We see a lot of patients at Acupuncture in the Park with fatigue. For some, overwhelming exhaustion is what brings them into the clinic. For others, fatigue is a secondary symptom to some other problem.
Fatigue can manifest in a number of different ways. Some people are so completely exhausted that they have difficulty getting through their day. Others manage to get things done, but struggle with motivation—everything just seems so hard. Many people are tired only at certain times—late in the day, after eating, or mid afternoon.
In western medicine, fatigue can be caused by anemia, thyroid issues, blood sugar problems, or the Epstein Barr virus that causes chronic fatigue syndrome. In addition, fatigue can be the side effect of certain medications. However, after those diagnoses have been ruled out, a western doctor may have a hard time getting to the bottom of why you’re so tired.
When we see a patient who complains of fatigue, one of my first thoughts is that they have a depletion of energy, or Qi. However, in Chinese medicine, there are many patterns that are associated with some element of fatigue, and the nature of your fatigue is often a clue to its source. In general, fatigue is caused by either a depletion of some body substance (Energy, Blood, Yin, or Yang) or there is some kind of blockage or impaired flow.
Here are some common patterns in Chinese medicine that can be a source of fatigue:
Energy (Qi) Depletion. The energy that fuels your body comes from the food you eat and the air you breathe. If those processes are not working well, you may find that a depletion of energy is making you…uh, low on energy. If your digestion is poor, you may feel tired right after meals, because your body is diverting all your energy into digesting what you’ve eaten. You may also feel exhausted or short of breath after any kind of exertion, but feel better after resting. That’s because you feel tired as you use energy, and better with a little down time.
Blood Depletion. This pattern is a little like being anemic, and can be brought on by a loss of blood, a chronic illness, or poor diet. It’s a common problem among people who have had surgery recently and new mothers, especially those who work too hard or too soon after surgery or childbirth. The fatigue associated with this pattern is also worse with any kind of activity or exertion. Sufferers may appear pale and experience eye problems, dizziness or feeling light-headed, and have dry skin, hair or nails.
Yang Depletion. In your body Yang works a little bit like a pilot light, which warms everything up and keeps things moving. People with depleted Yang feel a deep and disabling fatigue; and some can’t even get out of bed. Because their pilot light is low, Yang deficient people also feel cold at their core, especially in the winter, have a hard time warming up, and may retain water. Fatigue associated with this pattern is also worse after any kind of activity.
Yin Depletion. This is a common pattern in the clinic, especially among women going through menopause. In contrast to Yang’s pilot light, Yin acts like a nourishing coolant, keeping your body moist and keeping the warmth of Yang in check. Yin depletion is kind of an odd pattern in that sufferers may feel fatigued, yet feel jittery at the same time. This pattern is associated with symptoms such as night sweats, waking or restless sleep, dry skin, and a dry or sore throat on waking. Often symptoms are worse with overwork and stress.
Liver Energy Stagnation. This pattern is considered both a blockage and a depletion. Your Chinese Liver is responsible for the smooth flow of everything in your body. However when there is a blockage of the Liver, your digestion usually is also affected—it’s not flowing well, either. The result is that your ability to convert food into energy is hampered. The fatigue you feel with this pattern is intermittent, you usually feel tired in the morning, and actually feel a little better with movement or as the day goes on. Symptoms are usually aggravated by stress or emotional upsets, and are worse before your period. Many people with Liver stagnation would describe themselves as irritable or depressed. This pattern is usually a psychological response to things not going well in your job, relationships, finances, or life.
Accumulation of Phlegm or Dampness. Okay, this sounds really gross, but it’s a pattern that I frequently see in the clinic. Dampness occurs when your body doesn’t metabolize fluids or moisture very well. It’s a little bit like a farmer’s field that doesn’t drain well after a heavy rain. When dampness sits around for awhile, it congeals and becomes phlegm. People who have phlegm and dampness feel heavy or weighed down. The also tend to be overweight, with a history of eating lots of rich foods like greasy meats, fried foods, or lots of dairy, or they just eat too much food in general. They may also have visible phlegm, like sinus problems, a chronic cough, or asthma. Often the fatigue associated with this pattern is associated with feeling heavy, poor concentration, or foggy thinking.
Pain. Chronic pain has the ability to really wipe you out. This is also a pattern of both blockage and depletion. Basically, pain acts like a dam in your body, in which the pain is blocking the flow of energy. Because your energy has stagnated, its supplies are not available, causing you to feel tired. In addition, dealing with the pain psychologically wipes out your energy. Over time, your pain may become secondary to the fatigue it has caused.
The good news is that you don’t have to go through life tired. Fatigue associated with any of the patterns above can be treated effectively within the framework of Chinese medicine. Depending on the source of your fatigue, a practitioner would choose acupuncture points, herbs, foods, and other treatments appropriate for your particular case. Happily, one of the most frequent comments we hear from patients after their first treatment or two is that their energy has really improved!