Fatigue is a multifaceted and often misunderstood symptom that affects individuals across various conditions and contexts. It is broadly defined as a disabling symptom characterized by a reduction in physical and cognitive function due to interactions between performance fatigability and perceived fatigability, and it can only be measured through self-reporting. In clinical practice, fatigue is commonly described as an overwhelming sense of tiredness and exhaustion that significantly impacts daily activities and quality of life, particularly in patients with chronic illnesses such as heart and lung diseases, diabetes, and neurological disorders. Despite its prevalence, there is considerable confusion and inconsistency in defining fatigue, with various definitions focusing on different aspects such as experiential, physiological, and performance dimensions. This lack of a standardized definition complicates the assessment and management of fatigue, highlighting the need for a unified framework that can facilitate better understanding and treatment across different fields of research and clinical practice.

Types of Fatigue

Fatigue can manifest in various ways depending on the underlying causes and the systems it affects. It’s not just about feeling tired – fatigue can impact physical, mental, and emotional well-being, each with its own distinct characteristics. Understanding the different types of fatigue can help identify the root cause and develop targeted approaches for management. Here’s a breakdown of the most common forms of fatigue:

• Transient fatigue
• Cumulative fatigue
• Circadian fatigue
• Physiologic fatigue
• Secondary fatigue
• Chronic fatigue
• Social fatigue
• Emotional fatigue
• Physical fatigue
• Pain fatigue
• Mental fatigue
• Chronic illness fatigue

Common Causes of fatigue

Whether it’s a result of lifestyle choices, underlying medical conditions, or emotional stress, fatigue can significantly impact daily life. Identifying the common causes of fatigue is essential for finding effective ways to manage and overcome it. Here’s a look at some of the most frequent contributors to fatigue:

• Poor sleep habits or lack of sleep
• Unhealthy diet
• Lack of regular exercise
• Stress and emotional exhaustion
• Hormonal changes (e.g. pregnancy, menopause)
• Medical conditions like anemia, diabetes, thyroid disorders
• Infections (e.g. flu, COVID-19)
• Medications and medical treatments
• Chronic pain
• Being overweight or underweight
• Mental health issues like depression and anxiety
• Alcohol or drug use
• Dehydration
• Vitamin deficiencies
• Heart and lung conditions
• Autoimmune disorders
• Cancer and cancer treatments
• Sleep disorders like sleep apnea or insomnia
• Chronic fatigue syndrome
• Burnout

Best herbs for Fatigue

Using herbs to care for fatigue instead of medication offers several advantages, particularly in the context of chronic fatigue syndrome (CFS) and idiopathic chronic fatigue. Herbal remedies, such as those used in traditional Chinese medicine (TCM) and Ayurveda, have shown potential in managing fatigue symptoms with fewer side effects compared to conventional medications. For instance, herbs like Panax ginseng, Rhodiola rosea, and Astragalus membranaceus have been reported to improve energy levels, physical and emotional health, and overall well-being. Additionally, a systematic review and meta-analysis indicated that herbal medicines could significantly reduce fatigue symptoms, although the quality of evidence was low, suggesting the need for more rigorous studies. Furthermore, herbal treatments are often preferred due to their holistic approach, addressing not just the symptoms but also the underlying imbalances in the body, which is a core principle in traditional medicinal systems. This integrative approach, combined with the lower risk of adverse effects, makes herbal remedies a compelling alternative to conventional medications for managing fatigue.

1. Panax ginseng

Panax ginseng shows promise as a potential treatment for fatigue, particularly in individuals with chronic illnesses. Studies have demonstrated that ginseng supplementation can lead to significant reductions in fatigue symptoms, with improvements observed in both general and mental fatigue. The anti-fatigue effects of ginseng are thought to be related to its ability to lower oxidative stress, increase energy production in cells, and enhance mitochondrial function. In a systematic review, approximately 70% of participants across multiple studies showed significant improvements in fatigue scores after taking ginseng. Both American (Panax quinquefolius) and Asian (Panax ginseng) varieties have demonstrated efficacy, with dosages typically ranging from 500 to 2000 mg daily.

