Rising Lotus Wellness Center {The Standard in Acupuncture} Jason Laird, L.Ac.

Information

Patient Forms

Chronic Fatigue Syndrome

Concept

No single pathogenic influence, no physical finding or lab test can be used to confirm the diagnosis.
Chronic fatigue for more than 6 months, criteria for severity are met and four or more of the following:

Symptoms are concurrently present for more than 6 months
Impaired memory and concentration
Sore Throat
Tender cervical or axillary lymph nodes
Muscle pain
Multi-joint pain
New headaches
Unrefreshing sleep
Post-exertion malaise

Cause

Unknown, post-viral infection, such as Epstein-barr virus, Herpes virus, weakened immune, weak function of hypothalamic-pituitary adrenal axis, high stress lifestyle, emotional or physical trauma, long-term antibiotic use.

Common symptoms

Extreme fatigue after minimal exertion, shortness of breath
Myalgia, migrating arthralgias, headaches
Jaw pain, earaches, tingling in limbs
Chest pain, irregular heartbeat, sleeping disorders
Disoriented, short-term memory loss, dry eyes & mouth
Blurry vision, night sweat, low sex drive
Depression, anxiety, irritable, PMS
Digestive disorders, Urinary tract problems

Western Treatment

Not much affect - Treatment is all over the board from treating the anxiety to digestive trouble, using steroids to acyclovir to anti-depressants

Etiology & Pathology

Spleen Qi Deficiency - Liver overacting on Spleen is main etiology. Spleen Qi deficiency leading to dampness obstruction
Liver Qi Stagnation
Phlegm Damp accumulation, leading to Damp Heat
Blood Stasis and Stagnation
Defensive Qi Deficiency
Liver & Heart Blood Deficiency
Heat accumulation - Liver, Heart, Lung, Stomach, Bladder
Yin Deficiency - Kidney, Liver, Heart, Stomach
Spleen & Kidney Yang Deficiency - Water retention

Differentiation & Treatment

CFS due to Spleen Qi Deficiency with Middle Jiao Sinking

Symptoms

Fatigue that is not better with sleep
Weakness in muscles, lack of mobility
Tongue body is pale and swollen with teeth marks
Pulse is weak & slippery

Treatment Principle

Tonify Spleen, Soothe Liver, Resolve Dampness and Toxins

Points for CFS due to Spleen Qi Deficiency with Middle Jiao Sinking

ST 36, SP 3, Liv 3, Li 4, P 6, Du 20, SP 9, Liv 13

Herbs for CFS due to Spleen Qi Deficiency with Middle Jiao Sinking

Bu Zhong Yi Qi Tang - Tonify middle Qi & Blood, raise Clear Yang

Most dosages are 9 - 12 gr unless specified
Chai Hu: 3 - 6 for lifting, 9 - 12 for moving Liver Qi
Use White Ren Shen - More tonifying Qi & Yin, generates fluid

Sheng Xian Tang - Tonifies Lung Qi as well as Spleen Qi and raises Yang

Modifications

Blood Deficiency: Dang Gui, Bai Shao, He Shou Wu, Ji Xue Teng (12 - 15), E Jiao, Zi He Che
Dampness: Huo Xiang, Pei Lan, Cao Guo, Cang Zhu, Shi Chang Pu, Yi Yi Ren, Qiang Huo, Ge Gen
Indigestion: Sha Ren, Mu Xiang, Zhi Qiao, Shang Zha, Shen Qu, Mai Ya
Yin Deficiency: Shu Di, Nu Zhen Zi, Han Lian Cao, Gou Qi Zi, Wu Wei Zi, Mai Dong, Wu Mei, Xi Yang She
Deficient Heat: Zhi Mu, Huang Bai, Di Gu Pi, Yin Chai Hu
Dry Mouth: Sheng Di, Mai Dong, Sha Shen, Lu Gen, Tian Hua Fen
Insomnia: He Huan Pi, Suan Zao Ren, Bai Zi Ren, Ye Jiao Teng, Yuan Zhi,

CFS due to Invasion of Exterior Pathogens with Interior Deficiency

Symptoms

Tired all the time with concurrent flu or cold
Tongue body is pale or red depending on Wind Cold or Wind Heat, could be slightly swollen if dampness is present
Pulse is floating with weakness at a deeper level

Treatment Principle

Expel exterior pathogen, slight tonification

Points for CFS due to Invasion of Exterior Pathogens with Interior Deficiency

Lu 7; Li 4; BL 12, 13; GB 20; ST 36; Li 10, 11

Herbs for CFS due to Invasion of Exterior Pathogens with Interior Deficiency

Xiao Chai Hu Tang - Boost immune system, prevent infection

Huang Qi is good to add for immune function problem

Combo Excess/Deficient formulas:

Ban Xia Xie Xin Tang
Wu Mei Wan

Modifications

Heat Toxin: (Anti-viral - Ban Lan Gen, Da Qing Ye, Anti-Bacterial - Chuan Xin Lian) Lian Qiao, Jin Yin Hua
Lower fever: Zhi Mu, Di Gu pi, Yin Chai Hu
Sore throat: Niu Bang Zi, Shan Dou Gen, Xuan Shen, Guan Zhong, Pang Da hai
Swollen lymph glands: Zhe Bei Mu, Xia Ku Cao, Ban Xia
Headache: Chuan Xiong (except Liv Yang rising type), Bai Zhi, Tian Ma, Man Jing Zi
Bodyache: Qiang Huo, Du Huo, Ge Gen
Allergy: Fang Feng, Chan Tui, Bai Zhi, Bo He, Xin Yi Hua - (Bai Zhi & Xin Yi Hua are very drying)
Fever/Heat: Shi Gao, Zhi Mu

CFS due to Liver Qi Stagnation & Spleen Qi Deficiency

Symptoms

Lack of mobility, lack of desire
Hypo-sensitive, fatigue
Tongue body is pale
Pulse is weak

Treatment Principle

Soothe Liver, Tonify Spleen

Points for CFS due to Liver Qi Stagnation & Spleen Qi Deficiency

ST 36; SP 3; Liv 3; Li 4; P 6; GB 34, 41; Liv 13

Herbs for CFS due to Liver Qi Stagnation & Spleen Qi Deficiency

Xiao Yao San
Gan Mai Da Zao Tang - Originally for menopause

Modifications

Qi Xu: Huang Qi, Ren Shen
Anti-Depression: Yu Jin, He Huan Pi, Fu Xiao Mai
Anxiety: Long Gu, Mu Li, Zhen Zhu Mu, Suan Zao Ren, He Huan Pi, Bai Zi Ren
Insomnia: He Huan Pi, Suan Zao Ren, Bai Zi Ren, Ye Jiao Teng, Yuan Zhi
Dampness: Cang Zhu, Hou Po, Ban Xia, (Yi Yi Ren, Ze Xie - Swollen Lymph), Shi Chang Pu
Ab Cramps: Yan Hu Suo, Xiang Fu, Mu Xiang, Bai Shao, Gan Cao

CFS due to Liver Qi Stagnation with Heart Deficiency

Symptoms

Hypochondriac Pain, lack of mobility
Heart/Mind restlessness, insomnia

Treatment Principle

Soothe Liver, nourish Heart

Points for CFS due to Liver Qi Stagnation with Heart Deficiency

He 7; Ren 14, 17; Liv 3; Li 4; P 6; GB 34, 41; BL 15, 18

Herbs for CFS due to Liver Qi Stagnation with Heart Deficiency

Bu Gan Yi Qi Tang

Modifications

Heat: Huang Lian, Huang Qin
Digestion: Shan Zha, Shen Qu, Mai Ya
Dampness: Fu ling, Ban Xia, Yi Yi Ren, Shi Chang Pu
Yin Deficiency: Gou Qi Zi, Nu Zhen Zi, Wu Wei Zi, He Shou Wu, Mai Dong
Deficient Heat: Zhi Mu, Huang Bai
Blood Stagnation: Chi Shao, Dan Shen, Mu Dan Pi, Ji Xue Teng, Chuan Xiong
Heat Toxin: Jin Yin Hua, Lian Qiao, Pu gong Ying, Ban Lan Gen

CFS due to Phlegm Damp Accumulation

Symptoms

Most common to see, extreme fatigue, heavy body, anxiety
Insomnia, swollen lymph, body ache
Tongue is swollen
Pulse is soft, soggy or slippery

