Fatigue is one of the most common complaints in the modern society. Tonics such as Ginseng, Royal Jelly or Manuka Honey are heavily marketed as a miracle solution for chronic fatigue. However, these tonics might not be useful for everyone, and can even be harmful for many people. In this article we are going to describe three types of fatigue according to the Chinese medicine theory, and explain how to regulate health according to the condition.
Generally speaking, there are three main types of fatigue. The first is qi and blood deficiency. In this type, the lack of energy and nutritive material makes us feel tired. This type is often seen in people who suffer from cancer, severe blood loss, anorexia or severe chronic conditions, and is rarely seen in the average person in modern developed countries. The second type is liver stagnation. In Chinese medicine, the liver represents roughly the autonomous nervous system, which is deregulated in case of stress. This stress creates what we call qi stagnation, which can produce heat by excessive pressure. This heat can then consume our energy, which makes us feel tired. The third type is spleen deficiency and dampness. In Chinese medicine, the spleen is our ability to process materials (food, water or waste) in the body. Dampness is the metabolic waste that cannot be transformed or expelled from the body. When the dampness highjacks the spleen, the energy is blocked and we can also feel tired, even if there is no lack of energy per se.
In the following section, we will go through the signs of these three conditions and the way to regulate lifestyle in order to address these conditions.
1. Qi and blood deficiency
People with qi and blood deficiency are generally thin, have a pale complexion, a pale tongue and a weak, deep and thin pulse. Their fatigue gets worse with physical and mental activity, and get better after rest. In addition to fatigue, they may experience dizziness (especially when getting up abruptly), palpitations, shortness of breath, insomnia (without anxiety), abundant periods or purpura, and forgetfulness.
Tonics such as Ginseng, Manuka Honey and Royal Jelly are generally adapted to people with qi and blood deficiency as they can strengthen qi and blood. Ginger, alcohol and coffee are not adapted though as they tend to disperse instead of supplementing/nurturing. Rich food such as eggs or beef meat and slow-cooked soup and broth are particularly adapted as they can supplement qi and blood. People with qi and blood deficiency should be especially attentive to their work-rest patterns, and avoid intense exercise.
2. Liver stagnation
People suffering from liver stagnation are generally anxious and tend to have mood swings. Their pulse can be wiry or deep and strong. The fatigue gets worse with mental strain and emotions, and gets better after exercising or speaking/singing. In addition to fatigue, they may experience chest stuffiness, headaches, period pain or irregular menstruation, stomach pain, and tension in the upper back and neck.
The root of the problem is the stagnation leading to a consuming fire, not a lack of energy. Tonics such as Ginseng, Manuka Honey and Royal Jelly are not adapted for people with liver stagnation as they tend to increase the stagnation and produce fire. For them, the main way to increase energy levels is to regulate emotional stress. This can be done through moderate-to-intense exercise, mindfulness activities, meaningful conversations, and expressive activities. Walks in the nature are particularly recommended as blue and green colours nurture the liver.
3. Spleen deficiency and dampness
People suffering from spleen deficiency and dampness can be either overweight (common) or thin (less common), tend to have a yellowish complexion, black spots around the nose, a large and tender tongue with teeth marks, and a weak, soft and large or slippery pulse. The fatigue gets worse after eating sweets or oily food, when the weather is humid, or after drinking alcohol, and gets better after exercising. In addition to fatigue, they may experience all kind of digestive symptoms such as nausea, bloating or diarrhoea, heaviness in the body or the head, fogginess and laziness. Thick vaginal discharge, bad breath and itchy genitals are strong indicators of dampness.
The root of the problem is a stagnation of waste which prevents the energy to flow, not a lack of it. Therefore, tonics such as Ginseng, Manuka Honey and Royal Jelly are not adapted for people with dampness as they tend to increase the pressure on the spleen (metabolism) and nurture the dampness (waste) instead of the body. For them, the main way to increase energy levels is to improve the diet. Sweet foods such as jam, sweets, and chocolate bars, oily food such as fries, snacks, and fried foods should be avoided. Animal proteins should be eaten with moderation. Raw fruit (including fruit juice) should be avoided as they are cold in nature, which harms the digestive system. Dark chocolate (>85% cocoa) can actually be beneficial. Diet and intermittent fasting are an excellent idea (which is a bit counterintuitive), as well as regular exercise.
Nowadays, the main cause of fatigue in modern developed countries are emotional stress, unbalanced diet and work-rest imbalance leading to liver stagnation, spleen deficiency and dampness, NOT qi and blood deficiency. Therefore, for most people, tonics is not an ideal solution for fatigue, and can be actually harmful. You should consult with your Chinese medicine practitioner before taking any tonic ingredient.
This text was written by Yoann Birling, a clinician and researcher in the field of Chinese medicine. Yoann studied 10 years in China, following some of the best clinicians in Beijing, is practicing in Sydney and completing a PhD at Western Sydney University.
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