What Research Says?

• Based on research carried out by The Journal of Alternative and Complementary Medicine and Frontiers in Pharmacology Panax ginseng shows promise as a treatment for fatigue, with both American and Asian ginseng demonstrating potential benefits in people with chronic illness.
• As per studies undertaken by Foods and Nutrients The anti-fatigue effects of Panax ginseng are attributed to its ability to enhance energy metabolism, antioxidant activity, and anti-inflammatory properties.
• According to studies performed by Food & Function and Journal of Ethnopharmacology, Ginseng oligopeptides and polysaccharides improve mitochondrial function and reduce oxidative stress, contributing to reduced fatigue.
• Research undertaken by Pharmaceutical Biology and Molecules reveals ginseng supplementation improves physical performance, increases muscle mass, and enhances energy utilization, as evidenced by longer swimming times and increased grip strength in animal models.

How to Use

To use Panax ginseng for fatigue, take a standardized extract of 200-400 mg daily, divided into two doses. For optimal results, use it consistently for at least 4 weeks, as benefits may take time to manifest. Some studies suggest higher doses of up to 2 grams per day may be more effective for chronic fatigue. It’s best to take ginseng in the morning or early afternoon to avoid potential sleep disturbances. Always consult with a healthcare provider before starting any new supplement regimen, especially if you have existing health conditions or take medications.

Potential side effects of Panax ginseng

Panax ginseng can cause side effects such as insomnia, headaches, nervousness, and rapid heartbeat, especially when taken in high doses. Some users may experience digestive issues like diarrhea or stomach discomfort. Rare but more serious side effects include allergic reactions, liver damage, and severe skin rashes. It’s important to start with a low dose and monitor for any adverse reactions.

Who should avoid Panax ginseng

Pregnant or breastfeeding women should avoid Panax ginseng due to potential risks to fetal development and lack of safety data. Individuals with hormone-sensitive conditions, autoimmune diseases, or bleeding disorders should consult a healthcare provider before use. People with high blood pressure, heart conditions, or diabetes should exercise caution. Those with bipolar disorder or schizophrenia should avoid ginseng as it may exacerbate symptoms.

Interaction with medications

Panax ginseng can interact with various medications, including blood thinners like warfarin, increasing bleeding risk. It may affect blood sugar levels, potentially interfering with diabetes medications. Ginseng can interact with some antidepressants, particularly MAOIs, and may enhance the effects of stimulant medications. It’s crucial to consult a healthcare provider before combining ginseng with any prescription medications, especially those for heart conditions or mental health.

2. American ginseng

American ginseng (Panax quinquefolius) has shown promising results in alleviating fatigue, particularly in individuals with chronic conditions and cancer-related fatigue. Studies have demonstrated that daily doses of 1000-2000 mg of American ginseng can significantly improve fatigue symptoms compared to placebo. In a large randomized controlled trial involving cancer patients, 2000 mg of American ginseng taken daily for 8 weeks led to statistically significant improvements in fatigue scores. The herb appears to be well-tolerated, with minimal side effects or drug interactions reported. American ginseng’s anti-fatigue effects may be attributed to its ability to reduce oxidative stress, enhance energy production in cells, and improve mitochondrial function. 

What Research Says?

• Findings from research done by The Journal of Alternative and Complementary Medicine and Medicine, show American ginseng shows promise as a treatment for fatigue, with modest evidence supporting its efficacy and a low risk of adverse events.
• As research performed by JNCI: Journal of the National Cancer Institute and Supportive Care in Cancer suggests multiple studies indicate that American ginseng significantly reduces cancer-related fatigue (CRF) when taken at a dosage of 2000 mg daily over an 8-week period. 
• Research completed by JADPRO indicates no significant toxicities were associated with American ginseng treatment in these studies.
• According to investigations conducted by Food & Function, the anti-fatigue effects of American ginseng may be attributed to its ability to inhibit oxidative stress and improve mitochondrial function in skeletal muscles
• Research efforts by Summer Wildflowers of the Northeast show that American ginseng contains ginsenosides, which are believed to enhance the immune system and reduce fatigue.
• As demonstrated by research from Journal of Clinical Oncology, The treatment duration in most studies was 8 weeks, with improvements in fatigue symptoms observed over this period.

