 Have you ever felt really, really tired over a long period of time? And even though you're eating well and you're exercising and you think you're sleeping well, you're just constantly exhausted. I think when you Google kind of internet advice on how to feel less tired, you really, really, really rarely get very specific advice. It's usually typically generic. And that's kind of the best you can do with an article usually. But I thought in this video today, I would share three common types of fatigue that I see and the different routes where I see that they come from according to Chinese medicine. Hey, guys, Dr. Alex Hine, author of the health book, Master of the Day, Doctor of Chinese Medicine. Now, before we jump into this video, there are two very 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's a link below to contact my private practice and reach out that way. And the second, there's a free guide for daily rituals that could potentially help you add years to your life with Chinese medicine. And that is also right below this video. So when it comes to exhaustion and just chronically feeling tired, obviously, there are a lot of reasons for that, right? And that's where the skill differential diagnosis comes in. Is this fatigue because the person isn't sleeping well? Is it fatigue due to an underlying medical problem? Is it fatigue due to something else that's going on? So I thought I would share three patterns in Chinese medicine that I see as the most common patterns that fatigue come from. Now, brief overview. The first one is what I call digestive exhaustion. The second one I call nervous system exhaustion. And the third I call adrenal exhaustion, just to try my best to loosely translate them into plain English. So let's talk about digestive exhaustion first. This typically falls into two different sides of the coin, right? The first one is typically the person who has very low appetite, especially low appetite for hours in the morning, often are prone to more food allergies, food sensitivities, loose stools, frequent loose bowel movements or incomplete bowel movements. Now on the other side of this coin, we have the digestive exhaustion type, which is really more of a person who typically has constipation. And they're more prone to going several days or even a week or sometimes two or three weeks with minimal bowel movements or incomplete bowel movements, more prone to hard dry stools. So in one case, this person is more prone to what Chinese medicine considers deficiency. They're having these low appetite, loose stools, food sensitivities. And on the other side, it's really a problem of congestion for lack of a better word. There's just so much stuff inside that person's body that for some people, you just give them gentle purgatives and they feel more and more energized every single day. It's very interesting to see. So the formulas for this approach that I use for the one type, we typically give herbs with ginseng and with ginger that increase metabolism and help drain what we call dampness. So that's often why these people have very low appetite and why they're having these frequent loose stools or a kind of diarrhea prone. And on the other side, really, these people tend to do better with herbs that essentially are purgatives that help get things going a little better. After a week of having more frequent or regular bowel movements, they often will feel a lot more energized. Now, when it comes to these kind of digestive exhaustion patterns, for these people in terms of general life advice, they tend to do better feel better fatigue wise by really focusing on diet. That's it. It's not by focusing on sleep more or working less. It's just if they're disciplined about their diet, they will often feel the best. So that kind of becomes the the chink in their armor, their Achilles heel, they have to pay very close attention to. So let's go to the second type, nervous system exhaustion. Now, for this kind of pattern, this is what it looks like. These people are often sensitive people. They often have issues with sleep with their heart rate, typically tachycardia racing heart easily, they notice their heartbeat a lot, anxiety, palpitations. And they're very prone to feeling anxious, typically, these are usually sensitive people or the nervous system is just buzzing with too much activity. And it's way too hyper vigilant. It's picking up way too much way too many threats out in the bushes over there, right? It's just a blue jay, but it thinks it's you know, it's a tiger or a lion. And they think everything out there is going to harm me. But it's all really subconscious. It's really the body is is perceiving too many threats that are not real. That's what it looks like. Typically, I see a lot of sleep issues, anxiety issues, and issues with tachycardia. So the pulse rate of these people is often very, very elevated. Double triple quadruple a standard pulse rate, you know, 90 plus often for a lot of people. Some people it's 130 at rest. I mean, it's crazy. Or they have symptoms of POTS where they get dizziness, and they stand up too quick and they feel like they're going to faint