Key Takeaways

• Most New Year’s goals fail at the cellular level, not the behavioral level.
  If your cells can’t efficiently use oxygen to produce energy, motivation and discipline won’t hold.
• Oxygen utilization efficiency is the missing metric.
  VO₂ max / CPET testing shows how well your mitochondria convert oxygen into ATP—the energy your brain and body run on.
• Normal labs don’t mean normal energy.
  Many people with burnout, brain fog, or post-viral fatigue are told everything looks “fine” until oxygen efficiency is measured.
• January exposes underlying metabolic debt.
  Less light, more stress, disrupted sleep, and higher cognitive demands reveal systems that never fully recovered from the prior year.
• Pushing harder without metabolic capacity worsens depletion.
  Intensity without oxygen efficiency accelerates burnout rather than building resilience.
• Restoration requires measurement, not guessing.
  When oxygen delivery, mitochondrial function, and nervous system regulation are measured, recovery becomes targeted and effective.

The Oxygen Resolution: Fix This One Thing Before Your Next Goal

Janurary used to feel impossible.

Not because I lacked goals. I had those. Strategic plans, quarterly targets, systems I believed would finally create the breakthrough I needed.

But every January, by week three, I'd hit the same wall.

Energy gone by 2 PM. Brain fog in critical meetings. Sleep that didn't restore anything. The creeping realization that I was operating on fumes, again, despite doing everything "right."

I see this now in the people who walk into The Dearing Clinic every January. Executives burning out in corner offices. Professionals white-knuckling their way through another quarter. Spouses holding entire households together while quietly falling apart. People still trying to recover from viral infections that happened months or years ago.

They've survived Q4. They've made it through the holidays. And now they're supposed to execute at the highest level—with a system that never recovered from the last twelve months.

Here's what nobody tells you about New Year's resolutions:

They fail at the cellular level before they fail at the behavioral level.

Because if your cells can't efficiently use oxygen to produce energy, every goal you set is built on a foundation that can't support the load.

Let me explain what I mean.

‍

The Metric Everyone Ignores

You track everything.

Sleep scores. HRV. Steps. Macros. Meeting efficiency. Quarter-over-quarter growth.

But I'm willing to bet you've never measured the one thing that predicts whether any of those other metrics will actually improve:

Oxygen utilization efficiency.

Not how much oxygen you breathe in. Not your SpO2 saturation.

How efficiently your cells convert oxygen into ATP—the actual energy currency your brain, muscles, and every biological system runs on.

This is measurable. It's called VO2 max testing, or more precisely, Cardiopulmonary Exercise Testing (CPET). It tells you exactly how well your mitochondria are doing their job.

And here's what I've found after 17 years and over a thousand patients—including executives, professionals, exhausted spouses, and people struggling with post-viral fatigue and long COVID:

When oxygen utilization is compromised, everything else is a band-aid.

You can optimize your sleep hygiene, but if your cells can't use oxygen efficiently, sleep won't restore you.

You can dial in your nutrition, but if mitochondrial function is impaired, those nutrients won't convert to usable energy.

You can manage your calendar perfectly, but if your brain is running on compromised ATP production, decision-making degrades by mid-afternoon.

Oxygen efficiency is the rate-limiting step.

‍

Lessons from the Long Haulers

We've learned more about oxygen utilization in the past few years than in the previous decade—because post-viral and long COVID patients forced us to measure what matters.

These aren't people who were "out of shape" before they got sick. Many were athletes, high-performers, people in their prime. Then a viral infection knocked them offline, and they never fully recovered.

Let me show you what that looks like.

I'm going to share data from a long COVID patient who came to us eighteen months post-infection. We'll call her Sarah. She was a professional in her early 40s—sharp, driven, healthy before COVID. After her infection, she could barely get out of bed most days. Working even part-time left her crashed for days.

Her primary care doctor told her labs were normal. Her cardiologist said her heart was fine. A neurologist found nothing on her MRI. Everyone kept saying she should be better by now.

But when we ran her VO2 max testing, the truth was right there in the data.

Her oxygen utilization was catastrophically low. Not "a little below average"—we're talking oxygen circulation at 29%, in the limitation range. Her VO2 peak was 31, severe limitation. Her cells couldn't use oxygen to produce energy. Her mitochondria had shifted into protective shutdown mode and never shifted back.

No amount of willpower, positive thinking, or "just push through it" was going to fix that. You can't willpower your way out of cellular oxygen debt.

