Dr. Hirani’s Holistic Approach to CFS

Look for Hidden Nutritional Deficiencies:

First I measure the nutritional status of my patients. Specialty nutritional panels help me assess your levels of amino acids, minerals, fatty acids, vitamins and antioxidant status via blood tests. An empiric trial of MB12 shots can be an easy way to check for deficiency while also providing clinical benefit to the patient. Intravenous vitamin therapies like Meyer’s Pushes or Vitamin C Immune Drips can help correct nutritional deficiencies as well as providing relief to many patients. In addition, we utilize glutathione, which is a small protein and super antioxidant, that helps with immune system boosting, liver detoxification, and free radical scavenging to name just a few of its actions. Glutathione can be administered in the form of an oral “detox cocktail” or via an intravenous IV at my clinic.

Food Intolerances:

The role of food choices in health and disease is so vital yet largely ignored in conventional medicine. In my practice, food allergies play a key role in treating chronic fatigue as well as many other medical illnesses. I utilize an allergy elimination diet or food allergy blood testing through IgG antibody levels. I cannot tell you how many patients I have been able to help by simply helping them discover what foods they are intolerant to. Some major culprits are wheat, dairy, sugar, alcohol and caffeine.

Liver and Colon Detoxification:

This is a concept largely foreign for conventional doctors. I utilize medical foods that have been scientifically studied, are safe and very therapeutic in helping the liver and colon detoxify better.Standard blood testing for liver function only evaluates for end stage liver damage, thus normal liver function tests do not necessarily indicate if the liver is taxed and burdened. Relying solely on them especially when a patient is chronically ill is not helpful. Colon hydrotherapy can also be of great benefit for many patients.

Hormone Imbalances:

Looking at subclinical hypothyroidism is very beneficial for my patients. I do not rely solely on the blood TSH value to make the diagnosis of low thyroid. I look for other classical symptoms of low thyroid such as fatigue, weight gain, brittle nails, dry skin, constipation, and thinning hair.; I recommend patients check the basal axillary temperature for five days, and I also do a thyroid gland exam during your physical exam. When indicated, referral to ultrasound is offered. I recommend an excellent book, Thyroid Power, written by Richard Shamas MD, a Harvard trained physician.

Progesterone deficiency is also very common and when corrected appropriately, can help the mood, sleep and other symptoms as well. I diagnose this through blood or saliva hormones.

Testing for Heavy Metals:

I check all my patients with chronic fatigue for heavy metal burden, which is widely overlooked by most allopathic doctors. At my office we use the urine poryphrins test for mercury burden, and also the heavy metal challenge test. In the challenge test, a provoking or chelating agent is administered orally, rectally or intravenously and then the amount of metal excreted in the urine over next 6 hours is measured. A toxicology lab evaluates the urine and if high amounts of toxic metals are seen, the patient is treated for metal toxicity. Treatment for this condition can help with memory loss, fatigue, depression, brain fog, etc.


Diagnosing candidiasis or yeast is also very helpful for many chronic fatigue sufferers. I prescribe a yeast free diet along with herbal or prescription antifungals. What I find is a connection usually between mercury burden and candidiasis.

Stress reduction:

This is something that must be looked at much more in chronic fatigue sufferers.I recommend my patients read the book “The Balance Within” by Dr. Ester Sternberg. She is a conventional doctor who is able to describe the connection between immune dysfunction and stress. This is a major recommendation I give to all my patients with chronic fatigue: find some time in the day for yourself and stress reduction every day.  MBSR – Mindfulness Based Stress Reduction is a form of CBT (Cognitive Behavioral Therapy) that is very effective in reducing stress.  There are many workshops across Los Angeles, Santa Monica, and the South Bay that offer free classes.  In addition there are self guided workbooks that you can purchase from Amazon.


Since there is no one etiology for chronic fatigue, the integrative and alternative medicine approach promises to be of great benefit to chronic fatigue sufferers, since it looks at the whole person, from nutrition to stress.More than one million people suffer from Chronic Fatigue Syndrome.

Link to Centers for Disease Control site for some more Basic Facts on CFS.

Leave a Reply


Contact Us

Hirani Wellness Medical Center
Karima Hirani, MD MPH
9736 Venice Blvd.
Culver City, CA 90232
Map & Directions

Phone: (310) 559-6634
Fax: (310) 559-6652

Send E-mail