Tiredness and Fatigue – the Traditional Chinese Medicine Approach
Tiredness includes lack of physical and mental energy, poor motivation, excessive sleepiness, exhaustion, listlessness, feeling flat or a devastating inability to perform even the simplest of tasks.
In western medicine tiredness is often difficult to diagnose. Unless there is an underlying disease such as an underactive thyroid gland or low iron levels, tiredness is often diagnosed as depression or as a psychological disorder.
In TCM, there are two main causes of tiredness: Either a person has a “deficiency condition” eg, Qi or Blood deficiency, or an “excess condition”. This “excess” may be due to an external pathogen (e.g. virus or a climatic factor such as “external dampness”) In practice, it’s usually a combination of both deficiency and excess.
Overwork , or working excessive hours, may deplete our fundamental energy. Poor diet, medication, poor sleep patterns and constitutional factors will all add to underling triggers.
You might not need a pick up tonic just because you’re feeling tired. You’ll know your tiredness is due to a deficiency condition if it improves with rest. However, if rest makes you feel worse it’s probably down to an excess condition. An excess might be an external pathogen (maybe you had a virus leaving lingering effects). Prescribing a tonic in this case would make everything worse! We need to clear the excess first. We might use herbs to transform dampness, or acupuncture points to do the same thing.
Often with fatigue people will describe feeling heavy in their bodies and having a foggy brain. They will describe how they can’t think clearly, their concentration and memory is poor. We might diagnose “Dampness accumulation” an excess condition. Taking a tonic would be the wrong treatment for these people as it will just increase the symptoms, making them worse.
Persistent fatigue often occurs following an acute illness (eg Flu and Covid) or immunisation. Here we might diagnose “Lingering pathogens”. Although the original pathogen may have completely cleared, there may be damage to our internal physical body. This is more frequent in people who ignore the original illness, or do not rest properly during the illness itself. Often they have returned to work too soon.
Emotional factors e.g stress, worry, prolonged concentration alongside a sedentary lifestyle, poor dietary habits and certain drugs, can all add up to TCM conditions resulting in tiredness and fatigue. Poor sleep patterns, or continually “burning the midnight oil” may deplete both Qi and blood.
Overworking and exhaustion deplete our internal energy to the point where we may feel extremely depleted. This is often seen in over trained athletes and also people who may consider themselves physically fit, but who are chronically tired and vulnerable to repeated external pathogenic invasions.
There are lots of different TCM patterns causing tiredness and fatigue. We don’t treat them the same
Here are some ideas of how they may present.
Qi Stagnation: tiredness, lack of motivation, feeling flat with muscle stiffness, tension headaches, indigestion and disturbed sleep. The pulse might feel like a tight wire. TCM treatment here would include choosing acupuncture points to help move Qi, alongside appropriate Chinese herbal prescriptions. We might also add herbs such as Magnolia bark to lift mood..
Dampness: Another excess pathogen is where the dampness blocks the internal mechanisms. Typically people will feel heavy in their body, feel easily full when they eat. Their tongue may have a sticky coating and the pulse have a “slippery” quality. We select acupuncture points to clear dampness alongside using herbal prescriptions to drain it.
A lingering pathogen always need to be expelled from wherever it is hiding. If it’s in the surface of the body, we might just try and sweat it out, but if it’s deeper inside then we may use herbs or acupuncture points to clear the pathogen in a different way.
Deficiency can be Qi deficiency of various organs and depending on which organ is deficient, the symptoms will differ. Primarily there will be tiredness that improves with rest. Maybe a patient is sweating too much, as well as being tired, or the appetite isn’t great, and the digestion is poor; each one will require different acupuncture points and different herbal medicine prescriptions to best treat the underlying weakness.
Another type of deficiency is blood deficiency. This isn’t the same as having low iron levels. Typically, if it’s “Liver blood deficiency”, you may have visual disturbances, a dull background headaches, alongside poor concentration and memory. The tiredness will leave you feeling drained, worse at the end of the day after prolonged use of the eyes. There may be difficulty falling asleep as well. If the “Heart blood” is affected, there’s more likely to be palpitations and anxiety alongside insomnia.
At the Jade Centre we see many patients each year to help them to manage their chronic fatigue and tiredness. Contact us now and book an appointment to get the support you need,