We spent six months—not weeks, months—methodically restoring her system. Stabilizing inflammation. Improving oxygen delivery. Retraining her autonomic nervous system. Supporting mitochondrial function. Moving at the pace her biology could handle, not the pace she wanted to move.

And now? Look at her most recent testing. Her oxygen circulation is nearly normal at 79%. Her VO2 peak is in the good range. Her mitochondria are finally functional enough that we can begin using exercise to help her thrive long-term—not just survive.

She's back at work full-time. She's consistently out of bed. She has her life back.

But here's the critical lesson: We couldn't have gotten her there without measuring what was broken.

If we'd just thrown supplements at her, or told her to pace better, or sent her to another round of generic rehab, she'd still be in bed wondering why nothing worked.

This is why oxygen utilization matters. It's not theoretical. It's the difference between guessing and knowing. Between symptom-chasing and root-cause resolution.

‍

The Professional's Oxygen Debt (And The Spouse Who Carries It)

If you're an executive, a high-level professional, or the spouse of someone in that world, you've likely been accumulating oxygen debt for years.

And I want to talk directly to both of you—because this isn't just the executive's problem.

For the professional: Here's how it compounds.

Stage 1: Compensation

You're still hitting targets. Still performing. But it requires more caffeine, more willpower, more recovery time. You used to bounce back from a hard week. Now it takes the whole weekend, and even then you're not quite there.

Your cells are working harder to produce the same amount of energy. Mitochondria are shifting into conservation mode. Oxygen delivery to tissues is declining, but you're compensating—so you don't notice yet.

Stage 2: Diminishing Returns

Now the interventions that used to work don't. You sleep 8 hours but wake up foggy. You work out but feel worse after. You take every supplement on the market and feel... nothing.

This is where most people are when they walk into my clinic. They've tried everything, but they've never measured whether their cells can actually use oxygen efficiently. They're trying to optimize systems that are fundamentally energy-starved.

Stage 3: Breakdown

This is where chronic fatigue, post-viral syndromes, burnout-related leaves, and "I can't do this anymore" moments live. The system can't compensate any longer. Even basic activities trigger crashes.

Most people don't get here overnight. They get here after years of ignoring the early signals.

For the spouse or partner: You're living this too, just differently.

You're managing the household while your partner grinds at work. You're absorbing the emotional overflow. You're the one who picks up the pieces when they crash on weekends. You're compensating for their depletion while slowly depleting yourself.

Or maybe you're both professionals, both grinding, both running on fumes and wondering why "date night" or "better boundaries" isn't fixing the exhaustion.

Either way, oxygen debt doesn't respect job titles or roles.

If you're carrying chronic low-grade stress, disrupted sleep, hypervigilance, deferred self-care, you're in the same metabolic crisis. Just from a different angle.

This isn't two separate problems. It's one household system running on compromised oxygen efficiency.

And the fix isn't self-care Sundays or vacation time—though those are fine. The fix is restoring the foundational biology that makes energy, focus, and resilience possible in the first place.

‍

Why January Exposes This

Q1 is metabolically unforgiving.

Less sunlight (lower vitamin D, disrupted circadian signaling). Colder temperatures (higher baseline energy demand). Post-holiday nervous system dysregulation (sleep disruption, dietary chaos, social stress). Increased cognitive and strategic demands (annual planning, goal-setting, execution pressure).

If your oxygen utilization was barely adequate in December, January will expose it.

And if you respond by pushing harder—more HIIT, stricter fasting, longer hours—you're compounding the problem.

Because intensity without metabolic capacity doesn't build resilience. It accelerates depletion.

This is what happened to Sarah, my long COVID patient. She kept trying to push through. Every attempt sent her into a deeper crash. It wasn't until we measured her oxygen efficiency and realized her system couldn't support even moderate activity that we could build a recovery plan that actually worked.

‍

What Oxygen Restoration Actually Looks Like

This isn't about breathing exercises or buying an oxygen concentrator.

It's about measuring and restoring the entire oxygen delivery and utilization system:

1. Oxygen delivery – Are red blood cells carrying oxygen efficiently? Is circulation adequate? Is inflammation blocking oxygen from reaching tissues?

2. Cellular uptake – Are mitochondria able to use the oxygen that arrives? Or are they in protective shutdown due to chronic stress, inflammation, or nutrient deficiencies?

3. Nervous system regulation – Is your autonomic nervous system stuck in sympathetic overdrive, vasoconstricting blood vessels and limiting oxygen delivery?

