You have been exhausted. You went to the doctor. Your labs came back normal. And somehow that made it worse — because now you have no explanation, no answers, and a quiet suspicion that something is still very wrong.
You are not imagining it. And this episode is where it finally gets addressed.
In the third and final episode of our fatigue series, Dr. Jillian and Dr. Ade deliver the complete clinical protocol: the labs that actually reveal what is driving your fatigue, the supplement stack with the full reasoning behind every ingredient, and the exact language to use when you sit down with your provider so you walk out with something more useful than a recommendation to sleep more.
This is the episode you bring to your next appointment.
Free Download Fatigue Protocol
Everything covered in today's episode — the complete lab panel organized by tier, the supplement stack with ingredient breakdown and dosing, patient advocacy language, and a quick-reference symptom guide — is available as a free download.
Get the Complete Fatigue Protocol at modernmidlifecollective.com/fatigue
Missed Parts 1 and 2?
Episode 31 — Why Am I Always Tired? The Root Causes of Fatigue Part 1 Covers: sex hormone dysregulation, thyroid dysfunction, and HPA axis dysregulation
Episode 32 — Why Am I Always Tired? The Root Causes of Fatigue Part 2 Covers: blood sugar dysregulation, nutrient deficiencies, and chronic low-grade inflammation
Labs Discussed in This Episode
Tier One — First Visit Essentials
Hormones: Estradiol (E2), Free and Total Testosterone, Progesterone, DHEA-S, FSH, LH, SHBG
Thyroid: TSH, Free T3, Free T4, TPO Antibodies
Metabolic: Fasting Insulin, Fasting Glucose, HOMA-IR, Hemoglobin A1c, Comprehensive Metabolic Panel, Fasting Lipid Panel
Nutrients: Ferritin (target 70 to 100 ng/mL), 25-OH Vitamin D (target 50 to 80 ng/mL), Vitamin B12
Inflammation: High-Sensitivity CRP (hsCRP)
Tier Two — Added Based on Clinical Picture
Thyroid extended: Reverse T3, Anti-Thyroglobulin Antibodies
Adrenal: 4-Point Salivary Cortisol and DHEA (functional lab — typically requires a functional medicine or integrative provider)
Metabolic extended: Continuous Glucose Monitor (CGM) trial
Nutrients extended: RBC Magnesium, Folate, Zinc, IGF-1
Gut: Comprehensive Stool Analysis (functional lab)
Supplements Discussed
Full supplement collection available through Dr. Jillian's professional dispensary: https://us.fullscript.com/plans/moderngynecology-modern-midlife-collective-s-fatigue-protocol
Magnesium Glycinate — sleep, nervous system support, restless legs. 300 to 400 mg at night.
Magnesium Malate — daytime energy and muscle function. 200 to 400 mg with food.
CoQ10 Ubiquinol — mitochondrial energy chain. Non-negotiable for statin users. 100 to 300 mg daily.
Berberine — insulin sensitivity and metabolic support. 500 mg with meals, titrate slowly.
Myo-Inositol with D-Chiro-Inositol (40:1 ratio) — insulin sensitivity and hormonal balance. 2 to 4 grams daily.
Ashwagandha standardized extract — HPA axis and cortisol rhythm support. 300 to 600 mg daily.
Rhodiola Rosea — cognitive fatigue and stress resilience. 200 to 400 mg in the morning.
Phosphatidylserine — evening cortisol reduction; wired-but-tired pattern. 100 to 300 mg at night.
Methylated B Complex — neurological energy and cortisol metabolism. Critical for women on oral contraceptives, PPIs, or metformin.
Vitamin D3 with K2 MK-7 — immune, hormonal, and energy support. 5,000 IU D3 with 100 mcg K2 daily with food.
Omega-3 EPA and DHA — anti-inflammatory and cardiovascular support. 2 to 4 grams of combined EPA and DHA daily.
Full curated supplement collection with professional-grade brands: modernmidlifecollective.com/fatigue
Research Cited
Women's Health (London) — 67% Fatigue Prevalence in Perimenopausal Women (n=3,000+) Menopause Journal (March 2025) — AUB, Iron Depletion and Fatigue During Perimenopause (n=2,300+) AIMS Molecular Science (2024) — Estrogens and Mitochondrial Biogenesis Frontiers in Endocrinology (2024) — Mitochondrial Dysfunction and Insulin Resistance The American Journal of Medicine (2025) — HPA Axis Dysregulation: Integrative Review PMC UK Survey (2025) — Fatigue in Treated Hypothyroidism (n=1,251; 89% abnormal fatigue) XX Midlife Women's Health Study — Stress-Fatigue Coupling Across Menopause Transition WellnessExtract Research (2025) — IL-6, TNF-alpha, and Perimenopause Inflammation
Connect With Us
Website: modernmidlifecollective.com
Free Fatigue Protocol: modernmidlifecollective.com/fatigue
Instagram: @modernmidlifecollective
Email: connect@modernmidlifecollective.com
Work With Dr. Jillian Modern Gynecology and Skin | Anchorage, Alaska
Instagram: @drjillianwoodruff
Transcend Retreat Waitlist: https://moderntranscend.com/retreat-waitlist
Transcend Retreat Waitlist: https://moderntranscend.com/retreat-waitlist
Website: www.moderngynalaska.com
Work With Dr. Ade Rejuvenate Health and Wellness | Anchorage, Alaska
Website: www.rejuvenatehealthak.com
Download Dr. Ade’s Metabolic Reset Cheat Sheet https://rejuvenatehealthakrlt.com/metabolic-reset
Take your Midlife Vitality Quiz https://dr-ade-the-vitality-gap-scorecard.scoreapp.com/
Instagram: @rejuvenate_health_wellness | @dr.adeakindipednp
Both practices serve patients in the state of Alaska.
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The Modern Midlife Collective Dr. Jillian Woodruff, MD, FACOG, MSCP x Dr. Ade Akindipe, DNP, MBA, APRN modernmidlifecollective.com