Based on the high incidence of Chronic Fatigue Syndrome amongst the clinically referred patients, and the role that biotransformation analysis may play to contribute to improved treatment and prognosis of chronic fatigue induced conditions, this TIA / CareDoc / NWU initiative was launched in 2013. Since then, the analysis platforms have expanded to include more than 20 metabolites and ratios related to liver detoxification. Furthermore, since certain hormone biotransformation metabolites have been implicated in the initiation of certain cancers, we developed an analytical method to measure more than 30 hormone biotransformation metabolites as well. These analyses have been done routinely in our lab since 2018.