Chronic Fatigue Specialist Melbourne
Naturopathic and functional medicine care for CFS, ME, post viral fatigue and adrenal dysfunction that has not improved with rest.
25+
Clinical Experience
ATMS
member
Telehealth
Australia-wide
Free 20 minute
discovery call
In-clinic at Kealba, Melbourne. Telehealth available across Australia. No referral required.
Looking Deeper Into Your Fatigue
Waking unrefreshed, hitting a wall after a short walk or a busy day, losing your words halfway through a sentence. Fatigue that does not lift with rest is hard to live with, and harder still when your bloods keep coming back normal. Standard tests are built to find disease. They are not designed to show how well your cells make energy, how your stress hormones move across the day, or how well your thyroid converts hormone.
Vital Health and Natural Medicine practises naturopathy with a functional medicine focus, and our care sits alongside your doctor’s, not in place of it. Testing looks at the drivers that standard pathology does not measure, and your protocol is built around what we find instead of a standard fatigue plan.
Many of the people we see have been told it is stress, anxiety or depression, or have tried rest, supplements and diet changes without lasting change. Fatigue often has several drivers working at once, including cellular energy, cortisol rhythm, gut health, thyroid conversion and nutrient depletion. That is why a single fix rarely holds.
Chronic Fatigue Patterns We Investigate and Treat
Fatigue has different drivers in different people. We identify which pattern is present through testing before any treatment starts.
Chronic Fatigue Syndrome (CFS) and ME
• Fatigue lasting six months or more that rest does not fix
• Post exertional malaise, feeling worse for a day or more after effort
• Unrefreshing sleep, brain fog and memory problems
• Muscle and joint aches without a structural cause
Post Viral Fatigue and Long COVID
• Fatigue that began after COVID, glandular fever, Ross River fever or gastroenteritis
• Slow recovery and repeated relapses
• Recurring infections and low resilience
Burnout and Adrenal Dysfunction
• Feeling wired but tired, with afternoon crashes
• Poor or broken sleep
• Anxiety, low mood or emotional flatness
• Symptoms that worsen under stress
Mitochondrial Dysfunction
• Whole body fatigue and slow recovery after effort
• Muscle weakness and low exercise tolerance
• Possible depletion of CoQ10, B vitamins, magnesium or carnitine
Thyroid Dysfunction
• Fatigue with weight changes and cold intolerance
• Brain fog and low motivation
• Normal TSH but ongoing symptoms
• Thyroid antibodies or a family history of thyroid disease
Gut Driven Fatigue
• Bloating and irregular bowels alongside fatigue
• New food reactions
• Fatigue that began after antibiotics or an infection
A note on terms. Adrenal fatigue is not a formal medical diagnosis, so we test your cortisol rhythm to see what is actually happening. ME/CFS is diagnosed by your doctor, and our care works alongside that diagnosis.
Testing That Goes Beyond Standard Blood Tests
Standard panels are designed to detect disease. They flag severe hypothyroidism but can miss poor T4 to T3 conversion, and they show anaemia but not early iron depletion. Most clients need two or three tests, chosen to match their pattern.
| What standard tests check | What functional testing looks at |
|---|---|
| TSH only for thyroid | Free T3, reverse T3 and thyroid antibodies |
| Full blood count for anaemia | Ferritin, B12 and folate assessed against functional ranges |
| Cellular energy: not tested | Organic Acids Test for mitochondrial function |
| Cortisol rhythm: not tested | Four point salivary cortisol across the day |
| Stool culture for infection | Microbiome map covering bacteria, fungi, permeability and inflammation |
The tests we use most often
Organic Acids Test
An at home urine test measuring over 70 metabolites linked to cellular energy, B vitamin status, oxidative stress, gut bacteria and neurotransmitter breakdown.
AdrenoCortex salivary panel
An at home test measuring cortisol at four points across the day, plus DHEA, to show your stress hormone rhythm.
Thyroid panel
A blood test covering TSH, free T4, free T3, reverse T3 and thyroid antibodies (TPO and TgAb).
GI Microbiome Map
An at home stool test, used when fatigue comes with gut symptoms or began after an infection.
Nutrient and blood panel
Ferritin, B12, folate, vitamin D, zinc, red cell magnesium, fasting insulin, CRP and homocysteine.
How We Decide What to Treat First
When several systems are running low at once, treating them in the wrong order can leave you more depleted, not less. The ROOT Method is how we decide what to look at first and what to leave until later. It follows four steps.
