Fatigue and low energy
Fatigue is normal after physical exercise, a busy period or a few bad nights. Usually your energy recovers when you get enough rest. However, if tiredness remains present for a long time, regularly returns or is disproportionate to what you have done, it can affect your daily life.
Fatigue can also feel very different. One feels physically exhausted and is mostly in need of rest, while another feels heavy and lame and just a bit of movement. Fatigue can also be associated with concentration problems, dizziness, indigestion, cramping, muscle pain or sleep disturbances.
Because fatigue has many possible causes, it is important for long-term or unexplained complaints to have any medical causes investigated. Acupuncture and Chinese herbal medicine can then be used as a supplement, tailored to the type of fatigue and overall symptoms.
How can fatigue express itself?
Not everyone experiences fatigue in the same way. For the assessment it is important not only how tired you are, but also when fatigue occurs, which makes it worse or better and which other complaints are present.
For example, you may experience:
- low energy during the day;
- physical weakness or exhaustion;
- mental fatigue or brain fog;
- difficulty concentrating or remembering;
- difficult to get started in the morning;
- an energy dip during the day;
- Feeling tired rapidly during physical exercise;
- long-term recovery after exercise;
- a heavy or lame feeling in the body;
- tired awakening despite sufficient sleep;
- little motivation or feeling of not getting anywhere.
Also symptoms such as dizziness, shortness of breath, headache, muscle pain, crampiness, sleep problems and indigestion may be associated with fatigue.
Possible Western causes and conditions
Fatigue is a specific symptom. This means that it can occur in many different physical and mental conditions. Sometimes the cause is obvious, for example after sleep deprivation, illness or a period of heavy stress. Long-term fatigue may require further examination.
Possible causes and conditions include:
- inadequate or disturbed sleep;
- prolonged stress or overload;
- anaemia;
- shortages of iron, vitamin B12 or folate, for example;
- thyroid disorders;
- diabetes;
- infections and recovery after infection;
- chronic infections;
- Cardiac and pulmonary disorders;
- sleep disorders, such as sleep apnea;
- depression and anxiety symptoms;
- burn-out;
- fibromyalgia;
- ME/CVS;
- post-COVID syndrome (Lung COVID);
- autoimmune disorders;
- hormonal changes, e.g. during pregnancy or transition;
- side effects of medicines.
Also nutrition, alcohol consumption, disturbed sleep-wake rhythm, shift work, low exercise or prolonged physical stress can contribute to fatigue.
Sustained, severe or unexplained fatigue should therefore not be automatically attributed to stress or lack of energy. It is important to have possible medical causes investigated, especially when fatigue is new, clearly increases or coincides with other unexplained complaints.
Possible causes
Even without obvious disease, various factors can contribute to fatigue. Long-term sleeplessness, irregular working hours, prolonged stress, insufficient recovery and physical or mental overload may gradually influence the energy level.
Nutrition also plays a role. Too little food, a one-sided diet or problems with the absorption of nutrients can contribute to fatigue. Also pregnancy, childbirth, breast-feeding, blood loss, surgery or recovery after an infection may temporarily require much from the body.
In some people, long-term tiredness clearly begins after an infection. They do not feel fully recovered afterwards and may, in addition to fatigue, keep muscle pain, difficulty concentrating, sleep problems or reduced capacity for activity.
The factors that are relevant vary from one person to another. Therefore, during a first consultation, extensive attention is given to the onset and course of fatigue and to sleep, nutrition, exercise, recovery and other physical and mental problems.
How can acupuncture help with fatigue?
An acupuncture treatment is tailored to the type of fatigue and the complaints associated with it. Someone who quickly becomes exhausted and recovers from rest requires a different approach than someone who feels especially heavy and lame and becomes more energetic by moving.
Depending on the picture of complaints, treatment may be directed at:
- supporting energy and capacity for activity;
- supporting recovery after illness or prolonged stress;
- improving rest and sleep when recovery is insufficient;
- reducing stress when stress contributes to fatigue;
- supporting digestion when tiredness is associated with stomach or intestinal problems;
- reducing feeling heavy or lukewarm;
- improving the flow of Qi when stagnation is involved according to TCM.
Acupuncture does not replace treatment for an underlying medical condition. For example, in the case of anaemia, thyroid disease, diabetes or sleep apnea, regular diagnostics and treatment remain important.
How can Chinese herbal medicine help with fatigue?
Chinese herbal medicine can be used when fatigue is part of a recognizable TCM pattern. Therefore, what herbs are used depends not only on how much energy you have, but also on for example your sleep, digestion, temperature sensation, response to effort and other symptoms.