How to Use

To use American ginseng for fatigue, take 1000-2000 mg of standardized extract daily, divided into two doses. Consistency is key, so maintain this regimen for at least 8 weeks to experience optimal benefits. It’s best to take ginseng in the morning or early afternoon to avoid potential sleep disturbances. Start with a lower dose and gradually increase if needed. As with any supplement, consult a healthcare provider before starting, especially if you have existing health conditions or are taking medications.

Potential side effects of American ginseng

While generally well-tolerated, American ginseng can cause side effects in some individuals. These may include headaches, insomnia, nervousness, and gastrointestinal issues such as diarrhea or upset stomach. Less commonly, some users might experience dizziness, euphoria, or changes in blood pressure. As with any supplement, it’s important to start with a lower dose and monitor for any adverse reactions.

Who should avoid American ginseng

Pregnant or breastfeeding women should avoid American ginseng due to insufficient safety data. Individuals with hormone-sensitive conditions, such as certain cancers or endometriosis, should consult a healthcare provider before use. People with diabetes should monitor their blood sugar levels closely when taking ginseng. Those with autoimmune diseases, bleeding disorders, or scheduled for surgery should also exercise caution or avoid use.

Interaction with medications

American ginseng can interact with various medications. It may enhance the effects of blood thinners like warfarin, increasing bleeding risk. Ginseng can affect blood sugar levels, potentially interfering with diabetes medications. It may also interact with some antidepressants and stimulants. Individuals taking medications for heart conditions, blood pressure, or mental health should consult their healthcare provider before using American ginseng to avoid potential interactions.

3. Cordyceps militaris

Cordyceps militaris has shown promising potential in alleviating fatigue and improving exercise performance. Studies have demonstrated that C. militaris can significantly delay fatigue symptoms in animal models, as evidenced by increased endurance in rotating rod tests, forced swimming tests, and forced running tests. The anti-fatigue effects of C. militaris are believed to be related to its ability to increase ATP levels, enhance antioxidative enzyme activity, and reduce lactic acid and reactive oxygen species levels. Furthermore, C. militaris has been found to activate the AMPK and AKT/mTOR pathways, which play crucial roles in energy metabolism and muscle function. In human studies, C. militaris supplementation has been associated with improved VO2 max and exercise performance, particularly when combined with other mushroom extracts.

What Research Says?

• Research initiated by Journal of the International Society of Sports Nutrition and International Journal of Medicinal Mushrooms suggests Cordyceps militaris (C. militaris) has been shown to significantly prolong swimming endurance time in mice and reduce fatigue-related biochemical markers such as blood lactic acid (BLA), creatine kinase (CK), blood urea nitrogen (BUN), and malondialdehyde (MDA).
• According to the research carried out by Evidence-Based Complementary and Alternative Medicine, Treatments with C. militaris increased levels of glycogen, lactate dehydrogenase (LDH), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px), which are indicators of improved physical performance and reduced oxidative stress.
• Studies conducted by Antioxidants and Mycobiology indicate the fruiting bodies and mycelium of C. militaris contain bioactive compounds such as cordycepin, polysaccharides, and ergothioneine, which contribute to its anti-fatigue and antioxidant properties.
• Research executed by Foods reveals the presence of these compounds in C. militaris supplements makes them ideal for enhancing physical performance and reducing fatigue.
• As shown by research done by Mycobiology, C.militaris enhances ATP production and activates key metabolic pathways such as 5′-AMP-activated protein kinase (AMPK) and protein kinase B (AKT)/mammalian target of rapamycin (mTOR), which are crucial for energy metabolism and fatigue recovery.
• Research organized by Integrative Cancer Therapies suggests Its use in combination with other treatments, such as sorafenib for cancer-related fatigue, has shown promising results in improving hepatic function and alleviating fatigue.

