Qi Deficiency: how to overcome tiredness

Qi Ascends and Descends

As explained, one of the Spleen’s functions is to ascend things and to hold things up or in place. If your Spleen qi is deficient, it can’t do this and that means that Qi is weak.

There’s a saying:

‘When Qi is weak, fluids leak‘.

How might you recognise this? Examples of leaking fluids include:

• Eyes running – lachrimation  – even though you aren’t crying and you’re not sad. They could also weep from exposure to bright light or cold wind.
• Nose runs for no good reason, or when outside on cold days
• Saliva escapes your mouth, unexpectedly, like after a dental anaesthetic when your lips are numb: dribble!
• Perspiration – sweating –  even though you  aren’t hot and haven’t been exercising
• Involuntary urination: Mums recognise this after giving birth but it happens when you’re ill sometimes, or when coughing or sneezing
• Loose stools: so loose you could lose some unexpectedly – embarrassing!

So we’d reached Zong qi, also called essential or gathering qi. It’s reached your chest and picked up air so the body can use it. The body uses it by helping the Lungs and Heart to push Blood and Qi to wherever they are needed in the body. On its way downwards, it gets first to the hands.

Cold Hands?

So if your hands are often cold, probably your zong qi is deficient. If so, probably one or more of the following are causes of this:

• poor nutrition,
• weak digestion, ie Stomach and Spleen Deficiency,
• deficient Lung qi or
• deficient even stagnant Heart qi.

Your Voice

Zong qi also gathers in your vocal cords. You can tell how healthy someone’s zong qi is by listening to his voice. If it’s strong, it suggests good zong qi and healthy lungs.

If it’s unclear, muddled, hesitant, then because your Heart controls your speech, possibly your Heart zang qi is deficient in some way, or not functioning well.

It could also happen because of phlegm, which is garbage left behind when your Spleen was not tidying up very efficiently.

Zong qi also helps your Heart regulate your blood vessels. So signs of weak circulation, including varicose veins, suggest either zong qi is weak, or your Heart is not doing its job.

What does an acupuncturist do if zong qi is weak?

This depends on the training and background of your acupuncturist. If he or she is a 5 Elements acupuncturist, he wouldn’t worry much about weak zong qi, because he expects that his treatment of what is called the ‘causative factor’ will eventually sort it out.

If he’s using TCM theory, he’d have a range of options.

• Using acupuncture theory, he might use an important point on the chest, Conception-vessel 17. This can strengthen zong qi, but other acupuncture points also help.
• He would probably use moxibustion – moxa
• Many other acupuncture points affect qi and its movement
• He might suggest you do exercises. (Eg yoga breathing exercises. He might teach you to nose-breathe more often, even when out of breath, because this can invigorate the nose, which ‘comes under’ the Lungs.)
• Oh! … and please note! … you can nullify or antidote the effect of a good treatment by not doing what you are advised to do, whether it be exercise or nutrition or something else!
• He might suggest skin body brushing to invigorate circulation (because the Lungs ‘rule’ the skin)

• He might ‘test’ you with funny stories, to see how your ‘spirit’ responds. How high or low-spirited you are is an important manifestation of your qi! Laughter is the best medicine.

Zhen Qi – True Qi

Zong qi now undergoes the last of these formative changes. By interaction from your inherited genetic know-how – your jing-essence (technically called yuan or ‘original’ qi) it becomes one of two different forms:

• Nutritive qi – ying qi or
• Defensive qi – wei qi:

Nutritive Qi – Ying Qi

Nutritive qi (ying qi) – goes inside us to nourish our internal organs and the rest of our body. As such it undergoes further changes, becoming the qi of our individual organs as it passes around and within them. It circulates the Blood and flows along the acupuncture channels.

This is the qi that acupuncture treatment manipulates.

So if you present for acupuncture having eaten no breakfast, acupuncture won’t work so well.

And please don’t gulp down a coffee just before your treatment as coffee has precious little nutrition in it. If coffee does make you feel better it will have yanked a bit of yang energy out of  your yin reserves, so you will probably already be mildly yin deficient as you walk in for the treatment! Read coffee for more on this!

Before acupuncture, make sure to have some food in you!

Please! Before acupuncture, make sure you have some good food in you to provide enough nutritive-ying qi for acupuncture to work with.

