Fatigue is a symptom of many different disorders, both psychological and physical. It is often difficult to discover its cause with modern Western diagnostic methods. Fortunately, diagnosing and treating this sort of generalized complaint is one of the strong points of traditional Chinese medicine. The first and most important step is to examine the person's lifestyle to eliminate any possible causes of fatigue, such as lack of sleep, poor diet, insufficient exercise, or overworking. Without correcting these problems, it is difficult or impossible to restore the patient's energy level. Once the proper lifestyle adjustments are made, treatment, particularly moxibustion and herbal therapy, are much more likely to be effective.

The most common diagnoses in cases of chronic fatigue are deficiency of qi, blood, or yang, and many cases are a combination of these syndromes.

Treating Fatigue Caused by Qi Deficiency with Traditional Chinese Medicine

In cases of qi deficiency, there may be no physical abnormality, but the body lacks sufficient energy to perform various functions. In addition to fatigue, the patient has a weak pulse, pale tongue, bright pale face, and, possibly, shortness of breath and poor appetite, depending on the organs involved.

Most qi tonics boost energy by improving the function of the lungs, spleen, and kidneys. Some appropriate patent remedies to rectify qi deficiency are Bu Zhong Yi Qi Wan, Nu Ke Ba Zhen Wan, Shen Qi Da Bu Wan, Extractum Astragali, and Ginseng Royal Jelly Vials. Typically, these herbal remedies are taken for a few months, since chronic deficiency syndromes take longer to rectify.

Acupuncture therapy is administered to bring energy to deficient organs, and moxibustion is applied to important systemic points to bring new energy into the body. Acupuncture points are selected that tonify the vital substances, since a deficiency of one or more of them is usually the underlying cause of fatigue.

The most important tonifying points are Stomach 36, Spleen 6, Kidney 3, Du 4, and Ren 4. When these points are activated with acupuncture and moxa, the entire body becomes energized. When combined with herbal therapy, a course of treatment typically takes place over a few weeks or months, depending on the severity of the problem.

Treating Fatigue Caused by Blood Deficiency with Traditional Chinese Medicine

In cases of blood deficiency, there is insufficient blood to nourish the organs and tissues of the body. In mild cases, the blood count may be within the normal range, while more severe cases are diagnosed as anemia, which can occur as a result of decreased bone marrow function, vitamin or iron deficiency, general malnutrition, blood loss from excessive menstrual flow, or an abnormal destruction of red blood cells.

In traditional Chinese medicine, anemia is associated with a deficiency of vital substances in the heart, liver, spleen, and kidneys. Herbal therapy and moxibustion are frequently successful in normalizing the blood count, no matter what the underlying pattern of disharmony is. Such therapy is closely monitored with regular blood tests, since anemia can have serious consequences if it persists.

A typical course of treatment -- a weekly acupuncture and moxa session and daily use of tonifying herbs -- might take a few months. Two of the important acupuncture points for anemia are Spleen 10 ("Sea of Blood") and Stomach 36 ("Leg Three Miles"). Spleen 10 is chosen for its regulatory effect on the blood, while Stomach 36 improves the assimilation of nutrients from food, aiding in the production of new blood cells.

Treating Other Causes of Fatigue with Traditional Chinese Medicine

A deficiency of both spleen qi and heart blood produces dizziness, poor appetite, and fatigue, with a pale face and tongue. This pattern often appears in students after excessive studying. The standard formula for this pattern is Kwei Be Wan. In addition, longan (long yan rou) fruit can be eaten as is or boiled in a decoction. It is sold in dried form, but in tropical climates it can sometimes be found fresh. It nourishes the heart blood, making it a good supplement to herbal therapy. If the underlying disharmony is liver and kidney yin deficiency, symptoms are fatigue, blurry vision, low back pain, sexual dysfunction, leg weakness, and night sweats. The treatment principle is to tonify liver and kidney yin with Rehmannia Teapills. Another tasty fruit, Lycium berries (gou qi zi), can be added as a supplement for this pattern. The berries replenish the yin of the liver and kidneys, nourish the blood, and improve eyesight. The best-quality fruit is brownish and soft and can be eaten as is, cooked into cereal, or boiled in a decoction. When anemia is the result of spleen and kidney yang deficiency, fatigue, a pale face and tongue, lack of libido, cold limbs, and loose stools can occur. Moxibustion is especially helpful in this pattern. Also, the person should avoid cold foods. In this case, a good patent remedy is Nu Ke Ba Zhen Wan, which tonifies both qi and blood. In addition, a decoction made of 10 grams dried ginger and 10 grams cinnamon bark tonifies the yang qi.

In all types of anemia, another patent medicine, Tang Kwei Gin, a pleasant-tasting liquid supplement, further builds the blood. The diet should be especially nutritious, with generous amounts of dark greens and legumes at most meals. Refined foods such as pastas, breads, and pastries should be avoided, since they are filling but provide very little nutrition.

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ABOUT THE AUTHORS:

Bill Schoenbart has been practicing traditional Chinese medicine (TCM) since 1991, when he earned a Masters degree in TCM. He teaches TCM medical theory and herbalism at an acupuncture school in California, and also maintains a clinical practice.

Ellen Shefi is a licensed massage technician, licensed acupuncturist, and registered dietician. She is a member of the American Association of Acupuncture and Oriental Medicine, the American Herb Association, and the Oregon Acupuncture Association.