If you’re struggling with CFS, you need no diagnosis. You know what it’s like to be constantly tired, dizzy, achy, and sleepy with no relief even after resting.
You also don’t need to know the cause – as even researchers aren’t quite sure whether it’s viruses like herpes 6 and Epstein-Barr, impaired HPA axis which controls your reaction to stress, low blood pressure, dehydration, hormonal imbalance, or genetics that trigger this debilitating disease.
What you do need is a skilled, compassionate doctor who understands that it’s not “all in your head.” A doctor like Dr. Borenstein, who knows there is no such thing as a one-size-fits-all solution.
Hundreds of patients with unique combinations of symptoms in varying degrees have come from all corners of New York State to find relief through his customized, carefully crafted treatment protocols. Protocols that he will monitor and adjust until you’re back on your feet and ready to embrace all the joy and adventure life has to offer.
So, if you’re still asking yourself “why am I always tired and sleepy,” join the hundreds of patients who’ve found relief at Manhattan Integrative Medicine. Call Dr. Borenstein’s team at ☎ (212) 262-2412 or contact us here.
CFS can begin gradually after a period of severe physical or emotional stress, or it can feel like a sudden case of severe flu that just won’t go away. Other symptoms may include:
Dr. Borenstein has treated all of these symptoms with clinically validated treatments – and he has hundreds of happy patients to prove it. His treatment strategy is powered by the S.H.I.N.E® protocol.
If you’re feeling profoundly exhausted and too heavy to carry out basic tasks you need help – now. Women between the ages of 30 and 50 are most commonly affected, and symptoms can worsen if patients push themselves into post-exertional malaise.
Just as a variety of factors can cause CFS, a variety of approaches can treat it. Deciding which work for your unique case requires thorough testing to address each symptom, then observe results.
That’s why Dr. Borenstein follows the protocol of chronic fatigue expert and innovator Dr. Jacob Teitelbaum, who has enjoyed decades of success treating chronic fatigue patients with his S.H.I.N.E® (Sleep, Hormones, Infection control, Nutrition, and Exercise) protocol.
In a peer-reviewed double-blind placebo-controlled study, 91% of people applying S.H.I.N.E® improved with an average 75% increase in quality of life at 99 days and 91% increase two years later (the people in the placebo group reported minimal improvement). After treatment, many patients no longer even qualified for the diagnosis of CFS!
This proves that chronic fatigue is treatable and that anyone who now says it’s “all in your head” is wrong.
Infections, hormonal deficiencies, poor sleep, and other factors can cause your body to “blow a fuse.” Then your hypothalamus—which controls autonomic functioning—throws your body in a kind of protective hibernation.
Dr. Borenstein realizes this occurs in different ways for different patients. He treats every person that enters his office as a unique ecosystem, with unique combinations of genetics, age, general health, environmental factors, and lifestyles. That’s why he takes the time to understand your whole health before crafting your custom S.H.I.N.E® treatment plan.
People with CFS must get a lot of sleep – preferably 8 - 9 hours a night. Sleep replenishes your body's energy and helps heal sore damaged muscles. Inadequate and/or poor quality sleep will leave you exhausted and in pain. That’s why Dr. Borenstein provides aggressive but patient-appropriate sleep support.
After examining you and carefully noting all your symptoms he will test you to diagnose or rule out sleep apnea – a serious condition that can lead to heart disease or stroke.
Then, he will prescribe one or more of the following to optimize your energy levels:
Amino acids like L-theanine and tryptophan, melatonin, and 5HTP – a supplement extracted from the African Griffonia Simplicifolia plant – have all been clinically validated as sleep and relaxation aids
If necessary, pharmaceutical sleep aids like Ambien, Trazodone or Gabapentin can be prescribed as hypnotics to help foster deep sleep
Sleep Hygiene Lifestyle
Abiding by a strict sleep schedule to establish a consistent biorhythm is crucial; sometimes altering window coverings to ensure complete darkness and tweaking humidity levels for ideal breathing comfort can enable you to sleep deeply through the night – so can cutting out caffeine and alcohol
Whether it’s meditation, Qi Gong, Tai Chi, relaxing music or an Epsom salt bath before bed, Dr. Borenstein will brainstorm strategies until you’re able to relax and get at least 8 hours of restorative sleep every night
Various hormone deficiencies can stimulate chronic fatigue syndrome. Unfortunately, traditional blood testing often misses subtle imbalances, and your tests come back in the imprecisely defined “normal” range.
Dr. Borenstein will perform thorough blood, saliva, and urine tests to determine your precise levels of the following:
The ratio of the three forms of estrogen - estrone (E1), estradiol (E2), estriol (E3) - is important for both women and men; imbalances have been linked to heart disease and can stimulate depression.
Helps balance and neutralize effects of excessive estrogen; if a woman's symptoms are worse around her menses, estrogen, and progesterone may be needed.
Men with CFS have testosterone levels in the lowest 30% of the population.
Insulin resistance is a hormonal resistance pattern (your body is producing insulin but it’s not shuttling blood sugar into your cells where you can use it); can occur in those who are pre-diabetic or have a sub-clinical blood sugar imbalance.