Defensive qi – Wei qi

Defensive qi – wei qi – goes to the outside of your body to protect it. Because it is on the outside, it is yang in relation to nutritive (ying) qi which is on the inside: yin. The theory says it circulates under the skin and between the muscles.

It protects you mainly against external factors described by Chinese medicine as:

• Wind
• Cold
• Dryness
• Damp
• Heat
• Summer Heat

Your Lung energy is mainly in charge of this protective Wei Qi. If you often catch colds, probably your Lungs and/or Wei qi are weak. However, that’s not quite all, because your Kidney Yang qi also supports your Wei qi. If your Kidney yang is weak, that also weakens your Wei qi.

When, in the early stages of an infection, you sneeze, that’s your Kidney Yang supplying your Lung qi with the energy to eject the invader.

Don’t suppress that sneeze! It’s designed to put the bug outside you, not inside you!

The Mechanism of Qi

Another important way the Chinese understood Qi was by the six actions in the body it performs.

You’ve read about some of them already, such as

• transforming (done by the Spleen as it turns food into blood),
• warming, partly done by your Kidney Yang qi
• protecting  done by your wei-defensive qi under the control of your Lungs

The three other functions are:

• raising things up:
• holding things in place:
• transporting things around.

All of which your Spleen does!

Of course Qi also protects you when you are wounded.

(Bit of  pernickety stuff! Of course it’s the reaction of your body that produces the symptoms, not the wind or cold etc. It is the way your internally generated defensive energy reacts to the external stimulus that shows how your qi is working.)

How is Qi made? As we saw, it starts with food which after Spleen involvement and input from jing essence (which is controlled by Kidney yang) rises to the Lungs and becomes True or Zhen qi.

So deficient defensive wei qi happens when one or more of the following occur:

• Weak jing essence and/or Kidney yang deficiency
• Unhelpful, under-nourishing food intake
• Weak Spleen qi
• Weak Lung qi

Symptoms of Deficient Defensive Qi – deficient wei qi

• Cold skin, chilliness

• Frequent respiratory infections – meaning you often catch colds or get runny noses and streaming eyes, not necessarily from invading bugs but cold come from drafts of cold air or sudden temperature changes (walking into or out from air-conditioned buildings, for example)
• Spontaneous daytime perspiration

Putting all this together let’s list the various functions performed by qi:

• Protecting – a sign of our wei qi
• Warming – a sign of our yang qi
• Holding things in place; otherwise we get prolapse – Spleen qi
• Raising things up – mostly Spleen qi, again
• Transforming from one form to another: eg food (eventually) to Blood; fluids to urine: air to ‘true’ qi
• Transporting and circulating, throughout the body and its organs and acupuncture channels

However, it is more complicated than even that, because although the main functions above relating to movement are upwards, yangwards one might say, one function of Lung qi is to descend qi towards the Kidneys, which later raise it up again.

Equally, qi can stagnate – as in qi stagnation. You get that when stressed and under pressure to do something that may be impossible or for which you haven’t developed resilience. (There’s a lot to be said for experiencing what it’s like to fail important exams a few times. You learn resilience, not to be over-sensitive, and it helps you to develop a sense of humour!)

Some typical questions about qi and tiredness

Loss of Appetite and Tiredness

The main cause of loss of appetite and tiredness from not eating enough, is Stomach Qi Deficiency.

However, low spirits (eg deficient Gallbladder qi, or deficient Heart Qi) and depression or sadness (stagnant or deficient Liver or Lung qi), and qi stagnation (mostly Liver Qi stagnation), can put you off food.

Then, because you aren’t eating enough, you get tired.

What Causes Tiredness? ie what are Tiredness Causes?

Causes of Tiredness and of Tiredness all the time, you can see from what’s gone above, include:

• Wrong diet – nutrition is poor
• Poor digestion which could include Stomach qi deficiency or Stomach Cold and Deficient
• Spleen qi deficiency: digestive process isn’t working properly, either from worry or a history of poor eating habits. For more, read Spleen functions.
• Kidney yang deficiency: there are many causes of Kidney qi deficiency – for some click here
• Lung qi deficiency which could arise from a previous disease, respiratory problems, smoking, genetic defects
• Gallbladder deficiency including a lack of what Chinese medicine calls Hun energy – roughly this is ‘spirit’: an optimistic outlook

Pregnancy Tiredness

Tiredness in pregnancy has different causes depending on the stage of pregnancy reached.

