Fatigue is a normal response after a marathon (or, for amateurs, a 10K run), a night of sleeplessness due to worry or a sick child, or a stressful day at work. Generally, though, a good night's sleep banishes this kind of fatigue. Abnormal fatigue is waking up tired, feeling exhausted walking up the stairs or vacuuming, not being able to make it through a normal day, or feeling tired for weeks on end despite getting enough rest. Fatigue can be associated with increased stress, mood swings, or it can be a sign of physical illness. When fatigue is chronic it is a symptom that something is wrong and should not be ignored.

These days fatigue seems to be a way of life for many Americans. One recent study showed that 28 percent of patients who visited their doctors complained about fatigue being a "major problem" for a month or more. The root cause of fatigue can be difficult to determine since physical, psychological and lifestyle factors can all contribute to the problem. We'll examine each area to help you do your own personal detective work.

Western Medicine

Your doctor or nurse practitioner will take a health history to identify possible causes for fatigue, followed by a complete physical examination including blood tests. This will be done to distinguish between short-term, explainable fatigue and chronic fatigue lasting longer than six months. One common cause of fatigue is anemia. Symptoms of iron deficiency such as tiredness and irritability can occur even before the onset of anemia. Other common causes include thyroid disease (which is more common in women and runs in families), viral and bacterial infections.

Traditional Chinese Medicine (TCM)

A TCM practitioner identifies two kinds of fatigue: overuse and disease. Overusing energy is generally a short-term problem due to lack of sleep or other modifiable cause and does not require treatment. Fatigue due to illness or disease in the Chinese view is a deficiency of Qi (energy) in the blood, Yin or Yang, involving the spleen and stomach meridians.

Usually treatment would include tonifying or strengthening the energy and blood through Chinese herbology and a course of acupuncture lasting up to four to six weeks.

Unrelieved stress is a common cause of fatigue. Taking the time to engage in mindfully relaxing activities can help to manage that stress-related fatigue. A regular program of relaxing massage or reflexology can be a vital part of your fatigue-fighting program.