Fatigue
Definition
Western
Fatigue is a condition when one feels constantly weary, tired and lack of motivation. Often, it is also accompanied by the constant desire to sleep regardless of day or night, which is coupled with low efficiency at work. Fatigue can be classified into two general categories, mainly acute and chronic conditions.
Acute fatigue is the sudden onset of physical and mental tiredness resulting from insufficient sleeping hours or overexertion of workload. It usually recovers shortly after a good period of rest and relaxation.[1]
Chronic fatigue syndrome (CFS) is a complex disorder that presents with unexplained profound exhaustion and tiredness. Furthermore, the condition worsens upon extreme physical or mental activities such as constant lack of sleep, daily stress or over-exercise. Unlike acute fatigue, CFS cannot be recovered by simply a few nights of sleep or rest and may persist for a prolonged period of time, even up to years. CFS may display the following symptoms at the same time:
· Short-term loss of memory or concentration
· Sore throat
· Painful, mildly enlarged or tender lymph nodes in the neck and armpits
· Muscle pain with unexplained reason
· Multi-joint pain without any obvious swelling or redness
· Headaches of unexpected pattern or severity
· Non-refreshing sleep
· Extreme exhaustion or bodily discomforts for more than 24 hours after physical or mental activities
In addition, fatigue is also a common symptom that is displayed in many chronic diseases such as anaemia, diabetes and hypothyroidism.
Traditional Chinese Medicine (TCM)
In TCM, fatigue is referred to as a type of condition in which one’s body constitution has been weaken for a prolonged period of time. It is often due to physical, mental or medical reasons such as:
· Being constantly overworked
· Unhealthy dietary habits or malnutrition
· Insufficient rest
· Depression, stress or anger
· Suffering from certain chronic diseases
· Loss of large amount of blood due to injuries or surgeries
All these factors can lead to the weakening and impairment of the body system, causing the body not to be able to function properly. Hence, resulting in symptoms such as:
· Tiredness and lethargy
· Loss of appetite
· Breathlessness
· Experiencing mild fever or having a feeling of being feverish when the body temperature is normal.
Symptoms Displayed and Classifications in TCM Context
Overwork induced
When one overworks and has inadequate amount of sleep for a pronounced period of time, both the body and mind do not gain enough rest to recuperate. Consequently, one will feel more tired and less energetic easily. Symptoms include pale complexion, lethargic or lack of energy, reluctant to speak or softly spoken and may experience giddiness unexpectedly.
Weak immunity induced
The course of most chronic diseases is usually long, thus requires longer recovery period. Hence the patients have to go through various extensive treatments which drain their immunity to fight against diseases. Symptoms displayed such as afraid of cold, constant cold limbs, uncontrolled sweating or experience mild fever in the late afternoons, night sweats and easily irritable, constant thirst, dry lips or throat may also be experienced.
Causes and Risk Factors
Inheritance/ Congenital Conditions
Due to genetic factors, the body constitution of some individuals is usually not strong or stable since birth. Therefore, this group of people is more susceptible to diseases and may take longer time to recover.
Lifestyle
Unbalanced lifestyle such as stress, unhealthy diets or malnutrition and lack of rest do not provide the body with enough energy or alertness for the-next-day activities.
Medical Reasons
Patients with certain chronic diseases deteriorate faster than normal individuals. Hence, feelings of lethargy and weariness are more easily observed amongst them, and it is even more obvious for those who did not receive full treatments diligently. For instant, fatigue is one of the common symptoms for anaemia, diabetes and cancers.
Treatments
1. Huang Qi -黄芪
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English/ Common name
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Astragalus Root, Béi Qí
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Latin species
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Astragalus membranaceus radix
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Park of plant used
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Roots
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Action/s
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Helps to strengthen the immune [2-3] and digestive systems [4-5], as well as help to promote wound recovery [6,23].
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Precaution/s
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Healthy individuals who experience common colds and flu, indigestion, mild fever in the late afternoons or night sweats are not advised to use.
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2. Dang Shen -党参
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English/ Common name
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Codonopsis Root
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Latin species
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Codonopsis pilosula
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Park of plant used
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Roots
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Action/s
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Helps to strengthen the immune [7-8], digestive and respiratory systems [23]. Found to be able to improve learning and memory abilities [9-10].
It is advised not to be used together with Radix et Rhizoma Veratri, Lí Lú (藜芦).
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Precaution/s
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Codonopsis Root
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3. Bai Zhu –白术
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English/ Common name
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Largehead Atractylodes Rhizome
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Latin species
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Atractylodes Macrocephala Koidz.