Produced by fat cells to signal your brain to use the body’s fat stores for energy; leptin resistance occurs when your hypothalamus stops recognizing it, tricking your brain into thinking you’re starving.
Because all of the systems in your body function synergistically, if one hormone is out of whack, others are likely imbalanced as well. Dr. Borenstein will analyze your blood and saliva samples to determine which combination of imbalances you’re struggling with. He’ll check levels and adjust doses every time he gets feedback about how you’re feeling.
Underlying viral, bacterial, bowel, sinus and yeast infections are common and can be contributing causes of CFS, or even the result of it. Dr. Borenstein will test you for viruses and concurrent bacterial infections like:
Then, after explaining which condition/s you have and at what stages, he will prescribe low sugar chronic fatigue syndrome diet, probiotics, antivirals, or antifungals accordingly.
As with hormones, Dr. Borenstein will perform a series of tests to determine your vitamin and nutrient levels. Then he’ll prescribe a supplement plan/diet to address your deficiencies and their related symptoms – which present differently in, and are delivered differently to every patient.
To maintain your normal health and optimal energy levels, he may also prescribe a diet that will flush out your specific irritants. If your tests show you have candida, for example, he will determine the strongest candida killer for your age and body type. If it turns out you’re deficient in magnesium, acetyl L-carnitine, glutathione, vitamins B-12, A, B, C or D he will prescribe the optimal supplementation in the most efficient form.
As research shows that only about 30% of oral vitamins are absorbed and available to the body, Dr. Borenstein prefers to use IV infusion to deliver these treatments:
This powerful treatment combines vitamin C, several B vitamins, and magnesium to provide a patient's metabolism with optimal cellular and immune function.
The cocktail is usually given 1-2 times per week, and beneficial effects are usually felt by the fourth visit. Many patients with chronic conditions choose to continue the infusions every 1-4 weeks or when they feel their energy slipping.
Low Dose Naltrexone
Studies have shown that LDN helps relieve symptoms, but have not yet demonstrated how. Some researchers have observed that this drug helps normalize the immune system by acting as an anti-inflammatory in the central and peripheral nervous systems, possibly by limiting the activity of specialized microglia cells. Others theorize that LDN blocks certain receptors in the nervous system that cause symptoms.
Whatever its function, LDN has been clinically proven effective. Researchers at Stanford University have observed as much as a 30 percent decline in patients’ symptoms compared to placebo. The drug is well tolerated, and results are best in people who have an inflammatory response.
For treating chronic fatigue syndrome, naltrexone is generally given in doses of 4.5 mg or less. Typically, you'll start at 1.5 mg, work up to 3 mg, then increase to 4.5. The effects attributed to this low dosage are not seen at higher doses.
After a thorough investigation of your symptoms and medical history, Dr. Borenstein may also deliver other electrolytes, vitamins, anti-oxidants, minerals, amino acids, and various supplements to resolve each symptom. Here is a list of all the supplements he may prescribe:
- to boost energy: carnitine, CoQ10, creatine, D-ribose, magnesium malate, NADH, SAM-e, vitamin B12
- to improve immune function: carnitine, CoQ10, DHEA, lysine, Rhodiola, theanine
- to relieve pain and tenderness: lysine, magnesium malate, omega-3 (fish oil), turmeric, vitamin D
- to improve sleep: melatonin, valerian
- to manage mood: DHEA, folic acid, lysine
- to optimize brain function/neurotransmitter balance: 5-HTP, carnitine, folic acid, omega-3 (fish oil), rhodiola, SAM-e, theanine
Dr. Borenstein is very experienced in detecting possible contraindications with any medication you may be taking, as well as avoiding negative interactions between these supplements.
Exercise is crucial, but only as much as your body can handle. After 10 weeks on the first four steps above, you should be able to slowly increase your amount of exercise without being wiped out the next day.
Don't overdo it trying to follow "normal" exercise recommendations, as it may throw you into Post Exertional Malaise, which can leave you wiped out for days.
How do you know which type and how much exercise you need? Start with the least possible amount of exertion (basic yoga, walks in the park, Qi Gong, Tai chi). If those don’t cause Post Exertional Malaise, try moving it up a notch (swimming, weight lifting, light jogging).
Still asking yourself “Why am I always tired and have no energy?” Stop dragging your tired, depleted self around without any enjoyment of the world around you.
Let Dr. Borenstein help you take your days back into your own hands, and your life joy back into your heart – so you’re not too exhausted for the relationships, productivity, and beauty you’ll find all around you once your energy has been restored.
Dr. Borenstein has spent years researching and practicing solutions that have cemented his reputation as one of New York’s top chronic fatigue healers. To schedule an appointment, call Manhattan Integrative Medicine at ☎ (212) 262-2412 or contact us here.
We are now working with POST COVID 19 fatigue patients.
308 5th Ave, 5th Floor
New York, NY 10001
Monday - Thursday: 8:00am - 5:00pm
Friday: 9:00am - 5:00pm
Saturday - Sunday: Closed