How to Use

To use Cordyceps militaris for fatigue, a typical dosage ranges from 3 to 6 grams daily, taken orally. Some studies suggest a moderate dose of 2 grams (2000mg) of full-spectrum mushroom powder for daily use. For improved exercise performance, a regimen of 1.3 grams taken three times daily for a week has shown benefits. It’s important to start with a lower dose and gradually increase as needed. As with any supplement, consult a healthcare provider before beginning use, especially if you have existing health conditions or are taking medications.

Potential side effects of Cordyceps militaris

While generally considered safe, Cordyceps militaris may cause side effects in some individuals. These can include gastrointestinal discomfort, such as nausea, diarrhea, and dry mouth. Some users might experience dizziness, weakness, or ringing in the ears. In rare cases, it may cause liver problems. As with any supplement, it’s important to start with a lower dose and monitor for any adverse reactions.

Who should avoid Cordyceps militaris

Pregnant or breastfeeding women should avoid Cordyceps militaris due to insufficient safety data. Individuals with autoimmune diseases, bleeding disorders, or cancer should consult a healthcare provider before use. People with type 2 diabetes should exercise caution as Cordyceps may affect blood sugar levels. Those scheduled for surgery should stop taking Cordyceps at least two weeks prior to the procedure to reduce bleeding risk.

Interaction with medications

Cordyceps militaris may interact with various medications. It can enhance the effects of blood thinners, increasing bleeding risk. Cordyceps may interfere with immunosuppressant drugs, potentially reducing their effectiveness. It might also interact with medications that affect blood sugar levels. Individuals taking testosterone should use Cordyceps cautiously. Always consult a healthcare provider before combining Cordyceps with any prescription medications.

4. Rhodiola rosea

Rhodiola rosea has shown promising results in alleviating fatigue and improving overall energy levels. Studies have demonstrated that Rhodiola supplementation can significantly decrease experienced levels of fatigue, particularly under stressful conditions. The herb appears to be effective in reducing both physical and mental fatigue, with improvements observed in concentration and overall performance. In a study involving subjects with prolonged or chronic fatigue, Rhodiola rosea extract provided relief from fatigue symptoms. The adaptogenic properties of Rhodiola are believed to contribute to its anti-fatigue effects, helping the body better cope with stress and maintain energy levels.

What Research Says?

• Findings from studies performed by Preventive Nutrition and Food Science  indicate Rhodiola rosea extract (RRE) has been shown to significantly improve mental performance and reduce general fatigue in healthy individuals under stress, such as night duty physicians and nursing students.
• Research performed by Phytomedicine and Phytomedicine shows Clinical trials have demonstrated that RRE can enhance cognitive functions, including associative thinking, short-term memory, and concentration, particularly in stressful situations.
• According to the findings from research conducted by Phytotherapy Research, Rhodiola rosea exhibits adaptogenic properties, helping the body resist physical, chemical, and biological stressors. This adaptogenic effect includes anti-fatigue, neuroprotective, and cardioprotective activities.
• Studies executed by International Journal of Molecular Sciences indicate the plant’s phenolic compounds, such as rosavin and salidroside, are responsible for its anti-fatigue and cognitive-enhancing effects.
• Research work done by PLoS One suggests some studies have shown that Rhodiola rosea can worsen fatigue in certain populations, such as nursing students on shift work, indicating that its efficacy may vary depending on the context and population.
• As evidenced by research led by Molecules, Despite some negative findings, the majority of studies support the beneficial effects of Rhodiola rosea in reducing fatigue and improving mental performance under stress.

How to Use

To use Rhodiola rosea for fatigue, take 200-400 mg of a standardized extract (containing 3% rosavins and 1% salidroside) once or twice daily. For optimal results, take it on an empty stomach, preferably in the morning or early afternoon to avoid potential sleep disturbances. Start with a lower dose and gradually increase if needed. Consistency is key, so maintain the regimen for at least 4-8 weeks to experience full benefits. As with any supplement, consult a healthcare provider before starting, especially if you have existing health conditions or are taking medications.

