The Five Root Causes of Chronic Fatigue: Insights from Dr. Jenny Tufenkian

Chronic fatigue, long COVID, and other complex chronic conditions can feel like an endless maze with no clear way out. In my recent conversation with Dr. Jenny Tufenkian, a naturopathic physician with over 20 years of experience in treating complex chronic illnesses, she shared her framework of the five root causes that often contribute to these conditions. 

What makes her perspective especially valuable is that she has traveled this road herself, overcoming debilitating chronic fatigue during her medical training and again later in life. It’s a journey that I’m also on, and the conversation we had here was incredibly validating.

Understanding the Root Causes Approach

Dr. Jenny emphasizes that healing from chronic fatigue is not a one-size-fits-all journey. Through her practice and personal experience, she's identified five key root causes that often work together to create these complex conditions.

"It's not a one-size-fits-all situation. I'm all about helping people uncover what are their root causes and what are the health foundations they need to focus on."

Her approach involves identifying which of these root causes are present and addressing them in the right order. Most importantly, she believes complete recovery from chronic syndromes is possible, having experienced it herself and helping countless patients heal as well.

The Five Root Causes

1. The Hormone Triangle (The Gateway Root Cause)

Dr. Jenny describes this first root cause as the "gateway" because it often creates vulnerability to the other causes. It involves three key components:

  • Adrenal/HPA axis: Your stress response system

  • Thyroid function: Often compromised in chronic fatigue

  • Sex hormones: Testes and ovaries

When one part of this triangle becomes imbalanced, it tends to pull the others out of balance too. Many of us arrive at this imbalance through what Dr. Jenny calls "the stress express" - pushing ourselves too hard for too long.

In her own journey, Dr. Jenny experienced flatlined cortisol levels, requiring physiological doses of cortisone to help recover. For those in perimenopause or with hormone fluctuations, she notes how decreased estrogen (a natural anti-inflammatory) can increase vulnerability to inflammation and fatigue. This highlights for us just how individualistic this experience is from person to person, and why it’s so important to work with a competent and experienced provider.

2. Chronic Infections

The second root cause involves infections that can contribute to fatigue:

  • Reactivated viral infections (like EBV, herpes viruses)

  • Fungal infections

  • Bacterial infections

These infections can be present in various parts of the body, including the sinuses, gut, and even organs like the thyroid or liver. Dr. Jenny shared how she diagnosed one patient with a reactivated viral infection based on how they described their fatigue:

"There's kind of a 'walking through molasses' feeling... I have cement in my legs... We talk about tired like wine sommeliers talk about wine."

The specific quality and pattern of someone's fatigue can provide important diagnostic clues about which root causes are at play. 

3. Toxic Overload

The third root cause addresses how toxins impact our health:

  • Environmental toxins like glyphosate and plastics

  • Heavy metals like mercury and lead

  • Mold and mycotoxins

Dr. Jenny explains that while we all live with some level of toxicity in today's world, our individual capacity to handle these toxins varies based on:

  • Genetic detoxification abilities

  • Daily habits that support or hinder detoxification

  • Total toxic burden from all sources

In her personal experience, black mold in her home and office significantly impacted her health. While she was able to make improvements even while living in the moldy environment, removing that exposure was crucial for her full recovery.

4. Mitochondrial Dysfunction

The fourth root cause focuses on cellular energy production:

"The mitochondria, the powerhouse in all of your cells... This is something where people who have post-exertional malaise, where you do a little bit more one day and then you are just flat-out exhausted... That's a definite sign that your mitochondria are not functioning well."

Dr. Jenny shared a powerful personal story about how addressing her mitochondrial function allowed her to hike three miles and stay up late without experiencing the crash she expected. She emphasizes that if mitochondrial support doesn't work, it may indicate heavy metal toxicity blocking the nutrients from reaching the mitochondria.

