Raena Morgan: Dr. Langer, many people complain of fatigue, lack of energy. It's very common, right? Dr. Stephen Langer: Commonest complain that I see walking through my door in Berkeley, California, are my patients telling me that they're tired all the time, they go to sleep tired and they wake up tired. Very few people come to see a doctor because they're complaining of too much energy. Raena Morgan: But at what point does it become chronic? Dr. Stephen Langer: Again, when you're talking about chronic fatigue, I mean, it depends a lot about the makeup of the person. If a person isn't feeling good about themselves, if they've been depressed, chronic can be an hour or two, believe it or not. In other words, time goes slowly and they just feel tired all the time. Raena Morgan: Is it like that limp feeling, where you just can't pick yourself up and go? Or is it just, does it feel like it's glandular? Dr. Stephen Langer: Well, there are many different manifestations of fatigue as there are people. But I started to say, is the Centers for Disease Control defines chronic fatigue, which is chronic fatigue syndrome as being bone-chilling fatigue for over six months. But if you're tired for more than a few weeks, every single day, I would define that as chronic fatigue. As you asked, how a person feels, again, it depends on the makeup of that particular person. If that person is in relatively decent shape before they feel tired, they'll express their fatigue in one way. If somebody is in poor shape and is not getting enough sleep and has different lifestyle things that have to be corrected, they'll have a totally different set of symptoms. Raena Morgan: So, I guess what I'm asking is, could it be circumstantial, or could it be just organic, or -- Dr. Stephen Langer: It can be both. It can be a combination of all and I usually see fatigue as being a combination of all of these things. We're talking about lifestyles. Commonest cause of fatigue as far as lifestyle goes, first question I ask out of the shoot if somebody says that they're tired, is number one how did they sleep? Raena Morgan: Okay. Dr. Stephen Langer: Number two, how many hours a day. Because a person can say, "I sleep great." "How many hours do you sleep?" "Oh, I sleep four to five hours a night." Four to five hours a night, for most adults, is sleep deprivation. Now, a person can be sleep deprived, not because there's anything organically wrong. A person can be sleep deprived because they have a newborn child in the house, or they have a toddler who doesn't sleep, or somebody who is sick, or a partner who snores. It's a very common complaint, you know, for people not sleeping. Raena Morgan: Is it really? Dr. Stephen Langer: Absolutely. Raena Morgan: A snoring partner. So that would be circumstantial. Dr. Stephen Langer: That would be circumstantial, right. But as a person experiences fatigue for a long period of time, what starts out, perhaps as a lifestyle kind of an event, can evolve into more of an organic event. In other words, as your body is stressed out, due to the fatigue, your immune system starts to suffer, your adrenal glands start to suffer, your other glandular systems start to suffer. And it's superimposed upon that a person's digestion is off, or they're too tired to cook for themselves, or to get food, which is very often a common event in people who are too tired. They're too tired to, you know to really live. They're too tired to really eat the right kinds of food, so they start to develop sub-clinical malnutritions. In other words, nutrient deficiencies and it starts to cascade. So you really have to intervene and help on many different levels. Raena Morgan: So, then it does become more organic? Dr. Stephen Langer: It does become more organic. The first thing that I look to do, because anybody can do this, is to try and change their lifestyle. Raena Morgan: All right. Dr. Stephen Langer: Number two is to start eating a proper diet. And, you know, wit