Potential side effects of Rhodiola rosea

While generally well-tolerated, Rhodiola rosea can cause side effects in some individuals. These may include dizziness, dry mouth, headache, and mild jitteriness or anxiety, especially at higher doses. Some users report sleep disturbances if taken too close to bedtime. Gastrointestinal issues such as nausea or upset stomach can also occur. Most side effects are mild and tend to resolve with continued use or dose adjustment.

Who should avoid Rhodiola rosea

Pregnant or breastfeeding women should avoid Rhodiola rosea due to insufficient safety data. Individuals with bipolar disorder should not use it as it may potentially trigger manic episodes. Those with autoimmune conditions should consult a healthcare provider before use, as Rhodiola may stimulate the immune system. People with low blood pressure or diabetes should exercise caution, as Rhodiola can affect blood pressure and blood sugar levels.

Interaction with medications

Rhodiola rosea may interact with several medications. It can enhance the effects of antidepressants, particularly MAOIs, potentially leading to serotonin syndrome. It may interfere with blood thinners, increasing bleeding risk. Rhodiola can affect blood sugar levels, potentially interacting with diabetes medications. It may also interact with medications metabolized by the liver’s cytochrome P450 system. Always consult a healthcare provider before combining Rhodiola with any prescription medications.

5. Astragalus

Astragalus has shown promising potential in alleviating fatigue and improving energy levels. Studies have demonstrated that Astragalus supplementation can significantly reduce fatigue symptoms, particularly in individuals with chronic conditions and those experiencing stress-induced fatigue. The anti-fatigue effects of Astragalus are believed to be related to its ability to enhance energy production in cells, improve mitochondrial function, and reduce oxidative stress. In a clinical trial involving nurses with post-COVID-19 chronic fatigue syndrome, Astragalus root extract significantly decreased the prevalence of chronic fatigue compared to a placebo group. Additionally, animal studies have shown that Astragalus can improve exercise performance, extend swimming time, and reduce the accumulation of fatigue-related metabolites like blood lactate and ammonia.

What Research Says?

• Research undertaken by Journal of Ethnopharmacology and Metabolic Brain Disease shows AM significantly improves fatigue severity, cognitive functioning, social functioning, and overall quality of life in patients with post-stroke fatigue.
• According to studies led by Molecules, AM supplementation increases endurance exercise capacity, reduces exercise-induced accumulation of blood lactate and ammonia, and increases hepatic and muscle glycogen content in trained mice.
• Research carried out by The Journal of the Science of Food and Agriculture indicates Combined extracts of Astragalus with other herbs (e.g., Codonopsis Radix and Jujubae Fructus) improve exercise performance by modulating gut microbiota and its metabolites, which helps alleviate fatigue.
• Based on research carried out by Journal of Medicinal Food, A combination of Astragalus with other natural resources (e.g., Cervus elaphus and Angelica gigas) significantly reduces muscle fatigue and enhances endurance capacity during exercise.
• As per studies undertaken by Journal of Ethnopharmacology, AM flavonoids help ameliorate chronic fatigue syndrome by balancing abnormal cytokine levels and improving immune function, which enhances endurance capacity.
• According to studies performed by Complementary Therapies in Medicine, Myelophil, an extract mix of Astragalus Radix and Salviae Radix, significantly decreases fatigue severity in patients with chronic fatigue.
• Research undertaken by Complementary Therapies in Medicine reveals Myelophil, an extract mix of Astragalus Radix and Salviae Radix, significantly decreases fatigue severity in patients with chronic fatigue.
• Findings from research done by Journal of Clinical Oncology show Astragalus Polysaccharides (PG2) significantly improve chemotherapy-induced fatigue in premenopausal breast cancer patients, helping them maintain normal daily activities and better compliance with chemotherapy.