5. Limbic System Dysfunction

The fifth root cause involves the brain's alarm system:

"Looking at that emotional limbic ring... The limbic brain is the emotional brain in the subconscious mind. They're finding the amygdala-insula is a really huge part of this as well, and it connects to the vagus nerve, which is the longest nerve in the body that connects to all the organs."

The Individualized Healing Journey

What stands out in Dr. Jenny's approach is how she treats each person as an individual:

She uses multiple strategies to identify which root causes are present:

  • Careful listening to symptom descriptions

  • Reviewing previous lab work

  • Ordering targeted tests only when clinically necessary

  • Using treatment trials to see how the body responds

Hope and Persistence

Perhaps the most powerful message Dr. Jenny shared is to maintain hope:

"The one thing I would say is to just maintain that hope. I know you have days where you're really down and you feel like you're just banging your head against the wall and it's not going anywhere... but what do you do after you have that cry or after you feel down and disappointed? What's the next thing? Because I know that if you keep trying, if you keep knocking on doors, there's gonna be one that opens up."

Her journey illustrates the importance of persistence. Even after achieving full recovery once, she had to navigate relapses and find new solutions as her life circumstances changed. The toolkit she developed through this process is something she encourages all her patients to create for themselves, so they're prepared if symptoms return.

Conclusion

What I appreciate most about Dr. Jenny's approach is her combination of scientific rigor and genuine compassion. Her framework provides a roadmap for those navigating the complex terrain of chronic fatigue, while her personal journey offers proof that recovery is possible, even after multiple setbacks.

For those struggling with chronic fatigue, understanding these five root causes might just illuminate the next step in your healing journey.

If you'd like to learn more about Dr. Jenny Tufenkian's approach to chronic fatigue, join the waitlist for her upcoming summit, Brain Fog, Chronic Fatigue, Long Covid, Memory Loss and Pain Breakthrough Summit, running April 11-18.

Connect with Dr. Jenny on her website, on Instagram @Dr.jennytufenkian, or Facebook @Dr. Jenny Tufenkian.

Disclaimer: Everything we discuss here is just meant to be general education and information. It's not intended as personal mental health or medical advice. If you have any questions related to your unique circumstances, please contact a licensed therapist or medical professional in your state of residence.

Listen to Dr. Jenny’s interview with me, Destiny, on Ep 87: The Five Root Causes of Chronic Fatigue: Insights from Dr. Jenny Tufenkian

Listen on Apple

Listen on Spotify

 
Podcast cover art for "The Chronic Illness Therapist Podcast" with Destiny Davis, LPC CRC

Listen to Dr. Jenny’s interview with me, Destiny, on Ep 87: The Five Root Causes of Chronic Fatigue: Insights from Dr. Jenny Tufenkian

Listen on Apple

Listen on Spotify


Dr. Jenny Tufenkian, Licensed Naturopathic Physician, smiling wearing a white lab coat and a stethoscope around her neck

Dr. Jenny Tufenkian, a licensed Naturopathic Physician with two decades of experience, specializes in empowering health-conscious professionals to conquer long COVID and ME/CFS fatigue. Her personal battle with chronic fatigue inspired her to uncover its root causes, leading to the creation of a transformative system that addresses the five core root causes of Chronic Fatigue/ME. This approach helps those overwhelmed by exhaustion regain their energy and vitality, allowing them to fully embrace life once again. Combining a thorough functional medical approach with deep subconscious work, Dr. Tufenkian's method facilitates significant shifts in both physical and energetic well-being. She believes in a holistic healing process that integrates the physical, mental/emotional, and energetic dimensions, emphasizing the body's inherent ability to be vital. Dr. Tufenkian earned her medical degree and completed her residency at the National University of Natural Medicine. She is also a mom of two, happily married and loves her time outdoors and in the kitchen.

Connect with Dr. Jenny:

Website

Instagram

Facebook


Destiny Davis, LPC CRC, smiling in a pink sweater standing outdoors with crossed arms

Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.

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