NYC’s Leading Integrative Health Care Center
NYC’s Leading Integrative Health Care Center
Medically reviewed by Rashmi Gulati, MD — Last updated: September 26, 2026
MD-led chronic fatigue treatment on Fifth Avenue. We test deeper to find what is draining your energy, then build a step-by-step treatment plan that targets those causes, not just the tiredness.
Integrative care since 1974
New patient consultations
Testing, plan & follow-up
Chronic fatigue is treated by finding what is causing it and treating each cause directly. At Patients Medical, treatment starts with deeper testing, then a personalized plan that may combine thyroid and hormone balancing, nutrient repletion or IV therapy, sleep treatment, gut and inflammation care, and paced recovery, all prescribed and monitored by an MD.
Hormone and thyroid care, nutrient and IV therapy, NAD support, sleep, gut and pacing plans
Consultation and deeper testing first, then a plan that treats causes in the right order
Adults tired for months, or told their labs are normal but still exhausted
Some patients feel a lift within weeks; long-standing fatigue usually takes months
Our treatment is for adults whose tiredness has lasted for months, does not lift with rest, or keeps coming back despite a normal check-up. If several of these symptoms sound familiar, it is time for a proper evaluation.
Not sure if it is chronic fatigue? Read why you may always feel tired or our overview of chronic fatigue symptoms.
Chronic fatigue is often a sign of another condition. Your treatment plan addresses whichever of these your testing uncovers.
We look at how your body’s systems affect each other, not one symptom in isolation. Every step is supervised by a physician.
Treated with thyroid medication adjusted to your full thyroid panel and how you feel, not just one number.
Repleted orally or by IV, then retested so levels reach a healthy range and stay there.
Sleep apnea and insomnia treated directly, because energy treatments work poorly on broken sleep.
Perimenopause, menopause and low testosterone treated with bioidentical hormones when appropriate.
Nutrition changes and, if needed, medication to steady glucose and stop energy crashes.
Anti-inflammatory nutrition and targeted gut treatment to restore steady energy.
Paced recovery plus treatment of inflammation, sleep and nutrient gaps after COVID, EBV or Lyme.
Stress reduction, mind-body therapies and cortisol-rhythm support built into the plan.
Your treatment follows four clear steps, so you always know what is being treated, why, and what comes next.
A 60–90 minute first visit to understand your fatigue, sleep, stress and health history, and decide which tests will guide treatment.
As appropriate: full thyroid panel, iron and ferritin, B12, vitamin D, hormones, cortisol rhythm, blood sugar and inflammation markers.
Thyroid testing, Adrenal testing, Hormone testing, Vitamin testing
Your physician treats the most important findings first, in sequence, so you are not chasing ten fixes at once.
Regular follow-ups adjust doses and activity as your energy returns, because pushing too hard too soon can set recovery back.
Most plans combine two or more of these. Your physician recommends only what your results and symptoms support.
Correcting an underactive thyroid, low testosterone, perimenopause shifts or a disrupted cortisol rhythm, with bioidentical hormones when clinically appropriate.
Full thyroid testing and carefully adjusted medication for hypothyroidism and Hashimoto’s, one of the most common treatable causes of fatigue.
Restoring iron, B12, vitamin D, magnesium and other nutrients found low on testing, by IV when faster repletion helps.
Nutrients such as CoQ10 and NAD that support your cells’ energy production, used when your symptoms and results point there.
Screening for sleep apnea and insomnia, then a plan to fix sleep quality, because no energy treatment works well on broken sleep.
Treating gut problems and chronic inflammation that quietly drain energy over months or years.
A personalized eating plan that steadies blood sugar, reduces inflammation and supports energy through the day.
Treating gut problems and chronic inflammation that quietly drain energy over months or years.
Stress reduction, mind-body therapies and a pacing plan that rebuilds energy without triggering crashes.
Serving New York patients since 1974.
Every plan is prescribed and monitored by an MD.
Deeper panels and a closer read of your results, not just a pass or fail.
Hormones, sleep, gut, stress and nutrition looked at together.
Recovery built at a pace your body can handle, without crash-and-burn cycles.