In the early months possible causes include:

• Not eating enough of the right foods – see nutrition for more on this
• Stomach qi rebels – meaning ongoing nausea ie morning sickness
• Stomach qi deficiency giving abdominal weakness
• Spleen yang deficiency – often from worry
• Not enough rest and sleep: reading our page on insomnia might help
• Jing essence depleted by demands from the foetus
• Kidney Yang deficiency, which often gives backache too – patients prefer to sit or lie down
• Chong mai rebels (hard to explain quickly!… see chong mai rebels)
• Heart Qi upset (‘vexed’). Sometimes this happens because of an imbalance between Blood and Qi.
• Please note that this list is only indicative! It’s not a full list!

In pregnancy later months possible causes include:

• Not eating enough of the right foods
• Not enough rest and sleep
• Stomach qi deficiency
• Jing essence depleted by demands from the foetus
• Kidney yang deficiency
• Please note that this list is only indicative! It’s not a full list!

Overwhelming Tiredness After Eating

If you get tired after eating, fundamentally you will have some kind of pre-existing qi deficiency. This could take several forms. For example:

• Stomach yang deficiency: this could happen if you eat too much cold, iced or chilled food, or too many foods with a Cold energy – see Cold Foods
• Stomach qi deficiency.   Usually the cause is a history of poor nutrition – the wrong foods, or not enough right foods – or poor eating habits, such as eating too quickly or while working. It can also follow exhausting, chronic illness. If there is great pain after eating, which goes on to produce tiredness, consider other Stomach syndromes, like Stomach Damp-Heat and  Stomach Blood stasis, for example.
• Stomach and Spleen deficiency. For example, over-eating damages your Spleen.
• Kidney yang deficiency.   Common causes include exposure to cold, frequent sitting on damp, cold ground, physical over-strain, age, poor genes, and improvident use of resources, including, for men, too much sex!
• Lung qi deficiency: your lungs are your first, main source of qi. Your Lung channel starts from your stomach area, your solar plexus. Lung and Stomach affect one another in many ways. Cold conditions in general, and cold liquids in particular (even more than cold food) deplete Lung qi. So large quantities of chilled beer, quite apart from filling you up, may reduce your Lung qi and its ability to support your Stomach qi. That means you can’t eat too much food and eating tires you.

Spleen Qi again!

• Spleen qi, which turns food passed on from the Stomach to the intestines into Blood and Qi, is ‘injured’ by excessive sitting. If you sit for long periods (eg driving), or work at a desk all the time, and don’t get up and move around regularly, your Spleen qi won’t work well. Around 30 minutes after a meal you may find yourself very sleep and lethargic. This will be worse if your meal contained many foods that quickly turned to sugars in your digestion, such as refined flour (pizza, pasta, white bread, white of potato, food made of refined flours – just some examples): these would give you a quick burst of energy and then a ‘hypo’. This often puts weight on you. And, because you feel tired, you don’t exercise.
• Over-thinking and worry also upset Spleen qi. Pre-exam nerves on the one hand, and long-term anxieties (finance, family, relationships, job …) on the other. Both can diminish health digestion.

Shortness of Breath and Tiredness – often due to anaemia tiredness

As with Western medicine, one suspects anaemia. This – in Western medicine – comes from deficiency or shortness of red blood cells, the kind that carry oxygen round your body. Chinese medicine doesn’t classify it in quite such specific terms but certainly  the result is similar:

• Qi and Blood deficiency from poor nutrition. Also from Stomach Qi deficiency.
• A need for Blood-Building foods. Many of the foods mentioned on the linked page are rich in iron and from the Chinese point of view, more healthy than iron tablets but perhaps not as fast-acting.
• Lung qi deficiency comes with breath shortness and tiredness.
• Severe qi stagnation can make  you feel resistant to doing anything, and we interpret this as tiredness

Vitamins for Tiredness and Energy, persistent tiredness

Tiredness from vitamin deficiency occurs mainly when what you eat doesn’t contain the necessary nutrients for health and vitality, or because of poor digestion.

