Tiredness (Fatigue)

I've now been in full-time practice since the beginning of 1989 and, from that time till now, the number one problem that people have come to see me for is a deep level of abiding tiredness that might be better described as fatigue, even exhaustion

You have to treat the cause of a problem to expect a lasting cure from it and that is what I mostly want to talk about in this article but I firstly want to talk about some of the great herbs that anyone who has become deeply tired should most certainly use.
I use these tonic herbs more than any other kind of medicine for the simple reason that, so long as they are used patiently and correctly, they reliably and consistently lift energy, brighten the spirits and help people to heal from whatever has caused them to be bought low.

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

The tonics

In my own view, and that of many others in this work, the two top energy tonics in all the natural world are Panax Ginseng and Withania somnifera. Panax Ginseng is known as the 'Emperor tonic' in Chinese medicine and has been revered for millennia for its ability to restore energy. Withania is equally as highly regarded in the great Ayurvedic system of the Indian sub-continent and likewise has a tremendous history of use for all kinds of problems where increasing a person's vital energy is understood to be the key to their healing. If you will use either or both of these herbs, then I certainly encourage you to learn a lot more about them; I write about Panax Ginseng in much more detail here and Withania root here.

Because they are such important tools in my own practice I've gone to some lengths to obtain the best possible quality dried herb of each in its raw form, which we then we get encapsulated by a local company. On the one hand this means I know exactly where they come from and can guarantee their quality, on the other it also means we cut out all the middle men and can supply herbs to our patients most economically! I mostly use the capsules of the two combined but I also use them singly in their raw form as a simple powdered slurry in water (Ginseng) and an evening drink made with the cut herb and milk decocted together over a gentle heat (Withania)

As you will have already seen if you have looked around my website I do not sell these herbs or anything else online and likewise I cannot advise someone unless I see them in person first so the reason I mention all this is because, as mentioned in the beginning, it may be wise to find a good herbalist to get these or other herbs for you or your loved ones. Another dedicated herbalist will, like me, surely take great care in getting the best quality herbs and they may also be able to help you much further with some of the other issues I discuss further below about finding and treating the causes of fatigue.

Panax Ginseng and Withania may be my favourite energy tonics but they are by no means the only herbs I use when people are tired and run down and in practice I will typically combine a handful of herbs together for my patient to take each day for as long as their support is required. For example, the humble Hawthorn, both leaf and berry, has been seen to restore physical vitality to the hearts of many hundreds of people who were tired and unable to restore their fitness before they made good use of its certain help - more on it here. Another great favourite is St John's wort and, much more than just the natural 'anti-depressant' it has been marketed to be, I have tremendous respect for its ability to nourish an exhausted nervous system; learn more about it here.

Hypericum perforatum (St John's wort)


Common causes of fatigue

From a great deal of positive experience in this area I know that anyone who has a deep and chronic tiredness should take tonics, regardless of why they are fatigued. That said you still have to follow the rules of medicine to get a lasting cure from whatever is wrong and one of the most important of those rules is tolle causam -- 'treat the cause' (if interested you can read more about the three old laws of medicine in a little more depth here)

Do make sure that you have carefully ruled out an underactive thyroid function and if you have not explored this already I write in practical detail about how to test for that common issue as well as treat it here. Further to that, in my experience, it has been one or more of the following that are, by far, the main causes of tiredness and fatigue in people


The brain is the most sensitive organ in the body and the first symptoms of deficiency of any of the essential nutrients can be simple tiredness or irritability. The most common deficiency in the world is iron and I test nearly of my own patients for low iron when they first come in and I can tell you for a fact that a lot of people are anaemic without realising they are! Less common are the blood deficiencies of vitamin B12 and folic acid but these can certainly also be checked for in a routine blood test in any case.

Further to a blood test to rule out the essentials there are often other visible 'tells' that deficiencies are a key issue, especially in the growth of hair on the head and the nails of the hand. Losing significant amounts of hair can be caused by stress but it can also be a sign of nutritional deficiency. Likewise signs on the nails such as weakness, slow growing, splitting, spots etc. can all be clues that something essential may be lacking.

