function can cause low energy, sluggishness, increased sleep, weight gain etc.
– Low Temperature – If the basal body temperature is <1°C than normal, the thyroid or adrenal hormone production may be low. [Normal temp. = 37°C or 98.6°F] - Desiccated thyroid - Depending on how low you may be, you would be prescribed desiccated thyroid, which is better than synthetic alternatives like eltroxin and synthroid. Desiccated thyroid is actual dried and powdered porcine thyroid glands. • ADRENAL HORMONES: (a) Cortisol - Deficiency of cortisol can cause symptoms like morning tiredness, cold hands and feet, low energy levels all day, low blood sugar, emotional hypersensitivity etc. - Saliva cortisol test – This test is done to see if you are deficient in cortisol levels. It measures your cortisol levels at 4 different times of the day. - This result will then be interpreted by me - and on the basis of your levels and symptoms, a treatment plan will be drawn out for you. - Treatment -  Licorice drops  Cortef ( bio identical low dose cortisone)  Intravenous Chronic Fatigue Drip – - This treatment contains the Adrenal Support Drip, along with several minerals and vitamins like Ca, Mg, Zn, Cr, Se, Cu, Vit B’s, Vit C etc. While the ACE helps to supplement the deficiency, the minerals serve as the raw materials to rebuild the gland. - Usually about 20 sessions are advised depending on the level of fatigue. - All the treatment options, their risks and benefits are discussed in detail in another article by me, called “CHRONIC ADRENAL FATIGUE”. (b) Aldosterone - Your aldosterone levels may be low if you are unable to retain salt and water. - Having to urinate often, low blood pressure, light headedness and sunken eyes are some symptoms of low aldosterone levels.  Florinef - This may be prescribed to those patients who are severely deficient. ADRENAL FATIGUE: A condition in which the adrenals are so exhausted that they are unable to produce sufficient amounts of the adrenal hormones. Therefore, if you are deficient in the above hormones and have symptoms, I would suspect AF. The reasons, symptoms, advice and treatment options are discussed in detail in another article I have composed called “Chronic Adrenal Fatigue”. • SEX HORMONES (a) DHEA (b) Testosterone (c) Estrogen (d) Progesterone - DHEA is a hormone produced by the adrenal glands that converts into other hormones like Testosterone and Estrogen. The deficiency of these hormones may cause tiredness, low libido, menopausal symptoms, erectile dysfunction etc. - It is good to top up these levels in order to bring down your biological age. - Most of these tests are OHIP-covered, and depending on the results, you may be supplemented with:  DHEA 25 mg daily  Testosterone cream  Triple hormone cream (This cream is prescribed mostly for menopausal patients. It contains estrogen, progesterone and a hint of testosterone)  Progesterone cream (This cream is mainly prescribed for patients who also currently have heavy periods and PMS symptoms. The dose is 0.1cc twice a day, to be applied from Day 15 to Day 28 of the menstrual cycle. This dose may be increased up to 0.2cc if hot flashes are not controlled) - These bio identical hormone creams are specially compounded as per my prescription and are available at all my clinics. (3) INFECTION - Do you have symptoms like achiness, chills and rigors, low-grade fevers, night sweats or a chronic “under the weather” feeling? - These, according to me, are signs of a chronic ongoing infection that you are unable to get rid of. It could be bacterial, viral, fungal or even parasitic. Nothing else in the world will give you chills other than infections. - Several patients are able to go back in time, and find that the onset of the above symptoms coincides with an infection or invasive procedure they had in the past. - Several examples are:  Gynecological infection/procedure (Caesarian section/endometriosis/biopsy etc)  Urinary tract infections/ Colitis, amoebiasis, parasites and other GI tract infections  History of root canal/ tender gums/ hypersensitivity/ other dental procedures  History of sinusitis/ pneumonia/ any chronic infections  History of arthritis/ other joint diseases. - These infections gradually enter the blood stream and spread to other organs. There, they multiply and silently form pockets of infection in different parts of the body including the joints. - Areas like the joint spaces are inaccessible to the white blood cells (our germ fighting squad) because of the tough, impenetrable capsule around the entire joint. This causes the immune system to attack the area around it in an effort to reach the target, and this explains the joint aches and pains. • Tracing the culprit – Depending upon the suspected source of infection, tests can be carried out.  Urine culture and microscopy  Sputum culture / stool culture  Throat swab / vaginal swab  Stool and saliva test (to check for several parasites and yeast) The above tests only check for bacteria, and therefore, are not comprehensive enough.  