Depending on the pattern, herbal treatment may be directed at:
- supplementing Qi with low energy and reduced capacity for activity;
- nourishing Blood when fatigue is associated with, for example, dizziness or paleness;
- supporting Yin or Yang when signs of heat or cold are present, respectively;
- supporting the digestion and processing of food;
- reducing Dampness or Phlegm when feeling heavy, lame or misty;
- improving Qi flow when voltage and stagnation are at the forefront;
- supporting recovery after illness or prolonged stress.
Herbs are taken daily and can therefore also be used between acupuncture treatments. The composition is tailored to the individual grievance image and can be adjusted during the treatment process.
How does Chinese medicine view fatigue?
Within Chinese medicine, fatigue is not automatically seen as a lack of energy. There are roughly two different mechanisms.
At the first mechanism the body according to TCM does not have enough Qi, Blood, Yin or Yang available. There is then a form of deficiency. The fatigue usually gets worse due to exertion and improves through rest or sleep.
With the second mechanism there is not necessarily too little energy, but the normal movement and distribution of it is hampered. This can be done for example by Qi-stagnatie, Dampness, Phlegm or Blood stasis. People may feel heavy, futless or blocked. Long-term sitting or sleeping does not always help and some people feel better after they have moved.
This distinction explains why fatigue can feel very different in different people.
The moment you're tired gives information
In Chinese medicine, therefore, it is asked among others:
- Are you getting better at rest or moving?
- Are you especially tired in the morning or later in the day?
- Will you get tired after dinner?
- Does the fatigue worsen after physical exertion?
- Does stress or emotional tension clearly affect you?
- Has fatigue started after an infection?
- Is fatigue associated with a heavy or foggy head?
- Are there also digestive problems, crookedness, warmth, dizziness or sleep problems?
For example, fatigue that clearly improves by rest can fit a pattern other than fatigue that decreases when someone starts moving.
Qi, Blood, Yin and Yang
Qi describes various functional activities of the body within Chinese medicine and is inter alia connected with energy, movement, breathing, digestion and recovery.
Blood has a nourishing function for muscles, skin, eyes and mental functions among others. Insufficient Blood can therefore add to fatigue for example dizziness, concentration problems or pale facial colour.
Yang represents, among other things, heating and activating functions. Therefore, a shortage is more often associated with crunchiness and a deep lack of energy.
Yin represents more nourishing, moistening and cooling functions. In case of a shortage someone may be exhausted but at the same time restless, warm or poorly able to truly unwind.
Which TCM organ systems play a role?
Fatigue may involve different TCM organ systems. A TCM organ system is wider than the anatomical organ with the same name.
The Spleen is linked to the processing of food and making Qi and Blood available. The Lungs play a role in breathing and Qi. The Kidneys are connected to the deeper reserves of the body and can become important especially during prolonged exhaustion.
The Liver is especially important for the free flow of Qi. When this movement is obstructed, someone may feel tired and useless while there is no need for real deficiency.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance according to Chinese medicine is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Common TCM patterns in fatigue
Liver-Qi-stagnation
This pattern is not so little energy, but less free distribution of Qi. As a result, fatigue can change with mood, stress and activity. It is striking that rest does not always help: one can feel better when he or she moves or gets distracted.
Common symptoms
- fatigue and lack of motivation;
- difficulty in getting started;
- irritability or frustration;
- symptoms that increase with stress;
- tense neck, shoulders or chest;
- sighs;
- bloating or varying bowel movements;
- fatigue that can be improved by movement.
Examples of Western disorders
Stress-related fatigue, burnout and fatigue associated with functional gastrointestinal problems.
Dampness and Phlegm
At Dampness or Phlegm, according to Chinese medicine, the body feels rather heavy and blocked than really empty. Long-term sitting, lying or sleeping can make a person feel more dull, while physical activity sometimes gives more clarity and energy.
Common symptoms
- a heavy or lame feeling;
- heavy arms and legs;
- sleepiness;
- Brain fog or a heavy head;
- difficulty concentrating;
- bloating;
- nausea or low appetite;
- soft or sticky stools;
- sometimes mucus formation.
Examples of Western disorders
Some forms of long-term fatigue, fatigue with functional digestive symptoms and some post-viral complaints.
Qi-deficiency
At Qi deficiency there is actually insufficient functional energy in the foreground. Effort costs relatively much energy and fatigue usually increases as someone does more. Rest and a good night's sleep usually improve.
Especially the Spleen- and Lung-Qi can be involved.
Common symptoms
- low energy and vitality;
- Feeling tired rapidly during exercise;
- physical weakness;
- shortness of breath during exercise;
- need for rest;
- pale facial colour;
- low appetite or soft stools when the Spleen is involved;
- a weak voice or quickly out of breath when the Lungs are involved.