We look at how your body’s systems affect each other, not one symptom in isolation. Every step is supervised by a physician.
| STANDARD CHECK-UP | OUR INTEGRATIVE TREATMENT | SELF-MANAGING AT HOME | |
|---|---|---|---|
| Testing | Basic blood count and TSH |
Full thyroid panel, ferritin, B12, vitamin D, hormones, cortisol and inflammation markers |
No testing |
| First visit | Usually a short appointment |
60–90 minutes with a physician | None |
| Treatment focus | Ruling out serious disease |
Treating every contributing cause together | Easing tiredness day to day |
| Typical treatments | Treating a single abnormal result |
Hormone, nutrient and IV, sleep, gut and pacing therapies combined |
Caffeine, over-the-counter supplements, extra sleep |
| Follow-up | As needed | Scheduled visits with plan adjustments | None |
Your physician coordinates with your primary care doctor and other specialists when needed.
Trouble focusing and forgetfulness often come with chronic fatigue. When they do, your treatment plan covers both. If foggy thinking is your main problem, see our dedicated brain fog treatment program.
Individual results vary. Your physician will set realistic goals with you at your first visit.
Timelines depend on the severity of the imbalance, your age, other health conditions and the treatment approach.
Sarah, 48, came to us with PMS, weight gain, insomnia and brain fog. Testing showed estrogen dominance, low progesterone, suboptimal thyroid function and gut imbalance. Over four months her plan combined low-dose BHRT, thyroid optimization, gut support, anti-inflammatory nutrition and stress-focused mind-body practices. Sarah reported regular cycles, better sleep, improved mood and a 15-pound weight loss, with follow-up labs confirming her progress.
“After struggling with mood swings and fatigue for years, getting my hormones balanced changed everything.”
S.N., 32 Brooklyn
“The testing and treatment were so thorough. My sleep, energy, and focus have all improved dramatically.”
M.K., 50 Manhattan
“Balancing my hormones helped with weight, skin, and anxiety. I feel more in control of my body and mind.”
T.L., 41. Queens
Medical Director
Rashmi Gulati, MD, is a board-certified functional medicine doctor Manhattan and a leading holistic doctor in NYC.
Gynecologist & Obstetrician
Dr. Emine Cosar, MD has over 20 years of medical experience as a Gynecologist.
The best treatment is the one that targets your specific causes. For most patients that means a combined plan, such as correcting thyroid or hormone issues, repleting low nutrients, treating sleep problems and pacing activity, rather than a single pill or supplement.
Treatment starts with a detailed consultation and deeper testing. Your physician then treats each cause found, in order of importance, and adjusts the plan at follow-up visits as your energy improves.
Common tests include a full thyroid panel, iron and ferritin, B12, vitamin D, hormones, cortisol rhythm, blood sugar and inflammation markers. Your physician chooses tests based on your symptoms and history. Fatigue testing explained
Partly. Chronic fatigue is a symptom with many treatable causes. Chronic fatigue syndrome (ME/CFS) is a specific condition where exertion worsens symptoms for days, so treatment focuses on careful pacing and managing coexisting problems. Chronic fatigue syndrome
IV nutrient therapy can help when testing shows deficiencies or when faster repletion is needed. It works best as one part of a full treatment plan, not on its own. Energy boost IV therapy
Yes, when fatigue is linked to an underactive thyroid, menopause or low testosterone. Bioidentical hormones are prescribed only when your results and symptoms support them, and are monitored closely. Hormonal imbalance treatment
Most often because only one cause was treated, or the real cause was never tested for. Treating thyroid, nutrients, sleep and stress together, in the right order, works better than one fix at a time. Why fatigue treatments fail
Some patients feel a lift within weeks once a deficiency or sleep problem is treated. Fatigue that has lasted years usually improves over several months of treatment, follow-up and gradual pacing.
An integrative or functional medicine physician who looks at the whole picture is a good place to start. At Patients Medical on Fifth Avenue, MD-led treatment combines conventional testing with integrative therapies. Functional medicine for chronic fatigue
Cost depends on the tests and treatments your plan needs; we share an estimate before you begin.
We are an out-of-network provider. We provide superbills to help you seek reimbursement, and some lab tests may be partially covered. Fees & insurance
Your physician spends 60–90 minutes on your fatigue, sleep and health history, orders the right tests and explains your treatment options. What to expect on your first visit
Patients Medical specializes in gently helping the patient identify the root cause of their medical issues and then assist them to recover from their problems to help them move forward to good health.
To schedule an in person on Tele-medicine appointment, please call our office at (212) 794-8800 or email us at info@PatientsMedical.com We look forward to hearing from you
Patients Medical PC
1148 Fifth Avenue, Suite 1B New York, NY 10128
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