In New Zealand we have extremely low levels of Selenium in our soils (the second lowest in the world), likewise zinc and magnesium are chronically low in population studies done both here and elsewhere. I do not personally go in for a lot of nutritional supplement for most people but I am an advocate of a good multi-vitamin/mineral once a day along with some extra omega-3 fish oil if the diet is low in these healthy fats. Supplements aside, there is truly no substitute for a healthy diet and this is where tiredness that comes from deficiency is by far the biggest issue.

If you know that your diet is a long way off what could be considered healthy then don't kid yourself that your tiredness has nothing to do with this. It can't be overemphasised what a difference eating well can make to good health.

Give yourself a score out of 10 for your diet -- 10 being as good as you could imagine and 0 being as bad as you could get. If you score yourself below 7 (and you are presumably reading this because of excess tiredness) then you need to know that you have to do some work in this area.

The biggest issue with food and fatigue is the vicious cycle that happens when people who are too tired go for refined and processed foods because they are quick and easy to prepare and their high sugar and intense flavours trick us into thinking they will make us feel better.

I know that there is a lot of conflicting and crazy advice out in the health world but the simple and practical advice I've written up in a page on excellent nutrition is dependable information and may help to point you in the right direction in this vital matter; you can find it here.



Excess toxicity in the body can cause deep and unrelenting tiredness long before it shows up in such classic patterns as bad skin or joint pains. People often instinctively know that toxicity is a key part of what's wrong but an excellent indicator that this is the core reason for fatigue can be found by simply looking at the tongue. I have found a close correlation between signs of toxicity on the tongue (mostly showing as an off-white to yellow coating that is thick enough that you can't see the tongue underneath it) and high levels of debris and waste products in the plasma of the blood.

The subject of detoxification has many myths and misinformation in it; I've written a short article on the key points here and I've had much success in this area with the cleansing diet outlined here with much positive feedback from patients who've said they've enjoyed this diet and felt much better for it.

A clean diet makes a big difference but I could not imagine dealing with any kind of significant toxicity without using herbs at the same time. After the tonics, cleansing herbs are the second biggest class of herbs I prescribe and they are tremendous at activating a cleansing process that would otherwise take far longer with diet alone.

Again I urge you to find a good herbalist to help you with this if at all possible however if this is just not an option then what I can still confidently recommend as an economic and effective way to ensure a deep cleansing process is the Juniper & Celandine cleanse as written up in detail here.

Juniperus communis (Juniper berry)


Immune health matters

Issues of immunity can require particularly careful investigation if they are the underlying cause of fatigue and key physical clues include chronically swollen glands at the corner of the jaw, cracks in the corners of the mouth, dark rings under the eyes and slow healing from minor wounds or common colds.

When it comes to chronic immune health problems the conventional white blood cell quantity count of laboratory tests doesn't get close to the importance of the actual quality of those cells. One of the most important uses I have for my own dark-field microscope is its ability to graphically illustrate the structure and health of white blood cells whilst they are still alive which is of immense value in gauging the health and vitality of the immune system.

I have found that a great many people who experience especially bad fatigue are suffering from depressed immune systems. The two main reasons for this are low grade allergies (perhaps better described as intolerances) and chronic infections.

Allergies or intolerances

Many people have a mild but constant aggravation of their immune systems by foods that they are eating every day. They may not realise that they have a problem in this area because they never get an immediate reaction to the food but rather it causes a much deeper imbalance in their gut and immunity.

This is such an important area in health with so many misunderstandings in it that I've taken care to write a detailed article that I hope will be of much practical help to anyone who needs to address it. You can read that information here.


Chronic infections

I have worked with a great many people who have been diagnosed with chronic fatigue syndrome who in fact would be better described as having the post-viral syndrome. Post-viral syndrome also shows a typical pattern on blood microscopy but perhaps the best way to understand that this is the core issue is simply to look at what happened.

In many cases the history shows that they have been in good health up until they have had a vicious infection and from that point on they never properly recovered their vitality. Glandular fever (epstein-barr virus) is the most common culprit but CMV (cytomegalovirus) and others are clearly implicated.

