It is estimated that over 50% of the American population experiences chronic fatigue. The most common causes are stress, overwork, insomnia, depression, and various malfunctions in the major systems of the body (endocrine, cardiovascular, digestive, etc.) Western medicine is decidedly lacking in safe and effective treatment options for fatigue. Quite commonly, the first step is to use a selective serotonin reuptake inhibitor (SSRI), such as Prozac, Paxil, or Wellbutrin, as fatigue is commonly associated with depression. Although trends are changing among the newer generation of doctors, it is still quite rare that the patient is offered lifestyle counseling that focuses on nutrition, exercise, and sleep. There are many wonderful alternative treatment options that include acupuncture, herbs, nutrition, and exercise. Acupuncture tops the list because it tends to be so effective is supplementing the body’s energy.

ACUPUNCTURE
The majority of patients who complain of fatigue suffer from a deficiency of vital energy (Qi). Qi is the basic energy that creates optimal physiological and neurological function. Aside from fatigue, other signs of Qi deficiency are diarrhea, pallor, easy bruising, excessive sleep (more than 9 hrs. a night), scanty menses or amenorrhea, frequent urination, low libido, and shortness of breath. The strategy of Chinese medicine is to identify a pattern of disharmony that reflects the entirety of one’s symptoms, pulse qualities, and tongue appearance. Moxibustion, a topical warming therapy, is typically used as a nourishing adjunct to the needles. This entails burning mugwort on top of the needles or directly on the skin to induce a stronger supplementing effect. I recommend weekly acupuncture and moxa treatments for 4-6 weeks, then assessing for progress.

HERBS
Qi deficiency primarily affects 4 different organs: the spleen, kidney, heart, and lungs. Here are symptoms and herbal treatment options for each pattern:
Spleen: diarrhea, loose stools, bloating, bruising, fatigue, prolapse, laconic speech, internal cold
Herbal Formula: Bu zhong yi qi tang

Kidney: low back pain, low libido, fatigue, internal cold, frequent urination
Herbal Formula: Jin gui shen qi wan

Heart: restless sleep, worry, fatigue, heart palpitations, shortness of breath
Herbal Formula: Gui pi tang

Lung: chronic cough, weak immunity, allergies, fatigue, shortness of breath, asthma
Herbal formula: Bu fei tang

Adaptogenic herbs such as rhodiola rosea, ashwaganda, and ginseng may be helpful adjuncts .

SUPPLEMENTS
B Complex: B vitamins are warming and energizing. They build Qi and blood.

Tyrosine: precursor to norepinephrine (often deficient in chronic fatigue)

5HTP: precursor to serotonin, for deeper sleep, weight loss, anxiety

Adrenosen by Health Concerns and Adrenotone by Designs for Health are both effective adrenal tonics for fatigue due to adrenal burnout.

EXERCISE
I recommend getting 20-30 minutes of exercise 4-5 times a week. At first, this may feel forced and difficult because you won’t want to exercise when you feel tired. After a few days, however, your body will begin to love the endorphin release and serotonin boost that exercise provides. Exercise alone can be a wonderful cure for fatigue. Your program should be a combination of cardiovascular and restorative exercise. Cardiovascular exercise involves running, biking, swimming, hiking, etc. Restorative exercise involves yoga, tai chi, or qi gong.

IDENTIFYING WHERE YOU LEAK YOUR ENERGY
Many people with chronic fatigue can attribute this pattern to a central theme that is stealing their energy. Perhaps you are in a marriage that is not working or a job that feels stagnant. Maybe you have set your life up so that you never have time for yourself because you are too busy caring for others. Or maybe you have financial problems that make life feel burdensome. Low energy is often a sign that we are not in control of our life, whether it is in relationships, work, with our health or with our money. Set an intention to heal any area of your life that is spiraling out of control and that feels toxic to you.

IS THERE A PAYOFF FOR THE FATIGUE?
Strangely enough, many people are chronically tired because it allows them to get attention from others. Fatigue becomes a way to soak up the well wishes of others, all the while avoiding our personal responsibility to show up to life and offer something helpful. It can be a touch question to ask, but I encourage you to contemplate whether or not you are being a victim to the fatigue. What is your belief system around it? Do you have an internal dialogue that supports and sustains the fatigue? What would your life look like if the fatigue wasn’t an issue? I don’t bring this up to undermine the validity of this very common health concern. In my clinical experience, however, I have noticed a rather common theme of victimization and relinquishing personal power in cases of chronic fatigue.

There are many wonderful treatment options for chronic fatigue. This article is not intended to cover this issue in its entirety, as there can certainly be other factors involved in fatigue (immune dysfunction, low level pathogenic influences, etc.) The key is to be proactive in treating this condition.