How to Use

To use Astragalus for fatigue, take 500-1000 mg of standardized extract daily, divided into two doses. For optimal results, use consistently for at least 4-8 weeks. Some studies have used higher doses of up to 60 grams daily for specific conditions. It’s best to take Astragalus between meals, preferably in the morning or early afternoon. Start with a lower dose and gradually increase if needed. As with any supplement, consult a healthcare provider before starting, especially if you have existing health conditions or are taking medications.

Potential side effects of Astragalus

While generally considered safe, Astragalus can cause side effects in some individuals. These may include mild gastrointestinal discomfort, such as nausea, diarrhea, or bloating. Some users might experience a rash or allergic reactions, particularly those with legume allergies. In rare cases, it may cause headaches or dizziness. As with any supplement, it’s important to start with a lower dose and monitor for any adverse reactions.

Who should avoid Astragalus

Pregnant or breastfeeding women should avoid Astragalus due to insufficient safety data. Individuals with autoimmune diseases should consult a healthcare provider before use, as Astragalus may stimulate the immune system. People with diabetes should monitor their blood sugar levels closely when taking Astragalus. Those scheduled for surgery should stop taking it at least two weeks prior to the procedure, as it may affect blood sugar control.

Interaction with medications

Astragalus may interact with various medications. It can enhance the effects of immunosuppressant drugs, potentially reducing their effectiveness. Astragalus may interfere with medications that affect blood sugar levels, including diabetes medications. It might also interact with blood thinners, increasing the risk of bleeding. Individuals taking lithium should use Astragalus cautiously, as it may affect how the body processes this medication. Always consult a healthcare provider before combining Astragalus with any prescription medications.

FAQs

1. Can I take multiple fatigue-reducing herbs at the same time?

It’s possible to combine herbs like Panax ginseng, Rhodiola rosea, and Astragalus, but it’s important to consult with a healthcare provider before doing so. Some combinations may increase the risk of side effects or interact with medications.

2. How long does it take to feel the effects of fatigue-reducing herbs?

Herbs like ginseng and Rhodiola may take several weeks to show noticeable improvements in energy and fatigue levels. Consistent use for 4-8 weeks is typically recommended for optimal results.

3. Can herbs for fatigue be used in conjunction with prescription medications?

Many herbs may interact with prescription medications, such as blood thinners, antidepressants, and diabetes medications. Always consult a healthcare provider before using herbs with any prescription drugs.

4. Are there any dietary or lifestyle changes that can enhance the effects of these herbs?

Yes, combining herbs with lifestyle changes like a balanced diet, regular physical activity, proper hydration, and adequate sleep can enhance their effectiveness in managing fatigue.

5. Can these herbs help with specific types of fatigue, such as mental or emotional fatigue?

Herbs like Rhodiola rosea are particularly effective for mental and emotional fatigue, helping to reduce stress and improve cognitive function, while Panax ginseng and Astragalus are more suited for physical and chronic fatigue.

6. Can children or the elderly take herbs for fatigue?

Herbs for fatigue may not be suitable for children or elderly individuals without proper medical supervision, as the effects can vary based on age, health conditions, and potential interactions with other medications.

7. Are there any long-term risks associated with using herbs for fatigue?

While many herbs are considered safe for short-term use, the long-term effects are less understood. It’s important to regularly review the use of any herbal supplement with a healthcare provider to monitor for potential side effects or interactions.

8. What are the signs that herbal remedies are not working or may be causing harm?

If fatigue worsens, new symptoms develop, or there are signs of allergic reactions (rash, swelling, or breathing difficulties), discontinue use immediately and consult a healthcare provider.

9. Can herbs like ginseng or Astragalus help with fatigue related to chronic illnesses such as diabetes or heart disease?

Yes, studies suggest that Panax ginseng and Astragalus may be beneficial for fatigue in people with chronic illnesses. However, they should be used with caution and under medical supervision in such cases.

10. Are there specific times of day to take herbs for maximum effectiveness?

It’s generally recommended to take fatigue-reducing herbs in the morning or early afternoon to avoid potential sleep disturbances. Always follow the dosage instructions for the best results.

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