Examples of Western disorders
Fatigue during recovery after illness, fatigue in inadequate diet or intake and various forms of long-term functional fatigue.
Blood deficiency
Blood deficiency, in addition to fatigue, lack of nutrition of muscles, eyes and mental functions is central. This can occur, for example, or become clearer after blood loss, pregnancy or childbirth, or when insufficient blood build-up occurs.
Common symptoms
- fatigue and low reserves;
- dizziness or light-headedness;
- concentration or memory problems;
- pale facial colour;
- dry skin or hair;
- palpitations;
- light or restless sleep;
- Women sometimes have little menstrual blood.
Examples of Western disorders
Anemia, fatigue after blood loss and postpartum fatigue.
Blood deficiency within TCM is not the same as anemia. Regular blood tests are important when suspected of anaemia.
Yang-deficiency
With Yang deficiency not only the energy is reduced, but also the warming and activating function of the body. Fatigue often feels deep and physical and recovery after exercise may take a long time.
Especially Spleen- and Kidney-Yang could be involved.
Common symptoms
- deep or prolonged fatigue;
- Curvature;
- cold hands and feet;
- low energy in the morning;
- physical weakness;
- need for heat;
- sometimes retention of fluid;
- for example, low back weakness or increased urination.
Examples of Western disorders
Long-term fatigue images in which crookedness and low capacity for activity are at the forefront.
Yin-deficiency
With Yin deficiency there is a special combination: someone can be very tired, but at the same time struggle to really relax. Fatigue may increase later in the day, while in the evening inner restlessness or an active head arises.
Common symptoms
- fatigue or exhaustion;
- inner restlessness;
- difficulty in relaxing;
- light or disturbed sleep;
- feeling warm in the afternoon, evening or night;
- night sweats;
- dry mouth, throat, skin or eyes;
- irritability.
Examples of Western disorders
Fatigue associated with prolonged overload, sleep problems or hormonal changes, for example around the transition.
Sustained complaints after infection
Some people do not feel fully recovered after infection. Within Chinese medicine this may have several explanations. The disease may have weakened Qi, Blood or Yin, but according to TCM there may also be a residual pattern that hinders normal recovery.
Common symptoms
- fatigue that has started after an infection;
- the feeling of not being fully recovered since the disease;
- reduced load capacity;
- muscle pain or feeling heavy;
- brain fog;
- low appetite or nausea;
- persistent cough or mucus;
- sometimes varying heat or cold sensations.
Examples of Western disorders
Post-viral fatigue and some prolonged symptoms following respiratory or gastrointestinal infection.
This pattern is not a Western explanation for post-viral disease, but describes how such complaints can be assessed within the TCM framework.
Fatigue and exercise
The response to physical activity can give important information. For example, a simple Qi deficiency can make someone tired of exertion faster, but usually recover with sufficient rest. In case of stagnation or Dampness, light or moderate movement can temporarily give more energy and brightness.
In ME/CVS and some forms of Lung COVID, a different image can occur. Efforts may result in a clear and sometimes delayed worsening of symptoms. This is called post-exertional malaise (PEM).
If this is present, it is not wise to continue building activity despite worsening. Daily loading and treatment should then be tailored to individual capacity for activity and regular medical supervision remains important.
Outlook
The treatment course strongly depends on the cause, duration and severity of fatigue, underlying TCM pattern and any other conditions. Fatigue after a relatively short period of sleep deprivation, illness or overload can change faster than symptoms that have existed for months or years.
In the initial phase, one acupuncture treatment per week is a common guideline. If clear or severe complaints can be treated temporarily more often. When energy and capacity for activity improve and become more stable, the frequency can be reduced. Chinese herbs can be used daily between treatments when appropriate.
For long-term fatigue, it is important not only to look at how much energy someone has, but also at recovery after activity. Especially for ME/CVS and Lung COVID with post-exertional malaise (PEM), overload should be avoided and the treatment pathway adjusted to individual capacity for activity.
Contact
Do you have regular or prolonged fatigue and want to know if acupuncture and/or Chinese herbal medicine can fit your symptoms?
During a first consultation, we will discuss in detail how tiredness develops when it develops and improves or worsens. Also sleep, exercise, recovery, digestion, stress and other relevant symptoms are included. Based on the overall picture of complaints, we will examine which TCM pattern is likely to be at the forefront and what treatment fits.
In the event of persistent or unexplained fatigue, it is also important that possible medical causes are investigated where necessary.
You can make an appointment directly online or contact us for more information.