Persistent fatigue is a symptom with many possible causes, and identifying the contributors comes first. At PHI in Beverly Hills, board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi offer IV therapy, NAD+, and peptide therapy as supportive optimization, alongside primary care evaluation of the underlying cause.
When You’re Tired in a Way That Doesn’t Resolve
Most people experience occasional tiredness. Persistent fatigue is something different: the kind that does not improve with a weekend off, that makes basic tasks feel harder than they should, where coffee does not really help anymore but just temporarily masks how exhausted you actually feel.
Most patients we see for fatigue have been managing this for months or years, often having been told it is stress, age, or just how things are now. Sometimes that is accurate; often there is something more identifiable contributing. What we offer is the supportive optimization side of fatigue care, and we are honest that the most important first step is identifying what is actually contributing. For many patients, comprehensive primary care evaluation reveals specific factors, such as thyroid dysfunction, vitamin deficiencies, sleep apnea, or hormonal changes, that can be directly addressed. Our offerings work best alongside that evaluation rather than as a substitute for it.
Fatigue Has Many Causes
Persistent fatigue is a symptom, not a diagnosis. Causes that often have specific treatments include anemia, thyroid dysfunction, sleep apnea (often undiagnosed and a major contributor), vitamin D deficiency, hormonal imbalances, depression and anxiety, diabetes and prediabetes, chronic infections, autoimmune conditions, medication effects, and post-viral syndromes including long COVID.
Lifestyle and environmental factors include chronic insufficient sleep (the most common modifiable contributor), poor sleep quality, chronic stress, inadequate nutrition, a sedentary lifestyle, and alcohol or substance use. Some conditions, such as ME/CFS and fibromyalgia, have specific clinical considerations. The first step is identifying which categories may be contributing. For patients without prior workup, primary care evaluation typically comes first.
How PHI Approaches Fatigue and Low Energy
The first step is comprehensive evaluation: a detailed history of your fatigue and how it has progressed, discussion of potential contributors, review of any prior workup, and an honest assessment of whether wellness optimization fits your situation or whether primary care evaluation should come first.
IV therapy delivers nutrients directly into circulation, particularly useful for patients with documented vitamin or nutrient deficits; IV B-complex, B12, and other formulations may produce meaningful improvement when deficits contribute to fatigue. NAD+ therapy delivers a coenzyme involved in cellular energy production that declines with age, with evidence for fatigue we describe as emerging rather than established. Peptide therapy uses specific compounds that may support energy, mitochondrial function, and sleep, discussed individually without listing specific peptides publicly. These are delivered in our clinic setting, and we coordinate with your primary care physician for evaluation and management of underlying contributors.
When This Page Applies to You
You may benefit from PHI’s offerings if you have had primary care evaluation that identified specific contributors being managed but you still have residual fatigue, if your fatigue appears related to high stress or post-illness recovery, if you are in perimenopause, menopause, or andropause with appropriate hormone evaluation underway, or if you want supportive optimization alongside addressing underlying factors.
You are typically better served elsewhere first if you have not had primary care evaluation for persistent fatigue, if you have significant new or progressive fatigue without identified cause, or if you are hoping wellness intervention will substitute for evaluating treatable medical causes.
Why PHI for Fatigue Optimization
Two board-certified physicians
Dr. Faisal Lalani and Dr. Nadiv Samimi both trained in interventional medicine at Cedars-Sinai and bring medical rigor to wellness optimization.
Honest framing
We do not position wellness interventions as substitutes for primary care evaluation of fatigue. We recommend treatments only when they fit your specific situation.
Physician-supervised, clinic-setting delivery
IV therapy, NAD+, and peptide therapy are delivered in our clinic setting under physician supervision.
Coordination with primary care
PHI’s role is supportive optimization, not primary fatigue evaluation. We coordinate with your primary care physician rather than working in isolation.
Tailored recommendations
Each patient gets recommendations matched to their specific fatigue pattern, suspected contributors, and prior workup.
Concierge, coordinated care
Single-physician continuity from consultation through treatment and return to activity. Patients receive clear guidance and transparent pricing at consultation.
Frequently Asked Questions
For most patients with persistent fatigue, yes. Primary care evaluation typically includes basic blood work (CBC, comprehensive metabolic panel, thyroid function, B12, vitamin D, ferritin) and discussion of sleep, mood, and lifestyle. Many fatigue cases have specific identifiable causes that respond well to direct treatment. Wellness optimization works better as an addition to addressing underlying factors than as a substitute.
For patients with documented vitamin or nutrient deficits, IV nutrient therapy can produce meaningful improvement. For patients without specific deficits, it may provide more variable benefit. We evaluate whether IV therapy fits your situation rather than offering it as a universal energy boost.
The mechanistic rationale is sound, since NAD+ is involved in cellular energy production and declines with age. Some patients report meaningful improvement; others experience more limited benefit. We are honest that the clinical evidence is emerging rather than established.
Possibly. Sleep apnea is one of the most common and under-diagnosed causes of fatigue. If you have loud snoring, witnessed pauses in breathing, morning headaches, or fatigue that does not improve with adequate sleep, sleep apnea evaluation is worth pursuing, and treating it typically resolves fatigue more effectively than wellness interventions can.
Post-viral fatigue including long COVID is real and increasingly recognized. Some patients experience improvement with supportive interventions. Long COVID care typically involves coordination with primary care or specialty providers, and PHI’s offerings may complement that broader care for selected patients.
Yes, often. Hormonal changes commonly include fatigue as a prominent symptom. Hormonal evaluation through your primary care or gynecologist is typically the right first step, and PHI’s offerings may complement hormonal management once that is underway.
ME/CFS has specific clinical features including post-exertional malaise. Care typically involves specialty providers familiar with the condition. PHI’s offerings may complement specialty care for selected patients but are not substitutes for ME/CFS-specific evaluation and management.
Insurance coverage and payment options may vary. Please contact our office to discuss your specific plan, available options, and pricing. All pricing is disclosed at consultation.
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
Treatments We Offer for Fatigue and Low Energy
PHI offers supportive optimization treatments for fatigue and energy. Your physician will recommend the right options based on your specific situation, prior workup, and suspected contributors.
- IV Therapy, most useful when a nutrient deficit is contributing
- NAD+ Therapy
- Peptide Therapy
Schedule Your Fatigue Consultation
A 60-minute consultation will evaluate your specific fatigue, walk through whether wellness optimization fits your situation or whether primary care evaluation should come first, and recommend treatments that match your situation. Call (310) 856-9488 or book online now.