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    general medicine

    Chronic fatigue (adjunctive care)

    Also known as: chronic fatigue, chronic fatigue syndrome, ME/CFS, myalgic encephalomyelitis, persistent fatigue, post-viral fatigue

    Persistent fatigue requires medical work-up to exclude anaemia, thyroid disease, diabetes, sleep apnoea, depression and other causes. ME/CFS is a specific diagnosis with post-exertional malaise as its hallmark. Chinese medicine supports energy, sleep and symptom management alongside medical care — pacing is central and graded exercise must be handled carefully.

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    Lifestyle & Diet

    • •Pace activity — stay within the energy envelope and avoid boom-bust cycles.
    • •Keep a regular sleep-wake schedule; limit daytime naps to 20–30 minutes.
    • •Eat regular, easily digested meals.
    • •Gentle movement only as tolerated; stop if symptoms worsen afterwards.

    Cautions & Contraindications

    See sources
    • •Do not attribute persistent fatigue to deficiency patterns without medical exclusion of anaemia, thyroid, diabetes, coeliac, sleep apnoea and mood disorders.[,]
    • •In confirmed ME/CFS, graded exercise therapy is no longer recommended by NICE — do not push exertion-based programs.[]
    • •Strong tonifying or moving treatments can worsen post-exertional malaise — start gently and review.[]

    When to reassess or seek care again

    See sources

    Track energy (0–10), sleep quality, post-exertional symptoms and activity tolerance every 3–4 weeks. Any crash after treatment means reducing intensity. Confirm medical investigations are complete or in progress.

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    Sources & Further Reading

    Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.

    1. Chronic fatigue syndrome — Healthdirect
      Healthdirect Australia · 2024
    2. Fatigue — a diagnostic approach
      Australian Family Physician (RACGP) · 2022
    3. ME/CFS — NICE guideline NG206
      NICE · 2021
    4. Emerge Australia — ME/CFS information and support
      Emerge Australia · 2024
    5. Chinese medicine practitioner safety standards
      AHPRA / Chinese Medicine Board of Australia · 2024

    Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.