Fatigue may appear in the initial stage of various diseases. Irrational living habits, irregular living habit, irregular or uncontrolled life, and mental stimulation all below. may cause fatigue. The following are the common causes of fatigue.

1.       Visual disturbances due to hyperopia, myopia, and astigmatism may induce heavy headache, stiff neck, and generalized fatigue

2.       Mild fever in various chronic diseases.

3.       Autonomic disturbances, depression, anxiety, and other neurotic disturbances.

4.       Hypotension, anemia and hypothyroidism.

5.       Tuberculosis, hepatitis, HIV infection, and nephritis can give rise to fatigue and inappetence.

6.       Diabetes mellitus manifests generalized fatigue, thirst and polyuria.

7.       Hypertension and heart disease accompanied by heart deficiency.

8.       Other diseases such as carcinoma, for which the patient has taken excessive doses of drugs, which have resulted in drug poisoning.

9.       After violent muscular exercising, the body will feel very tired.

For the above conditions of fatigue, modern medicine relies on treatment of the specific disease on stimulants such as caffeine, and on antidepressant drugs. In many cases, little can be done to alleviate fatigue and lassitude using standard methods.

Fatigue that is associated with debilitating disease is called xu lao in traditional Chinese medicine. The condition is thought to result from impairment of the viscera and deficiency of primordial qi. Most often, the syndrome involves depletion of the yin which then adversely affects the strength of the yang.

1. Qi deficiency characterized by shortness of breath, stridor, spontaneous perspiration, fatigue, chlorosis, occasional fever and chills is commonly treated with Four Major Herb Combination or Ginseng and Astragalus Combination to strengthen the middle burner and tonify qi.

2. Blood deficiency manifested as fatigue, vertigo, dizziness, palpitation; pallor, dry, harsh skin and scanty menses or amenorrhea can be treated with Ginseng Nutritive Combination, Tang-kuei Four Combination, or Ginseng and Longan Combination to nourish blood and harmonize the organs.

3. Yin deficiency characterized by fatigue, tidal fever, night sweats, dry cough or coughing up of bloody sputum, florid cheeks, irritability, anxiety, spermatorrhea, insomnia, and poor memory is commonly treated with Anemarrhena, Phellodendron and Rehmannia Formula, Phellodendron Combination, or Astragalus and Turtle Shell Formula to nourish yin and clear heat.

4. Both qi and yin deficiencies of aging characterized by dry skin, thirst, fatigue, and shortness of breath may be treated with Ginseng and Ophiopogon Formula, or the combination of Ginseng and Ophiopogon Formula with Rehmannia Six Formula.

5. Yang deficiency characterized by soft voice, vertigo, dizziness, pallor, blurry vision, fatigue, poor appetite, intolerance to cold, loose stools, impotence, pale and flabby tongue, and deep, thready pulse can be treated with Eucommia and Rehmannia Formula or Rehmannia Eight Formula.

6. Fatigue induced by summer heat and dampness, and characterized by reduced appetite, fatigue, lassitude, weak limbs, nausea, vomiting, and soft stools or occasional diarrhea can be treated with Astragalus and Atractylodes Combination.

7. Blood stagnancy characterized by emaciation, abdominal distention, coarse skin, dark face, amenorrhea, hesitant or string-taut pulse, and dark red or purple tongue, which can be treated with Rhubarb and Eupolyphaga Formula (da huang zhe chong wan)· to break up and remove blood stasis and generate new blood. Cinnamon and Hoelen Formula or Rhubarb and Leech Combination may be used to promote blood circulation and removes blood stagnancy.

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