4. Metabolic flexibility – Can your cells switch between fuel sources efficiently, or are they rigidly dependent on glucose and struggling when it's not available?

We measure all of this. CPET for oxygen utilization. HRV for autonomic function. Organic acids testing for mitochondrial markers. qEEG for brain network efficiency.

Then we restore it—sequentially, methodically, tracking progress at every stage.

Not because it's complicated for the sake of being complicated. Because oxygen efficiency is a system output, not a single lever.

‍

The One-Thing Resolution

So here's my challenge for you this January:

Before you commit to another goal, measure whether your system can support it.

Specifically: measure your oxygen utilization efficiency.

One CPET test. One baseline. One objective data point that tells you whether your mitochondria are operating at 40% capacity or 90% capacity.

If you're at 40%, no amount of discipline, productivity hacking, or "pushing through" will work long-term. You'll hit the wall again. Maybe in February. Maybe in April. But you'll hit it.

If you're at 90%, optimize from there. You've earned the right to add intensity.

But most of the people reading this are somewhere in between—and they've been guessing.

Stop guessing.

Your cells either produce energy efficiently, or they don't. That's measurable. And once you know, you can fix it.

While everyone else is setting goals their physiology can't support, you'll be restoring the one system that makes all other goals possible.

‍

What Happens When You Fix This

I've seen it a thousand times:

The executive who couldn't think past 2 PM regains clarity that lasts all day.

The spouse who was "fine" (but exhausted) realizes they've been running on 60% capacity for years—and gets that capacity back.

The professional who needed weekends just to recover starts recovering overnight.

The long COVID patient who couldn't work for eighteen months gets back to full-time and starts rebuilding their life.

Not because they found a magic supplement or a better morning routine.

Because they measured what was broken and restored it systematically.

Energy becomes stable. Sleep becomes restorative. Exercise builds capacity instead of depleting it. Cognitive function sharpens.

This is what happens when oxygen utilization efficiency improves. Everything downstream gets easier.

‍

Your Next Step

If you've read this far, you already know something is off.

Maybe you've been told your labs are "normal." Maybe you've tried everything and nothing sticks. Maybe you're the person holding the household together while slowly falling apart yourself. Maybe you're still trying to recover from an infection that knocked you offline months or years ago.

Here's what I want you to do:

Stop adding interventions. Start measuring the foundation.

Book a New Patient Consultation. We'll measure your oxygen utilization, your autonomic function, your mitochondrial markers, and your brain network efficiency.

Then you'll know exactly what's broken and exactly how to fix it.

No guessing. No generic protocols. Just data, a clear plan, and the methodical restoration of the system that makes energy possible.

The Oxygen Resolution isn't about doing more.
It's about fixing the one thing that makes everything else work.

January doesn't have to feel impossible.
Not when your cells can finally use the oxygen you're breathing.

‍

Frequently Asked Questions (FAQs)

What is oxygen utilization efficiency?

It’s how well your cells use oxygen to produce ATP (energy). It’s not about how much oxygen you breathe in, but how effectively your mitochondria use it.

How is this different from a pulse oximeter or basic fitness test?

Pulse oximeters measure oxygen saturation in the blood. CPET / VO₂ testing measures how efficiently oxygen is used at the cellular level during stress and movement.

Why do I feel exhausted if my labs are normal?

Standard labs don’t measure mitochondrial efficiency or oxygen utilization. You can have “normal” labs and still be operating at a significant energy deficit.

Who benefits most from oxygen utilization testing?

High-performing professionals, executives, caregivers, athletes, and anyone experiencing burnout, brain fog, post-viral fatigue, or stalled recovery.

Is this just for athletes?

No. Athletes use VO₂ max to improve performance—but clinically, it’s one of the best tools for understanding fatigue, resilience, and metabolic health.

Why does January feel harder than other months?

Seasonal light changes, higher stress, disrupted routines, and increased demands reveal systems that were already compensating and nearing depletion.

Can supplements or lifestyle changes fix this without testing?

Sometimes—but often they act as band-aids. Without knowing whether oxygen utilization is impaired, interventions may not convert into usable energy.

What happens when oxygen efficiency improves?

Energy becomes stable, sleep more restorative, cognition clearer, and exercise builds capacity instead of causing crashes.

What’s the first step?

Measure the foundation. One baseline test can reveal whether your system can support the goals you’re setting—or why it keeps hitting a wall.

‍