• Poor digestion is easy to understand. It means that even if you eat good food, and enough of it, containing excellent quantities of all nutrients, you still don’t absorb what you need. That mainly comes under Stomach and Spleen deficiency.
• For ideas about healthy food and eating read first our page on Nutrition. Then read our page on Supplements.
• Deficiency of any essential nutrient may tire you, long-term. For example I tend to be slightly deficient in Vitamin B12. (No need for details, you would only be interested.) B12 is an essential vitamin for healthy red blood cells. So I take a B12 supplement. If you aren’t B12 deficient, and still take it, you’d be wasting good money.
• Likewise Qi and Blood deficiency can lead to iron deficiency. See Blood building foods.

Vitamins for Tiredness and Stress

Stress usually tightens you up, causing Qi Stagnation. On our page on Qi stagnation there is a long list of foods that people find useful for tiredness and stress.

These foods are helpful in reducing the symptoms of stress caused by qi stagnation. They are not specifically for the tiredness it causes. Their aim, like acupuncture or herbal formulae for it, is transformative. If they work, the qi stagnation eases and the tiredness goes. They transform the situation.

For vitamins for tiredness and stress, Western nutritionists suggest B vitamins but they don’t work unless you can absorb them. So take them with food, regularly.

Other nutrients that often deplete from stress include zinc, but really, ongoing shortage of any vitamin or nutrient makes you less resilient and more likely to get ill and stressed.

Eating regularly a good diet, avoiding food when working or driving, (really, these are just good eating habits), reduce stress and tiredness together. And don’t forget exercise, often the best antidote to stress and qi stagnation!

Tiredness and Weakness

Tiredness as distinct from weakness means a lack of energy and often sleepiness. Most of this page deals with tiredness.

Weakness is different. You might have slept badly but still be able to lift the shopping.

Weakness relates to muscular fragility. You can have weakness even when not tired.

• Overall, your muscles are ‘ruled’ in Chinese medicine by your Spleen. It feeds and nourishes your muscles with Blood. However, there are other considerations.
• Stomach qi deficiency reduces your interest in food and ability to digest it, so reducing your Qi and Blood. Stomach qi is said in Chinese medicine to carry the essence of food to all the limbs, so if it’s weak, so are they.
• Qi and Blood deficiency come from a whole range of different reasons:
• Qi deficiency can arise from mental factors, such as a lack of inspiration or leadership, sadness, grieving, depression, worry and so on.
• Qi deficiency also occurs with Qi stagnation. This usually comes with depression of spirits and feeling unable to get on in life. However, usually exercise dissipates Qi stagnation, releasing Qi. So if Qi stagnation is the cause, a short fast walk that gets you out of breath might reduce the weakness.
• Blood is the basis of personality and health. Read Blood. Also read Blood-building foods. Blood deficiency impairs muscular strength, giving weakness.
• Physical over-strain (it can come from mental over-strain or overwork, but it’s rare) impairs Kidney Yang which in turn can lead to weakness.

[Example of physical over-strain.

When 13 years old, I was extremely thin (still am) but both the tallest boy in my senior school of 800 boys, and – for a term – the youngest. At home in the holidays I worked on our farm. We used to carry railway sleepers to weigh down plastic sheeting over our silage pit. I could do it for a morning, but for several days afterwards I could hardly get out of bed, whereas the other, mature, farm-workers, continued to finish the silage pit and then get on with other jobs.]

• If weakness comes from a sense of heaviness of the limbs, the cause is probably Damp. Damp is too big a subject to describe quickly, so you’ll have to read the page linked!
• If your muscles ache so much that they feel weak, the cause is also Damp. See above.
• When muscles tingle leading to weakness, the cause is usually Blood deficiency, specifically Liver Blood deficiency. Of course, intense tingling or pain suggests nerve damage. Nerve damage occurs along one or more acupuncture channels, so treating the appropriate channels the right way often reduces or cures the tingle or pain. (For example, sciatica and peripheral nerve damage.) For old people, tingling can be due to other factors, such as a combination of Wind and Phlegm ‘obstructing’ the acupuncture channels. For example, some drugs to prevent or treat cancer cause progressive damage to nerves, and this is often (from TCM point of view) a mixture of Blood deficiency (so they also get leg or foot cramps) and Phlegm obstructing the channels.
• Weakness in a particular muscle often points to the zangfu organ related to the acupuncture channel traversing the muscle.

