 Fatigue is one of the most common complaints I hear from some of my patients and being a human being myself, I have experienced varying degrees of severe fatigue for years while in grad school all the way to feeling well rested every day for a long period of time. One thing I've learned seeing a lot of people in my private practice is that you tend to see common patterns in fatigue and I've tried my best to break this down into three of the most common causes that I see day to day for why people are very very tired all the time. Hey guys Dr. Alex Hine author of the health book master of the day and doctor of Chinese medicine and acupuncturist. So before we jump in here there are two important links right below the video. The first is if you'd like to become a patient of mine locally in Los Angeles or virtually via telemedicine there are links right below this video to contact my private practice and reach out that way. The second there's also a free guide I've put together which is four daily rituals from Chinese medicine that can potentially help you add years to your life. So those are right below this video those first links there. So let's talk about how to live forever according to Chinese medicine because it's almost like unless you can recognize what wellness is and what is normal you cannot recognize what is abnormal or pathological. So in Chinese medicine there's this concept that health and wellness according to our most ancient medical book is really the free flow of Qi in the body. Now I want to make this even more material. Let's not say that she is energy or something mystical. Let's just say the free flow of Qi is proper organ functioning throughout the body right. So when we look at all the major organs in the body the person doesn't have digestive problems anxiety depression sleep problems migraines major menstrual problems in general in terms of symptomatology in terms of raw symptoms right there's not much going on. Let's just say that is the definition of free flowing Qi good physiological function in the body and pathological function really illness is where this flow is impaired for whatever reason the flow can be something going on digestively acid reflux indigestion severe bloating food allergies it can be gynecological it can be you know having recurring yeast infections or uti's or discharge or it can be a dysmenorrhea it can be migraines anxiety depression and zombie let's just start with that basic fundamental description of what health is and what will predict disease according to Chinese medicine in my experience issues in that flow whatever the chink in the armor is whatever is causing a kink in that flow that will cause problems one of the common side effects is fatigue now the first pattern that I see is digestive related so fatigue associated with digestive problems primarily what we call digestive excess now one of my mentors in school was giving us a cautionary tale on why we shouldn't just throw a whole bunch of tonic herbs at people you know in the west we have this idea that you take herbs like ginseng or astragalus or adaptogens every day and you're going to live forever and that's just not true that's just bad medicine and no skilled herbalist or Chinese medicine doctor would ever do that and a perfect example that he gave me was that he said you know an example of why someone who complains of fatigue you still have to do a very very thorough work up on to do a differential diagnosis and a good example was he had a very overweight patient who was constantly complaining about bloating and fatigue and based on his abdominal diagnosis he found that she probably had very sluggish bowels for a very very long time and rather than giving her tonic herbs like ginseng that are very sticky they're hard to digest if people have digestive issues especially too much gas and accumulation it can worsen those things so he said instead of giving that he gave a formula that was technically classified as a purgative and formula that is basically a mild laxative that you basically use to literally help the person poop more he said rather than giving tonic herbs like ginseng what he gave her was a formula that basically helped her poop more it was really a digestive flush one of the only times I've ever seen him use really very symptomatic treatment but it turned out to be the actual root cause of her fatigue because he said ironically the more he purged her in terms of her bowel movements the more energized she felt and the more she pooped the more energized she felt and that just went on for about a month until the problem was basically resolved and he gave that as a great example of a differential diagnosis that actually very few people that are very fatigued you throw in a bunch of tonic herbs but that's exactly what your patients are going to do they're going to go online they're going to order huangqi astragalus renchen ginseng they're going to order ashwagandha they're going to order rhodiola they're going to go online and order all those things because they think that's what they need and lesser skilled practitioners will actually give those formulas to those patients not understanding that that is not the pattern digestive stagnation is one of the first causes and two of the areas that i see this the most are what we consider excess and more of the deficient stagnation more excess stagnation is either where there's reflux indigestion burning that kind of thing or on the deficient side is this these are often people with food allergies and sebo and bloating and a lot of gut sensitivities and they're often paler and a little bit more cold and a little bit flimmy in the throat i find that that is often the chink in their armor and that weak link is often what predisposes them to fatigue for this kind of patient this pattern it is often improved with fasting basically eating less food or eating healthier food or eating fewer meals often will improve this patient giving it a couple weeks of that the second most common cause of fatigue i see is what we would just call young deficiency young deficiency basically meaning the person's exhausted now young deficiency falls into the category of overworking being stressed not sleeping enough general exhaustion i would say and for these people often when i feel the pulse the pulse is very deep it's very weak they're fatigued they may not sleep well or they sleep a long time and they're still not rested but in general for this kind of person the result because of this fatigue is really debility it's weakness it's exhaustion so for these people this is often improved with long-term rest and sleep and moderate exercise so for a lot of people who have a low lying level of fatigue especially if they're good sleepers as in they can sleep a long time they're more prone to sleeping too much than too little these people would often feel better with a lot of moderate low level exercise so that's the young deficiency kind of fatigue sometimes category number three falls into this picture which is really stress related and it can push people into a state of young deficiency and this is really related to the stress response so the third category i'm just going to call constraint frustration and nervous system tension this is the kind of fatigue that happens like for example after you've exhausted yourself working for a long time i find that for a lot of these patients they have an elevated pulse rate elevated heart rate they may have palpitations they may be have problematic sleep anxiety or depression but really what we're talking about is long-term nervous system tension due to stress the stress can be purely emotional it could be purely in their head it could be lifestyle stress living in a city and driving two hours a day in their car work stress but what it is is it manifests in the nervous system being on too much and in a state of sympathetic dominance so for these people very often this is related to the feeling of overwhelm right so we can have stagnation when i feel the pulse and the abdomen stagnation can come from just eating too much food or bad food it can also come from being stressed all the time and you're just not even taking a full breath during the day because your boss is breathing down your neck for this kind of person this often improves different from just rest or different from just you know diet often improves with release type activities the biggest one being physical exercise so for this last category it's a manifestation of tension in the body that is exhausting the body for lack of a better word and these are the kind of people that after a long day at work even if they feel tired if they go to the gym for 45 minutes they feel great for hours after so very very common kind of fatigue as well and i think of it mostly as a superficial kind of fatigue but if it progresses for long enough and goes on it will result in a young deficiency kind of fatigue where now there is actual resource exhaustion in the body so the third type responds very well to physical exercise something that gets the tension out of the body is very essential for this kind of person so category one is usually digestive stagnation digestive problems two is just exhaustion not sleeping enough overworking just under rested and number three is really the overworked category so three common causes of fatigue and chinese medicine and my best advice for lifestyle advice that can help resolve those a little bit all right guys that's what i have for you for today and before you go check out these two related videos right over there