DNA test This test can find organisms that are not traceable by any OHIP- covered test. It can detect virus, fungi and semi-viruses too. This is because this test does not rely on actually “seeing” the organism, but it tests for the presence of its DNA! Examples include chlamydia spp, mycoplasma etc. • Treating the infection  Antibiotics or antifungals (as required)  Silver sol – Silver solution is a known antimicrobial. - It can kill bacteria, fungi and virus in the body and is completely safe for consumption. - An article on the FAQ’s of silver sol will be given to you. - Dosage is 1 tablespoon thrice a day (if 10 parts per million concentration) or 1 tablespoon a day (if 30 parts per million concentration)  IV H2O2 treatments - H2O2 is a well-known killer of germs –Its action is against viruses, bacteria, fungi and semi bacteria. It mostly works by creating a high oxygen environment in which the germs can’t survive. - A series of 20 sessions is usually prescribed (depending on the severity). - The 1st 5 treatments: These can cause worsening of symptoms because the H2O2 initially would break down and flush out the infectious agents and toxins into the blood stream. - 6th to 10th treatment: This effect gradually dies off and the initial fluish symptoms would begin to subside as well. You can use symptoms like chills, low grade fever, achiness as a yardstick of improvement. - After 10 treatments: A follow up consultation needs to be booked with me, so I can analyse your progress and revise your treatment plan if necessary. - An article and book explaining H2O2 treatments in detail with pros and cons will be available at the front desk. (4) NUTRITION • DEFICIENCY OF NUTRIENTS - Deficiency of certain nutrients can also cause tiredness and aches. - In order to rule out such nutritional deficiencies, I may test the following levels:  Vitamin D  Vitamin B12  Serum iron  Serum folic acid - The conventional recommended daily dosage of Vit. D is 1000IU/day. This is far from being adequate. The dosage I usually advice is 5000IU/day. - Vitamin B12 levels above 600 is ideal in my opinion. In order to keep it at such a high level, sometimes oral supplementation will suffice. For others, a subcutaneous injection of 1cc Vit B12 may be prescribed. • TOXIC NUTRITION (HEAVY METAL INTAKE) - Over many years, everyone tends to accumulate heavy metals in their bodies. - The source - The heavy metals may have entered your body through various sources like Cadmium (from cigarettes), Lead (from old water pipes) and Mercury (from seafood and dental fillings). High mercury levels due to amalgam fillings are one of the most common cases I come across. Other heavy metals include Aluminum, Cesium and Gadolinium. - The accumulation - These metals don’t have an escape plan in our body. They don’t get broken down or flushed out. They accumulate in our cells and circulation and over time, causes toxicity. This consequently produces symptoms like brain fogging, tiredness, circulatory issues etc. - Heavy Metal Challenge Test - For patients who have had long-term exposure to heavy metals, I strongly recommend this test. It’s a 2-hour IV treatment with EDTA and DMPS (which are chelating agents), following which a urine sample will be collected and sent away to the US for analysis. - Depending on the results, I can recommend chelation treatments like:  DMPS treatment – To chelate mercury. Must have amalgam fillings removed prior to starting treatments. Can be done once in 2 weeks only.  EDTA treatment – To chelate lead, cadmium, aluminum etc. Can be done up to thrice a week. • FOOD ALLERGY - Most patients struggle with some sort of food allergy on a daily basis – and most are unaware of it. The allergy can be mild, moderate or severe. - Severe allergies are the obvious ones - where one can swell up and have extreme difficulty in breathing, or have rashes and itching. - Mild-moderate allergies – these are the ones that just give you gas, reflux, bloating, belching, heartburn, abdominal cramps, diarrhea or constipation. - What many people don’t understand is that food allergies harm you over time. Every time you eat something you are allergic to, your body needs to produce antibodies against it. - Your body therefore, is constantly in fight mode as the ”enemies” keep pouring in – this weakens the immune system and distracts the body from the real issues like a possible underlying infection. This, in turn, causes or aggravates most of the symptoms.  Food Allergy Test - If you have any of the above mentioned symptoms, then I would strongly recommend a food allergy test. - This is a simple test that uses 3 drops of blood to identify IgG antibodies against 96 different foods. It covers all food groups like dairy, poultry, seafood, meats, fruits, vegetables, legumes, wheat etc. - The results even tell you what degree of reaction you have towards that food – ranging from “No reaction” to “Severe”. It also comes with a diet booklet that guides you through the allergy elimination process.  Biozyme - For patients who have food allergies, I also recommend taking digestive enzymes to aid the digestive process. This natural supplement contains bromolein, chymotrypsin, amylase, lipase, trypsin, papain, lysozyme etc. IN SUMMARY…. A fatigued person can be compared to a car with no horsepower. As you already know, a car needs constant maintenance – it has to be tuned up often, fluid levels need to be topped up, and the rechargeable battery must get a full overnight charge to ensure the best performance the next day. If the maintenance is well taken care of, the car will then return to the original factory settings – and it will perform as promised. In short, paying attention to all aspects of your health, and diagnosing & troubleshooting the issues you never realised you may have had, can bring you from FATIGUED to FANTASTIC!!