Acupuncture and Herbal Treatment of Fatigue and Anxiety
Chief Complaint: Fatigue and anxiety
Medical History: 23 y.o. female in overall good health, except that she feels run down and easily fatigued. Her anxiety levels are high and she feels that she can quickly enter into an anxiety attack or “fly off the handle.” Patient maintains a rigorous exercise regimen (weight lifting and cardiovascular exercise) and a healthy diet.
Questioning exam: Patient just finished college and is now in the process of finding a job. Even though patient sleeps 7-8 hrs each night and sleeps soundly, she feels as if she still wakes up tired. Once patient exercises, she feels better, but her energy drops at 6pm. Allergies and congestion can be bothersome at times and takes Zyrtec when needed. Tends to feel cold.
Pulse exam: Right and left side pulses even. Right yang pulses significantly weaker than right yin pulses – SJ pulse is weakest. Left yang pulses significantly weaker than left yin pulses – with the GB pulse being bigger, but soft, as compared to other left yang pulses.
Yin pulses on both sides were moderate and supple.
Palpation along SJ channel on arm was tender.
Tongue exam: Tongue exam was not remarkable. Pinkish (slightly pale) tongue body.
OM Diagnosis: Overall Yang deficiency as evidenced in patient’s pulses and description of her fatigue.
It appears that as the yang time of day begins, there isn’t enough yang energy to circulate and she feels sluggish as she awakes. Exercising and movement throughout day helps facilitate yang energy movement and patient feels better, but as the yin evening approaches, her yang cannot support the transition into yin and patient notices a significant energy drop around 6pm. Further, SJ precedes GB in ying-qi flow and if SJ exhibits deficiency, the GB is not properly receiving energy.
Treatment Principle: Tonify yang.
Point Prescription: SJ-5 bilateral with gold needles (tonify).
Palpation of left and right SJ-5 with tonification yielded significant increase in strength and fullness of yang pulses on both sides, SJ & GB pulses became even in strength and volume as all other yang pulses. Strength, fullness, suppleness and even nature of yang pulses maintained during and after needling. Yin pulses decreased in strength slightly, but remained supple. (Since SJ-5 tonifies all yang and sedates all yin, this is expected in the pulses following tx.)
Herbal Formula: None at this time. If a formula was given: Shi Quan Da Bu Tang – raw formula, coarsely ground: 15g dang shen (instead of ren shen), 15g bai zhu, 15g fu ling, 6g gan cao, 9g shu di huang, 15g bai shao, 15g dang gui, 9g chuan xiong, 12g rou gui, 24g huang qi, sheng jiang and 2 pc da zao. Dosage: 1 heaping tablespoon cooked in water per dose, TID.
Lifestyle Prescription: Recommended that she place more emphasis on cardio exercise than weight lifting (patient was placing more emphasis on weight lifting) to encourage circulation of energy, blood and yang movement.
Results: After one treatment, patient reported significant increase in energy: easier to awake in the morning, less drop of energy in the evening, and better overall balance of energy. Patient also reported feeling less anxious less frequently, and if onset of anxiety attack, she felt better able (stronger) to handle and control situation.
Synopsis: When the patient came for tx, she was frustrated by her constant fatigue and the fact that Western doctors, through blood tests on thyroid and other factors, could not reveal anything wrong. After one treatment, patient saw noticeable change in energy levels and anxiety levels. Patient has received total of 3 treatments thus far (tx is every two weeks) and has been able to maintain good energy levels which have continued to increase gradually, as well as a progressive decrease in anxiety levels and attacks. Patient’s overall demeanor has improved greatly, from her initial tired presentation, to a more animated and lively manner.