orthostatic hypertension. But generally, the heart is a key focus here. It's in particular. So the formulas here, typically, are we used to regulate the nervous system in the most general sense. So when I give people these formulas for this kind of pattern, the first thing I monitor is really the resting heart rate when I feel their pulse. So it goes from being 130 or 90 down to 68 72. And that's a really clear sign of the nervous system is really dropping down quite a lot. And that's almost always correlated with better sleep and less than zombie anxiety, that kind of thing. Now in terms of life advice for this kind of exhaustion pattern, really, what I would say is, because these people have a very sensitive nervous system, they have to absolutely prioritize stress and lower levels of stimulation in their life, which usually means nowhere less coffee, more physical exercise, because very grounding to the nervous system, time out in nature, or in the woods, maybe even avoiding city life, or if you are in a city, making sure your living area is very, very quiet, very, very restful for your nervous system. And in general, these people have to just be careful of general life stress. So everyone is born different, some people can tolerate a lot of stress, some people can't. And then we layer on our habits and our decisions every day that can improve that. You know, if you sleep well, and you exercise you eat well, you're going to have better resilience and better stress tolerance. But these people in general, because it's the nervous system, have to be very careful about the way they live their life in regard to stress, pressure, deadlines, stimulation. Now the third kind that I call adrenal exhaustion, it overlaps a lot with a nervous system exhaustion. But typically, these kind of people have heavy fatigue, and more depressive symptoms as part of their picture. So often there are issues with sleep, more depression, but often anxiety to often issues with urination, exhausted all the time, heavy, heavy, heavy fatigue. So when it comes to formulas that we use, we typically use formulas that are, I guess you could say more stimulating in nature formulas that work to help increase the energy reserves of the person, these people tend to do better with stimulants just genetically, this kind of person often tolerates coffee well, for example, they could drink a cup of coffee and go to bed, no problem. But on this side, they're more prone to somnones. So they will often be able to sleep 10, 12 hours, no problem. But they will still have a level of fatigue and malaise and lack of motivation, that kind of thing. So this is the more somnone body type, let's just say, nervous system type, where kind of struggles to get motivated, can sleep a lot more depressive in nature, more or a little bit more sluggish in nature, not typically anxiety prone. So for the formulas, we discussed that but for the life advice for this person, these people often do better with stimulants, or tolerate them or maybe they will help them. But they often deal better with exercise, exercise helps them a lot. Often have to be careful with their diet as well. I find that a lot of my friends with this pattern do better with fasting, just eating irregularly or eating just one meal a day seems to be something that helps a lot of them. But in general, eating frequently for them tends to produce a lot of fatigue and a lot of tiredness. Sometimes it overlaps with diabetes or pre diabetes. But this pattern, I just think of it as adrenal exhaustion. But there's a lot of overlap with these other types as well. But I try to categorize this a little bit differently. This is from Chinese medicine perspective, we're treating the kidney and the heart often. So those are three common types of fatigue or chronic exhaustion that I see that they all get treated differently. Right? The first type, I'm often giving formulas for digestion. But there's plenty of herbs in there that improve fatigue, because that is the weak link in the person's armor. Right? We don't think biometically in Chinese medicine, we don't think, Oh, fatigue, ginseng every single person doesn't work like that. Some people will have increased fatigue on ginseng, for example, the other type, you know, we're often using herbs that are calming to the nervous system. You don't usually think of a sedative as being more energizing. But for the person that's anxious and their nervous system is like this, they will be more energized because they are more calm, they have more steady focus. And for the last type, give them some uppers, something that helps, you know, get activity in their mind, their body and their their spirit, so to speak, and physical exercise being really important for them. So I hope those help something a little bit more specific than drink water and get sleep. It doesn't really help anyone. That's not a revelation there. But I hope that gives you some insights if you're dealing with fatigue or tiredness every day on how you can approach it. Alright, that's all I have for today. Check out these related videos before you go. And I'll catch you in the next video.