Exhaustion that outlasts a hard week
You may sleep and still wake unrefreshed, cancel plans by noon, or feel flu-like after a walk that used to be easy. Brain fog often rides along. That experience is real. It is also not, by itself, a diagnosis this office will rename on the first visit.
Drs. Sani Kohen, D.C. and Tara Kohen, D.C. ask how long it has lasted, what makes it worse, and what physicians have already ruled out. Functional Medicine here does not claim to treat myalgic encephalomyelitis or chronic fatigue syndrome as a specialty protocol.
Thyroid, iron, and metabolic markers come first
A slow thyroid, low iron, and unstable glucose can each produce a tiredness that feels total. Those are common, testable questions, and they belong early. Advanced bloodwork can include iron studies and metabolic markers your physician may already be watching.
The thyroid dysfunction page explains why TSH alone can miss the question. A fuller panel is considered when temperature, bowels, and hair changed along with energy. Medication, if you take it, stays with the prescriber. FRI does not raise a dose from fatigue alone.
Sleep and gut are next, not a grab bag
Sleep and insomnia covers pain, caffeine, and a cortisol curve when nights are the obvious hole in the story. If you snore, gasp, or wake with headaches, a physician should evaluate sleep apnea. This office is not a sleep laboratory.
Gut symptoms earn a stool or breath test only when you have them. An organic acids test is sometimes used as a urine look at metabolic clues. It is not ordered because you are tired. It is ordered when the history makes that specific question worth the sample.
Mold or metals only if the history fits
A water-damaged building, a job with solvent or metal exposure, or a diet very high in certain fish can justify those workups. They are not the default explanation for fatigue. FRI will not tell you that all exhaustion is mold, and it will not open with a chelation plan.
Functional medicine at FRI does not replace a primary physician, endocrinologist, gastroenterologist, or mental health clinician. If mood, grief, or a medication is part of the exhaustion, keep those clinicians involved. Nutrition and supplementation follows the labs, without a brand protocol.
What to expect when you are seen for Chronic Fatigue
A complimentary 20-minute consultation is the place to see whether this workup fits. FRI is out of network. Superbills are available, and HSA or FSA funds are accepted. Hours are Monday–Thursday, 9–6.
Bring prior bloodwork, a medication list, and a short note on what a typical crashed day looks like. Testing starts with the most plausible drivers. You will not be enrolled in an ME/CFS protocol. Describe whether a short walk, a flight of stairs, or a full workday is what flattens you, because that scale changes which test is worth doing first.
Coming north on I-5 to the clinic
The drive is I-5 north through San Juan Capistrano into Mission Viejo, about 16 miles. Without a slowdown it is a little over 20 minutes. A backup through the Capistrano stretch pushes it toward 35. Exit for the La Alameda side of Mission Viejo and come to 26400 La Alameda, Suite 100, CA 92691. Parking is on site. The doors are open Monday through Thursday, 9 to 6.
Because the drive is simple, people sometimes stack a visit onto a day that already includes a surf and a commute. Say if that is the plan. We may want the exam before the surf, or we may want you to skip the session that morning so the tests mean something. Call (949) 312-1754 if you are sorting the order. The 20-minute consultation can be the first appointment if you are not ready for a full evaluation.
Services that match this coastline
Board sports and trail hills make shoulder, neck, and knee complaints ordinary reasons to come north. McKenzie-based spine care is a fit when back or leg pain has a clear directional preference. Corrective exercise is how a Talega hill gets written into the plan instead of fought with a generic core sheet.
Families also come for problems that are not sports. Thyroid, sleep, and migraine questions are evaluated with the limits those conditions require. A migraine plan does not replace a neurologist. A thyroid plan does not replace the prescriber. Read the city overview at the San Clemente chiropractor page.
Before you get on the 5
No referral is required. Bring shoes you hike or walk the trail in if the foot or knee is the issue. Prior MRIs are useful and not mandatory. If you have bowel or bladder changes, saddle numbness, or a rapidly weakening leg, do not drive past an emergency department to reach us.
The practice is out of network. San Clemente patients typically use HSA or FSA funds and a superbill. We will not guess your benefits. The doctors are Drs. Sani and Tara Kohen. Their biographies are on the about page, and the clinic layout is on the office page.
Pier Bowl, Talega grades, and Trestles mornings
San Clemente has two terrains that matter clinically. The Pier Bowl, the beach trail, and the streets near the water are relatively level and sandy. Talega, Forster Ranch, and the newer hills are the opposite: repeated grades, youth sports, and a drive just to reach I-5. Surfing at Trestles and along the pier loads shoulders and low backs. Hill neighborhoods load knees on the way down and necks on the drive. We ask which part of town you live in because the home program has to match the grade outside.
A lot of San Clemente patients are trying to stay active while working north of here. The I-5 commute itself is a sitting test. If your low back or sciatica eases when you walk the beach trail and worsens in the car, that detail changes the exam. Tell us the direction of the commute and how long you sit, not only where it hurts.
Questions patients ask
Do you treat ME/CFS with a set protocol?
No. FRI does not claim a specialty protocol for myalgic encephalomyelitis or chronic fatigue syndrome. Persistent exhaustion is taken seriously, and the visit looks for contributors such as thyroid pace, iron, glucose, sleep, and, when the history fits, gut or exposure questions. Your physicians remain in charge of any formal diagnosis and of medications.
Which labs come before a toxin test?
Thyroid testing and advanced bloodwork for iron and metabolic markers usually come before mold or metal testing. Those common drivers can look exactly like a mysterious fatigue. Exposure testing is added when a building, a job, or a diet makes it plausible. Ordering a scare panel first is not the approach.
What if I crash after exercise?
Say so. Post-exertional worsening changes how training is discussed, and it is a reason not to push a generic fitness plan. Neuromuscular Rehabilitation and Chiropractic Sports Medicine can still help pain, with load kept inside what you can repay. FRI will not promise that a supplement prevents a crash.
Can sleep apnea be sorted here?
No. If apnea is suspected, a physician should evaluate it. FRI is not a sleep-medicine lab. The office can look at pain that wakes you, caffeine, thyroid pace, and a cortisol curve on a DUTCH test when those questions fit. Those findings do not replace a sleep study your physician orders.
Related care for San Clemente
Chronic Fatigue is handled at the Mission Viejo clinic, not in a satellite office in San Clemente. The related pages below stay on that same visit and add the methods or neighboring problems that usually come up in the history.
- San Clemente chiropractor
How people from San Clemente reach 26400 La Alameda and what the three pillars cover.
- Chronic Fatigue clinical overview
The non-geographic condition page, if you want the clinic-wide explanation without the drive.
- Functional Medicine
The pillar this problem sits in at Functional Restoration Institute.
- Thyroid Dysfunction in this city
Thyroid trouble is not one feeling. A slow pace can leave you cold, heavy, and constipated. A fast pace can leave you.
- Sleep & Insomnia in this city
Sleep problems have a clock, a chemistry, and often a body part that hurts. Caffeine, a late bedtime, a cortisol curve, thyroid.
- Mold Toxicity in this city
Some people feel worse after months in a water-damaged building: fatigue, fog, sinus congestion, or a taste of must in the air..
- Brain Fog in this city
Losing a word, rereading the same sentence, or feeling mentally padded is an experience, not a disease name. Sleep, thyroid pace, glucose.
- Advanced Bloodwork
Advanced bloodwork goes past a bare metabolic panel when the question needs more context. Lipids in more detail, glucose with insulin, iron.
