Tiredness is one of the most common presenting conditions in western patients. Very often tiredness is seen in Chinese medicine as a deficiency condition, although it may also be caused by and excess state as well.

The causes of tiredness can be from a variety of sources. A weak constitution, overwork, physical overexertion, poor diet, severe illness and childbirth to name a few can all cause tiredness.

From the Chinese perspective it is important to find out where these causes are affecting the body. For example it may manifest in the lungs where along with the tiredness a patient may feel slightly breathless, have a propensity to catching colds and have spontaneous sweating; or it may manifest in the spleen where there is also a poor appetite, muscular weakness, bloating and loose stools. These are just two examples of a large number of patterns caused by a deficiency of ‘qi’. A person under great stress may however suffer from an excess form of tiredness. Here, rather than having too little energy or 'qi' it is actually that the qi is stagnant and causes blockages. In this way energy cannot flow freely around the body and get to where it needs to. People suffering from this may also present with tiredness that is worse in the afternoon with a "wound up" feeling, distension or soreness of the ribs, PMT or headaches.

It may be that a patient falls largely into one category of cause but it may easily be that it is a combination of causes that leads to the tiredness.