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Root-Cause Fatigue Medicine

Persistent Fatigue: Evaluation and Care in Florida

Tired all the time despite getting enough sleep? Persistent fatigue isn't normal. It's your body telling you something is wrong. The answer is in your lab work, not willpower.

At Thrive RX, Dr. Kiswani-Barley uses comprehensive lab testing to uncover why you're exhausted, whether it's thyroid dysfunction, hormonal imbalance, metabolic issues, or nutrient deficiencies, and creates a targeted plan to restore your energy.

Medically Reviewed by Dr. Kiswani-Barley
Last updated: February 2026
Quick Answer

Why Am I So Tired All the Time?

Persistent fatigue that doesn't improve with rest typically has an identifiable medical cause. Research shows that thyroid disorders affect approximately 20 million Americans, many undiagnosed, and hypothyroidism is among the leading causes of unexplained fatigue. Hormonal decline, including low testosterone in men and estrogen/progesterone changes in women, is another major contributor.

A 2023 study in the Journal of Clinical Endocrinology & Metabolism found that subclinical thyroid dysfunction, insulin resistance, and micronutrient deficiencies (iron, vitamin D, B12) account for a significant percentage of chronic fatigue cases. Standard blood work often misses these when only basic screening is performed.

At Thrive RX, Dr. Kiswani-Barley orders comprehensive lab panels that go beyond standard screening to identify the specific cause of your fatigue. Initial evaluations start at $250 via telehealth throughout Florida.

Vandhana Kiswani-Barley, MD

Triple Board-Certified + FACHE · 15+ Years Experience

Family Medicine
Obesity Medicine
Pain Management
FDA-Approved Medications Only
Same Doctor Every Visit
Telehealth in FL
Transparent Pay-Per-Service Pricing

Common Causes of Chronic Fatigue We Test For

Fatigue is a symptom, not a diagnosis. Our comprehensive lab panel tests for all the major medical causes so we can treat what's actually wrong.

Thyroid dysfunction

Hypothyroidism or Hashimoto's thyroiditis slowing your metabolism

Hormonal imbalance

Low testosterone, estrogen decline, or DHEA-S depletion

Insulin resistance

Blood sugar dysregulation causing energy crashes and metabolic fatigue

Iron deficiency anemia

Low ferritin or iron reducing oxygen delivery to tissues

Vitamin D deficiency

Inadequate vitamin D levels affecting energy and immune function

Sleep disorders

Obstructive sleep apnea or poor sleep quality preventing restoration

Not sure what may be contributing to your fatigue? A comprehensive evaluation can help investigate possible causes and guide next steps.

Conditions That Cause Persistent Fatigue

Many medical conditions share fatigue as a primary symptom. Understanding these conditions helps explain why comprehensive testing is essential for accurate diagnosis.

Hypothyroidism

An underactive thyroid slows metabolism system-wide, causing persistent tiredness, weight gain, cold intolerance, and mental sluggishness. Even subclinical cases can cause significant fatigue.

Low Testosterone

Testosterone decline in men (andropause) and women causes fatigue, low motivation, reduced stamina, and poor exercise recovery. Affects men over 30 and women in perimenopause.

Perimenopause & Menopause

Declining estrogen and progesterone disrupt sleep, increase inflammation, and reduce cellular energy production. Fatigue is one of the earliest and most persistent symptoms.

Insulin Resistance

When cells resist insulin, glucose can't efficiently enter cells for energy. This causes post-meal crashes, afternoon slumps, and a persistent feeling of exhaustion.

Iron Deficiency Anemia

Low iron reduces hemoglobin, limiting oxygen delivery to muscles and organs. Causes exhaustion, shortness of breath, and exercise intolerance. Common in women with heavy periods.

Vitamin D Deficiency

Low vitamin D is linked to fatigue, muscle weakness, and immune dysfunction. Despite Florida's sunshine, many patients are deficient due to indoor lifestyles and sunscreen use.

Our Treatment Approach for Chronic Fatigue

Treatment is always matched to the root cause identified through your comprehensive lab work. Many patients have multiple contributing factors that we address simultaneously.

Thyroid medication optimization (levothyroxine, combination T3/T4)
Bioidentical hormone therapy (testosterone, estrogen, progesterone)
Iron supplementation and absorption optimization
Vitamin D and B12 repletion protocols
Metabolic interventions for insulin resistance
Sleep disorder evaluation and treatment referral
Lifestyle and dietary modifications for sustained energy
Ongoing lab monitoring and treatment adjustment

The Thrive RX Difference

Most doctors say "your labs are normal" and send you home. We dig deeper with comprehensive panels that reveal what standard screening misses.

  • 1
    We take fatigue seriously: your exhaustion deserves real answers
  • 2
    Comprehensive labs: thyroid, hormones, iron, vitamins, metabolic markers
  • 3
    Optimal ranges: we look beyond "normal" to find your best function
  • 4
    Ongoing monitoring: we adjust until you feel your best

How Fatigue Treatment Works at Thrive RX

Our structured approach ensures we find the cause and develop a treatment plan that restores your energy and vitality.

1

Initial Evaluation ($250)

Dr. Kiswani-Barley takes a detailed history of your fatigue, reviews your health background, and orders comprehensive labs targeting common causes.

2

Comprehensive Lab Panel

Thyroid, hormones, metabolic markers, iron studies, vitamin levels, and more. Labs billed separately (~$235-$300 through partner labs).

3

Root-Cause Diagnosis

Based on lab results AND your symptoms, we identify every contributor to your fatigue and create a targeted treatment plan.

4

Follow-Up & Monitoring ($200)

Regular check-ins to track your energy levels, repeat labs as needed, and optimize your treatment for lasting improvement.

Outstanding medical care and professional staff

"I highly recommend Dr. Kiswani-Barley to anyone looking for a compassionate and professional physician. The level of medical expertise and attentiveness is unmatched. Staff included provide exceptional care. They take the time to answer all questions and never make you feel rushed."

Originally posted on Google

Can't say enough good things

"I can't say enough good things about Dr. Kiswani! I am currently a hormone therapy patient of hers, but she has gone above and beyond to help me with my health. She truly cares about her patients and takes the time to listen and understand your concerns."

Originally posted on Google

Read reviews on Google

Frequently Asked Questions About Fatigue Treatment

Get answers to common questions about chronic fatigue causes, testing, and treatment at Thrive RX.

Serving Florida Statewide via Telehealth

Ready to Get Your Energy Back?

Stop accepting "your labs are normal" as an answer. Schedule your comprehensive evaluation to find the root cause of your fatigue and start feeling like yourself again.

Serving Fort Lauderdale, Miami, Boca Raton, Palm Beach & all of Florida via Telehealth

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