R — Review Your Full History
We map your fatigue timeline, including illnesses, stressors, sleep and everything you have already tried.
O — Order Targeted Testing
Two or three tests are selected to fit your symptom pattern, so you are not paying for a broad panel you do not need
O — Observe the Clinical Findings
We read your results together, for example how cortisol, gut and cellular energy findings feed into each other, alongside your history.
Treat the Cause
Your protocol targets the highest burden driver first and builds in stages, so treatment does not overload a body that is already depleted.
How Your Care Begins and What It Costs
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Free discovery call. We phone you for 20 minutes to hear about your symptoms, what has already been investigated and whether functional testing is the right next step. No obligation.
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First consultation. A 60 to 90 minute appointment in clinic or by video, covering your full health history, previous results and the systems most likely involved.
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Testing. We arrange the tests that suit your pattern, with kits posted to your home where the test allows, and review the results together in a detailed follow up consultation.
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Your protocol. A written plan sets out your herbal medicine, supplements and nutrition in stages, with follow up appointments and retesting to check that your markers are moving.
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Cost. The Thyroid and Energy Reset is $450 for the thyroid and adrenal panel and $97 for the consultation. That gets you a 90 minute appointment, a personalised energy protocol with nutritional and herbal support, and follow up. Your discovery call will confirm which tests suit you and what they cost.
Meet Domenic Pisanelli
Domenic Pisanelli has practised as a naturopath for more than 25 years and is an ATMS member. His qualifications span functional medicine, medical herbalism, nutritional medicine, live blood analysis, electro dermal screening and iridology. He works with people whose fatigue has been put down to stress, anxiety or depression without a functional investigation.
His approach is to test instead of guess, using the ROOT Method he developed to work through complex cases one step at a time. He looks at the whole picture, from gut health and thyroid function to stress hormones and cellular energy, and does not promise quick fixes.
Serving Melbourne’s Western and Northern Suburbs
Primary Suburbs
We also see patients from Richmond, Fitzroy, Brunswick, Frankston, Dandenong, and surrounding Melbourne suburbs — and telehealth patients from across Australia.
Not on the list? We still see you. Get in touch.
Frequently Asked Questions
Diagnosis usually starts with your GP, who rules out other causes and may refer you to an immunologist, neurologist, rheumatologist or a specialist fatigue clinic. Naturopaths with functional medicine training add a different layer, looking for drivers such as cellular energy, cortisol rhythm, gut health and thyroid conversion. Many of our clients see us alongside their doctor.
Yes, if you have not had a medical check. Fatigue can be linked to anaemia, sleep apnoea, thyroid disease and depression, which need medical assessment. See your GP urgently for unexplained weight loss, fevers or night sweats, chest pain, shortness of breath, fainting, severe headaches or new neurological symptoms.
Yes. ME/CFS is a recognised illness, and the World Health Organization classifies it as a neurological disease. The cause is not fully understood, and research is looking at immune, energy metabolism and gut changes. The idea that it is psychological comes from earlier diagnostic uncertainty, not from current evidence.
Post viral fatigue begins or worsens after an infection, including glandular fever, and often settles within a few months. ME/CFS is diagnosed when symptoms last six months or more in adults and include post exertional malaise and unrefreshing sleep. If fatigue after an infection is not lifting, testing can help find what is keeping it going.
Post exertional malaise is a worsening of symptoms after physical, mental or emotional effort, often appearing hours to a day later and lasting days or longer. It is why pacing matters, which means balancing activity and rest to stay inside your energy limits. Tell us about it at your first appointment, as it shapes how gently and in what order we introduce treatment.
There is no cure for ME/CFS, and results vary between people. Our aim is to find and treat the drivers that can be addressed, such as nutrient depletion, gut problems, thyroid issues and disrupted stress hormones, to improve energy, sleep and mental clarity over time.
It depends on which drivers are present and how long symptoms have been going. Progress is rarely a straight line, and most people see an uneven upward trend. Sleep and mental clarity often improve first, with energy following. Follow up testing is usually done around the three month mark, and long standing ME/CFS may need a longer course.
No referral is needed. Carry on with your prescribed medication, and share a full list of medicines and supplements at your first appointment, because some herbs and supplements interact with medicines. Any change to prescribed medication should be made with your doctor.
Ready for Answers About Your Fatigue?
Tell us what you have been through and what has already been investigated, and we will tell you whether functional testing is the right next step. The free call takes 20 minutes, with no obligation, and we phone you at a time that suits. Available by telehealth across Australia.