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Park of plant used
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Rhizomes
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Action/s
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Helps to strengthen the digestive system [11-12] and prevent miscarriages [13]. Also helps to control the rate and amount of perspiration [23] and have some diuretic effects [23].
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Precaution/s
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No significant side effects.
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4. Shan Yao –山药
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English/ Common name
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Common Yam Rhizome
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Latin species
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Rhizoma Dioscorea opposite Thunb
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Park of plant used
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Rhizomes
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Action/s
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Helps to strengthen the digestive [14-15] and respiratory [23] systems. Also helps to protect the kidney and renal systems [16-17], as well as promoting growth [18-19].
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Precaution/s
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No significant side effects.
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5. Suan Zao Ren – 酸枣仁
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English/ Common name
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Spina Date Seed
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Latin species
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Ziziphus jujuba Mill.var. Spinosa (Bunge)
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Park of plant used
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Seeds
Helps to improve the quality of one’s sleep by calming the nerves and mind [20-22]. Also helps to control perspiration [23].
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Action/s
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Individuals with the following symptoms should use the herb with caution: often experience diarrhoea, constant thirst and have preference over cold drinks, flushed face and dry throat, throbbing headaches, bitterness taste in the mouth, feel vexed easily and yellow urine.
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Precaution/s
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Spina Date Seed
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Test & Diagnosis
Laboratory Tests
1. Blood tests for haemoglobin and sugar levels and antibody tests for signs of anaemia, diabetes and other possible kinds of infections.
2. Urine tests to check for signs of diabetes or liver disorders.
3. Functional tests for thyroid, liver and kidney disorders to check for any underlying metabolic diseases.
Lifestyle and Home Remedies
Maintain healthy lifestyle by having consistent and adequate number of sleep hours, exercise regularly, adopting good healthy diet habits and knowing some physical techniques to free oneself from stress.
Tài Zí Shēn (太子参) or Dăng Shēn (党参) + Shān Yào (山药) + Suān Zăo Rén (酸枣仁) + Wolfberries (枸杞子) + Red dates (红枣)
a) Put all ingredients in a cooking pot and pour enough water to fill half the pot.
b) Bring to boil for 10 minutes. Simmer for a further 30 minutes.
c) Remove from heat. Serve warm.
References
1. Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier
2. Yao-Haur Kuo, Wei-Jern Tsai, Soy-Hwee Loke, Tian-Shung Wu, Wen-Fei Chiou. Astragalus membranaceus flavonoids (AMF) ameliorate chronic fatigue syndrome induced by food intake restriction plus forced swimming. J Ethnopharmacol 2009, 122 (1), pp 28-34.
4. Ko JK, Chik CW. The protective action of radix Astragalus membranaceus against hapten-induced colitis through modulation of cytokines. Cytokine. 2009, 47(2), pp85-90.
7. Sun YX. Immunological adjuvant effect of a water-soluble polysaccharide, CPP, from the roots of Codonopsis pilosula on the immune responses to ovalbumin in mice. Chem Biodivers. 2009, 6(6), pp890-6.
8. Zhuang SR, Chen SL, Tsai JH, Huang CC, Wu TC, Liu WS, Tseng HC, Lee HS, Huang MC, Shane GT, Yang CH, Shen YC, Yan YY, Wang CK. Effect of citronellol and the Chinese medical herb complex on cellular immunity of cancer patients receiving chemotherapy/radiotherapy. Phytother Res. 2009, 23(6), pp785-90
9. Xiao B, Chen G, Lan Z. [Study on the effect of promoting intelligence development and preventing hypoxia/reoxygenation injury of selenium-banqiao-Codonopsis pilosula-overground part in mice]. Zhong Yao Cai. 2005, 28(8), pp688-90.
14. Song MY, Lv N, Kim EK, Kwon KS, Yoo YB, Kim JH, Lee SW, Song JH, Lee JH, Lee SK, Shin BC, Ryu DG, Park BH, Kwon KB. Antiobesity activity of aqueous extracts of Rhizoma Dioscoreae Tokoronis on high-fat diet-induced obesity in mice. J Med Food. 2009 Apr;12(2):304-9.
21. Fang XSh, Hao JF, Zhou HY, Zhu LX, Wang JH, Song FQ. Pharmacological studies on the sedative-hypnotic effect of Semen Ziziphi spinosae (Suanzaoren) and Radix et Rhizoma Salviae miltiorrhizae (Danshen) extracts and the synergistic effect of their combinations. Phytomedicine. 2010 Jan; 17(1); pp75-80.
23. Gao Xue Min. Pharmacopoeia. 2002.