It doesn't really matter what the original infection was. If the pattern is one of deep fatigue and exhaustion after an initial infection then the main efforts in recovery need to be directed at rebuilding good immune health. In such cases I would say it is essential to lean heavily on the support of the two greatest immune tonic herbs there are namely Echinacea (more info here) and Astragalus (more here). Again please try to get these from a herbalist or at least a very reputable supplier if at all possible!

With my own patients who have the post-vital syndrome I will also often employ the ancient technique of sweating therapy to re-activate a positive immune response; you can read about how to do it here.

The other area to be conscious of when it comes to chronic infection and fatigue is the very real possibility of an overgrowth of bad bugs (dysbiosis) in the gut. If you can clearly associate your fatigue with symptoms of bloating in your abdomen and disturbed bowel function then this is an area that at the very least needs to be explored and to do that I recommend you start by reading my detailed article on the subject here.

I trust the above notes convey some key points of how immunity and fatigue can be interlinked. If a weakened immune system is the core issue for you then there are some further general notes on immune health that may be of further assistance here.

Echinacea angustifolia


Mental health matters

Mental health matters such as anxiety, depression and poor sleep are such enormous sources of fatigue in our society that by rights I should have put this subject at the top of the page but I wanted to get you to think about the potential physical causes before we touched on this at the end.

The reason for this is that one of the worst things about tiredness is how it creates its own problems in its wake. People who are chronically tired nearly always get a low mood and will often get sleep disruption and anxiety to boot. So which came first -- the tiredness or the effects on the mental health?

If there is some identifiable cause such as nutritional deficiency, toxicity, allergy or infection then I suggest working out a strategy to deal with those problems first.. However if it turns out that you have a fairly clean slate in your physical health but you are still extremely tired then consider the following possibilities and explore them further in the links provided.

Tired and anxious?

If you think that your tiredness is associated with a generally increased anxiety then there are some profoundly helpful medicines in nature to help as well as several other practical and highly effective steps -- read more on this subject here.

Tired and depressed?

If you feel that your tiredness is a part of a feeling of a low mood or a general depression then again, start by letting Nature take the first step to help and be assured that this is a problem that can always improve; more detailed information here.

Tired and not sleeping?

If the basic root of the tiredness is poor sleep then straight away you have to get acquainted with the herbs in Nature that help relax the body into a better state for deeper and healthier sleep starting with but not limited to Valerian root (more info on it here). Sleep is such an important subject that if you are not sleeping you really must put it at the top of your list for what to do! More info here.

Valeriana officinalis (Valerian)


Permission to rest!

Many people who go on to get chronic tiredness have an upbringing or a nature to push themselves hard in whatever they do and may not take well to being idle. For such people, the most important step of all in the healing process may be simply giving themselves permission to rest when tired.

This probably sounds simple and you could easily gloss over it (especially if it applies to you!) but in fact this can be the greatest challenge to the healing process and can be the thing that can sabotage what would have otherwise been a successful recovery.

Of course if you have a deficiency, or toxicity, or an immune or mental health issue then that must be attended to. Further to that only you can really know how much you push yourself through fatigue at times when you could actually let go and let your tiredness guide you towards the you need. It's a strange, counter-intuitive concept to think of tiredness as a friend but sometimes that is exactly what it can be... this brief poem sums up what I mean here.

Only you can say if you know how to give yourself permission to rest when you are tired. If you do, don't worry about this, but if not -- think about it. This could be the thing that makes or breaks your future health. If you want to relax but are struggling with actually doing it then it may be that some of the commentaries or music I have put up on the site may help, you can find them here.

Constitutional Health Note:

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as helping you to improve your energy. Constitutional health is an old and fascinating way of understanding our differences and to demonstrate how it works if you are a hot and dry person (an Eagle) then immune health matters are often a key issue in the fatigue, if you are a hot and damp person (a Tiger) then toxicity comes up the most, if you are a cool and damp constitution (a Bear) then mental health matters commonly need the most attention and if you are a cool and dry person (an Elephant/butterfly) then deficiency (and low thyroid function) are the leading causes of fatigue. There is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd