Fatigue and Chronic Fatigue 
Fatigue is physical and mental stress. However, it is not always due to overwork. In fact, sometimes people feel tired because they’re not doing enough, not working hard enough. For such people, fatigue can be due to boredom or lack of motivation.
In such cases, I’ve had to ask patients to walk or to do some physical work in order to get rid of fatigue and increase their energy level. So the first thing to determine is whether the tiredness is due to too much physical work or too much idleness!
Fatigue may be due to low gastric fire, weakness of the liver, low adrenal energy, or anemia. It may be caused by Epstein-Barr virus, a form of chronic fatigue syndrome related to high stagnant pitta in the liver. People having a history of infectious mononucleosis can feel very tired.
Here are some treatment recommendations for fatigue of various causes:
FOR FATIGUE AFTER EXERCISE OR HARD PHYSICAL WORK. Drink a cup of fresh orange juice with a pinch of rock salt. Adding 10 drops of fresh lime juice will help pacify pitta.
- Drinking 1 cup of ginseng or ashwagandha tea once or twice a day will help.
FOR ANEMIA. If the fatigue is due to anemia, treat the anemia with blood builders such as pomegranate juice, grapes and/or grape juice, beets or beet/carrot juice, or the herbs abrak bhasma and loha bhasma. (See “Anemia” for many more recommendations.)
FOR EPSTEIN-BARR VIRUS. If the fatigue is due to Epstein-Barr virus, treat it as a pitta disorder.
- Follow the pitta-pacifying diet (see chapter 8). • Use the following herbal formula:
shatavari 5 parts
bala 4 parts
vidari 3 parts
kama dudha ¼ part
Take ½ teaspoon of this mixture 2 or 3 times a day with 1 teaspoon of shatavari ghee. This will strengthen the liver and help to remedy chronic fatigue syndrome (see the shatavari ghee recipe in appendix 2).
TO STRENGTHEN GASTRIC FIRE
When your agni (gastric fire) is low and your digestion slow, nourishment from the food you eat will be poorly absorbed and assimilated. If the nourishment you derive from eating is insufficient, naturally your energy will be low.
- One of the best ways to kindle agni is to use some ginger. Before each meal, chop or grate a little fresh ginger, add a few drops of lime juice and a pinch of salt, and chew it up. Or just cut a thin slice of fresh ginger, put on a pinch of salt, and chew that.
- Avoid cold and iced drinks, especially during or after meals. They counteract agni and impede effective digestion. Take small sips of warm water during the meal.
- Taking chitrak-adivati, one 200-mg. tablet twice a day, after lunch and dinner, will help kindle the fire and the fatigue will go.
TIME TO SEE THE DOCTOR
Unusual exertion, stress, lack of sleep, and a number of other factors can make you understandably tired. But if you use the Ayurvedic remedies recommended for fatigue for a few weeks and you still have unexplainable feelings of exhaustion or continue to feel unusually listless, lethargic, and drained of energy, your tiredness may be due to a more serious illness. Fatigue is a symptom of many illnesses, including anemia, lung disease, diabetes, hepatitis, mononucleosis, thyroid disease, and cancer. You may also have developed chronic fatigue syndrome. So please be wise and consult a physician.
- You will find many additional tips for strengthening the digestive fire in “Indigestion.”
YOGA POSTURES AND PRANAYAMA. Alternate Nostril Breathing and some gentle yoga stretching can be beneficial to kindle the gastric fire. See appendix 4 and chapter 6 for help with yoga postures and pranayama. In general, unless fatigue is due to idleness, Ayurveda does not recommend much exercise for cases of fatigue. Exercise will burn ojas and may increase rather than decrease the feelings of fatigue.
TO BUILD STRENGTH AND ENERGY
Use the following food remedies for added nourishment and strength.
DATES. Soak 10 fresh dates in a quart jar of ghee. Add 1 teaspoon ginger, ⅛ teaspoon cardamom, and a pinch of saffron. Cover and keep in a warm place for at least 2 weeks. Then eat 1 date daily, in the early morning. Believe it or not, it tastes delicious, and it works to remedy anemia, sexual debility, and chronic fatigue.
A simpler tonic using dates is this date drink: Soak 5 fresh dates in a glass of water overnight. Next morning, liquefy in a blender and drink. It will give you energy and vitality. (Be sure to remove the pits before blending!)
MANGOES. Eating one ripe mango daily, and an hour or so later drinking 1 cup of warm milk with 1 teaspoon ghee added, is also good for increasing vitality.
A variation is to drink 1 cup of fresh mango juice, followed an hour or so later by ½ cup of warm milk with a pinch of cardamom, a pinch of nutmeg, and 1 teaspoon of ghee.