Treatment Principle

Resolve Dampness, tonify Spleen

Points for CFS due to Phlegm & Damp Accumulation

SP 9; ST 36,40; Ren 3; ST 25; BL 20, 21, 22

Herbs for CFS due to Phlegm & Damp Accumulation

Wen Dan Tang - Phlegm/Damp in Middle Jiao, disharmony between Gallbladder & Stomach, C/C is anxiety & insomnia
Liu Jun Zi Tang - Tonify Spleen, resolve Dampness
Ping Wei San - Middle Jiao flu like symptoms, bloating, cramping, nausea, diarrhea

Modifications

Phlegm Heat: Huang Qin, Dan Nan Xing, Gua Luo, Xing Ren
Insomnia: Suan Zao Ren, Bai Zi Ren, Ye Jiao Teng, He Huan Pi
Anxiety: Long Gu, Zhen Zhu Mu, Hu Po
Restlessness: Huang Lian, Zhi Zi, Mu Dan Pi
Nausea: Zhu Ru, Sheng Jiang, Dai Zhe Shi, Zi Su Geng

CFS due to Damp Heat Accumulation in the Middle Jiao

Symptoms

One of the more common types
More often shows up in the summer

Treatment Principle

Resolve Damp Heat

Points for CFS due to Damp Heat Accumulation in the Middle Jiao

Liv 5; BL 28; SP 9; Ren 3; BL 23; Ba Liao Points

Herbs for CFS due to Damp Heat Accumulation in the Middle Jiao

San Ren Tang - Heavy, fatigue, Damp collecting in the middle, digestive congestion
Si Miao San - Body ache with fatigue and damp, whole body inflammation

Modifications

Bodyache: Fang Ji, Mu Gua, Run Dong Teng, Qin Jiao, Qiang Huo, Du Huo
Ab Fullness: Lai Fu Zi, Zhi Qiao, Mu Xiang, Sha Ren
Ab Pain: Yan Hu Suo, Bai Shao, Mu Xiang, Xiang Fu
Edema: Fu Ling, Ze Xie, Zhu Ling, Yi Yi Ren

CFS due to Blood Stagnation

Symptoms

Long time aching
Treatment of resolving Stagnation is not working

Treatment Principle

Resolve Stagnation

Points for CFS due to Blood Stagnation

SP 10; Liv 8; Liv 3; Li 4; BL 17, 22

Herbs for CFS due to Blood Stagnation

Shen Tang Zhu Yu Tang - Heavy, fatigue, Damp collecting in the middle, digestive congestion

Modifications

Blood Deficiency: Dang Gui, Bai Shao, Ji Xue Teng, E Jiao
Bodyache: Qin Jiao, Qiang Huo, Du Huo, Ge Gen, Jiang Huang, Sang Zhi, Xu Duan, Sang Ji Sheng
Hypochondriac Pain: Chuan Lian Zi, Bai Shao, Yan Hu Suo, Wu Yao
Qi Stagnation: Chai Hu, Xiang Fu, Fo Shou

CFS due to Liver & Kidney Yin Deficiency

Symptoms

More chronic, menopausal symptoms

Treatment Principle

Nourish Yin

Points for CFS due to Blood Stagnation

Kid 2, 3, 6; BL 23, 43; SP 6; Liv 8; BL 18

Herbs for CFS due to Blood Stagnation

Da Bu Yin Wan - Yin Deficiency with excessive Fire, steaming bone, dry mouth
Zhi Bai Di Huang Wan - Yin Deficiency with night sweats, frequent urine at night, odor to urine, Damp Heat in low jiao
Qi Ju Di Huang Wan - Yin Deficiency with dry eyes
Tian Wan Bu Xin Dan - Kidney & Heart Yin Deficiency, insomnia, night sweats, anxiety at night

CFS due to Spleen & Kidney Yang Deficiency

Symptoms

Long time (10 yrs), chronic, cold limbs, water retention, morning diarrhea

Treatment Principle

Tonify Spleen & Kidney Yang

Points for CFS due to Spleen & Kidney Yang Deficiency

Kid 3; BL 23; ST 36; BL 20, 23; Du 4; Ren 4, 6

Herbs for CFS due to Spleen & Kidney Yang Deficiency

Fu Zi Li Zhong Wan - Spleen Yang Deficiency, low energy, diarrhea, loose stools
Jin Gui Shen Qi Wan - Kidney Yang Deficiency, frequent urine, low back and knee weakness
Ji Sheng Shen Qi Wan - Water retention flowing towards Heart, puffy limbs, edema