Example of acupuncture for muscular weakness along an acupuncture channel

For example, a super-fit weight trainer had an accident to his left arm which continued to feel weak for months even after good physiotherapy. The muscle in question was on his Lung channel. One treatment of Lung 9 on that channel with one extra point on the leg –  Stomach 36, cured him. It took less than two minutes. He couldn’t believe it!

Daytime Tiredness

Usually this comes from un-refreshing sleep. If so, read the following pages:

• Insomnia… this points up how yang and yin affect your ability to sleep
• Liver Blood deficiency… Liver Blood affects your moods and often how well you relax, and your muscles relax, as you try to sleep
• Shen disturbed…An un-calm mind cannot easily sleep
• Waking too often… If you keep waking up, you’re not sleeping enough so feel tired in the day
• If you are ill and can’t sleep because of it, deal with the illness, or wait for your body to recover. Then you’ll sleep better and feel less tired in the daytime! To read more click on Wind-Cold.
• Yang excess   Read the link to see what it means!
• Yin Deficiency. Read the link to see what it means!

Fuzzy Head and Tiredness

If the fuzziness continues, consider whether it is an excess or deficient condition.

• Not enough Qi ascending to the Head, as for example after rising in the morning. If this improves with food, probably due to Stomach Qi deficiency.
• If the fuzziness continues, may be due to an excess condition called Phlegm.
• May be due to Liver Yang ascending.  The main causes of this are emotional tension, or deficiency of either or both Liver Yin or Liver Blood.
• If with backache, weakness and tinnitus (just a few examples) could be from Kidney Yang deficiency.

Joint Pain and Tiredness – Aching Bones and Tiredness

Tiredness from joint pain is different from tiredness with joint pain. The former tiredness disappears when the joint pain goes so it is the pain that produces the apparent tiredness.

Tiredness with joint pain suggests the tiredness precedes the pain or would be present even without the pain. There are many causes of joint pain. Here are several:

• Wind: Pain from Wind moves around, often from joint to joint or from one area of a joint to another. Windy conditions or ‘windy’ people make it worse.

[Describe ‘windy’ people – you demand. 

Windy people rush around lots, make a noise, are usually young, often change their intentions or activities, tend to be disruptive. With the best will in the world, they cannot be entirely relied upon. But they are innovative, entrepreneurial, often hard-working and, if you can put up with them, a pleasure to be around. Small children are often ‘windy’: noisy, demanding, requiring constant attention, short attention spans etc. NB The term ‘windy’ as used here does not in any way denote ‘flatulence’ though it does not exclude it.  After all, busy young people often rely on simple dishes like baked beans for nourishment. Beans produce flatus.]

• Damp: pain from Damp usually comes with swelling and heaviness of the joint. Often worse in damp conditions or after swimming.
• Cold: Severe pain, stabbing, piercing, better with warmth and worse from cold conditions.
• Damp and Cold often ‘invade’ after heavy, unusual, prolonged or excessive exercise, with stiffness and painful muscles. It happens also during convalescence from a long illness, or as an accompaniment to general debility. It improves a bit after a good sleep, but then feels very stiff, temporarily better in a warm shower or bath, and better as long as you keep moving. However, it worsens when you remain still for a while. It needs lots of treatment with acupuncture and moxa … and/or herbs.

[This is where any remaining Western-thinking scientists disappear from our readership in what seems like a puff of magic …

I usually recommend a homoeopathic remedy for this, taken cautiously, because too much or too often makes it worse again! – Rhus Toxicendron 6c, up to three times daily, taken on its own and sucked like a sweet. If there is no improvement after a day, either the remedy or its potency are wrong for you, or perhaps you’re doing something to antidote it. If so consider acupuncture, moxa and herbs. Or get advice from a homeopath.]

• Heat: inflammation – heat, redness – of the joint.
• Dull aching joints which are better after rest, and worse when tired. Probably a mixture of Qi and Blood deficiency.
• Qi Stagnation: this comes with resistance to taking exercise, in fact to doing anything, although exercise usually helps it. This kind of joint pain often happens when you are emotional or upset about something, possibly beyond your control.
• Stasis of Blood: rather like pain from Cold, this pain can be strong. Somewhat better from motion, especially if it arose after Qi Stagnation, it gets worse when you are still for ages, as at night. Usually feels worse for pressure.