The Truth About Being Tired After Acupuncture

By: Michael Lam, MD, MPH; Dorine Lam, RDN, MS, MPH

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The problem with Acupuncture

Adrenal Fatigue sufferers can be left feeling tired after acupunctureUnfortunately, acupuncture does not work for everyone all the time. For some people there is no real improvement in their health after an acupuncture session. As a matter of fact, some will be even more tired after acupuncture, forcing them to retire early in the day and go to sleep well before their usual bedtime.

For some people, after an acupuncture session, they become lightheaded when they stand up too quickly. Some will feel tired after acupuncture. Some can be compelled to eat every two to three hours to avoid symptoms of hypoglycemia. In the worst-case scenario, some will become very unproductive and unable to hold down a regular job to earn a living for themselves and their families.

Even with more administered acupuncture sessions, things do not always improve for some people while they continue to experience chronic fatigue. For these people, health issues have become worse than before they started acupuncture. Eventually things will become so bad they become bed-ridden most of the time and are not able to go to work.

If you feel drained, fatigued, and tired after acupuncture and things do not seem to improve after twenty-four hours, then be aware acupuncture may not be helpful and may even be weakening your body and worsening your condition.

Why do some people feel better with acupuncture, but others feel worse? The simple answer is that everyone’s internal body composition is different.  If one has a high level of internal reserve at the time of acupuncture treatment, one may feel a bit better. However, if one’s reserve is low, then the amount of Qi being restored by an acupuncture session may not be sufficient to re-charge the body to a sufficiently high level and as a result, the body quickly runs out of fuel again and starts to put out a full neuroendocrine alert in the form of unpleasant symptoms such as nausea, fatigue, and anxiety.  For these people, acupuncture treatment may help for a short time but eventually they fall back in to their original state of extreme tiredness.

With chronic activation of the body’s alarm response, the body will further drain itself of its remaining limited energy reserves until finally, the body signals in no uncertain terms that it will not be able to tolerate any more acupuncture treatment. Fatigue would worsen the moment acupuncture is administered.

Being Tired After Acupuncture – When Acupuncture is NOT for you

In addition to worsening fatigue, a common undesirable symptom post acupuncture session is non-specific dullness or discomfort in the adrenal area, even though there are no physical somatic nerve innervations into the adrenal glands. Western medicine has no explanation for the origin of such discomfort.

Other symptoms that are associated include leg weakness, tinnitus, light headedness on rising, dizziness, nausea, stomach cramps, constipation, night sweats (especially in the middle of the night), inability to fall asleep, sleep maintenance insomnia, joint pain, and burning sensations in the feet and palms.

In women, menstrual periods become irregular. Hot flashes can become prominent. The central nervous system may be involved, with symptoms such as anxiety and a sense of being wired and tired after acupuncture are the most common.

On physical examination by the Traditional Chinese Medicine (TCM) practitioner or acupuncturist, little to no abnormality is detectable for those in mild or early stages of Adrenal Fatigue Syndrome (AFS) as the yang forces are dominant. Skin tone is good, blood flow is strong, and pulse is regular and strong, though a bit fast at rest. Strong yang is present.

As Adrenal Fatigue Syndrome becomes severe and unresolved, worsening fatigue after acupuncture session is experienced, the tongue is seen as pale, swollen and wet; and the pulse is deep but weak, and may be irregular. This is consistent with kidney yang depletion as the body transitions in to a state of yin dominance.

In Western medicine, post acupuncture fatigue can be seen as the consequences of excessive toxin release, liver congestion, or excessive excitation of the sympathetic nervous system alarm response mentioned previously. Increased fatigue is the end result of a body down regulating its neuroendocrine system as AFS progresses. The body’s response is to slow down all the organ systems to conserve energy as it signals its rejection of acupuncture as appropriate for your body.

Can acupuncture and TCM help AFS?

Eastern medicine can help if you feel tired after acupunctureTraditional Chinese Medicine is a great tool for reaching deep into the body and effecting balance for those who are healthy or in a very mild form of AFS bought on by stress. With acupuncture, for example, opening up the meridian and re-establishing clear energy flow can reduce fatigue dramatically and lead to a sense of well-being. Unfortunately, this is often short lived, unless the underlying root stressors are removed. In other words, this approach is at best symptom patching rather than attacking the root cause.

Chinese herbs, such as schizandra berries, and Ayurvedic herbs, such as holy basil and ashwagandha, work along the same lines. A prescription is usually given concurrently for these herbs, as they tend to increase energy flow. Some possess adaptogenic properties.

In early stages of AFS, many are misled by the temporary improvement of energy from such compounds, along with acupuncture treatment, into thinking that the root problem is resolved. Unfortunately, this is not necessarily so.

Unless the underlying stressor is removed and the adrenal glands are properly and gently nurtured back to a point where they have enough nutritional reserve to facilitate the self-healing mechanism, simply enhancing energy flow is like trying to whip a tired horse into running further.

Over time, a reduction in marginal response is common. The body gets used to such therapy, and develops resistance. More acupuncture sessions and more herbs are needed to generate the same response. This is similar to developing tolerance to medications over time, requiring an ever-larger dose.

Acupuncture and TCM in Advanced Adrenal Fatigue Syndrome

As Adrenal Fatigue Syndrome progresses and advances to the more advanced stages where weakness becomes more pronounced, acupuncture and TCM seldom work, but may in fact backfire and worsen the condition. This is a time when the body is weak and internally decompensated. Further acupuncture stimulation may be too much for the body to handle, triggering numerous paradoxical reactions, feeling tired after acupuncture, and hypersensitivities to food, temperature, and supplements. Adrenal crash prevalence increases.

It is common for many who have advanced AFS to report more fatigue and crashes immediately or soon after having acupuncture or taking herbs. Not knowing why, the sufferer thinks that the acupuncture session is not strong enough because it had worked well before, when the AFS was mild. Not realizing that the body is now weaker, more sessions are demanded. The body is then subjected to more. This further weakens a body that is already low in energy reserves, and the sufferer is left feeling extremely tired after acupuncture.

The weaker the body, the more the sufferer is at risk with such kidney yang boosting techniques. In the Western world, the use of medication, sauna, sun bathing, deep tissue massage, hot yoga, hot bathes, and steam bathes can all generate a similar undesirable response often seeming to defy conventional medical logic. Their use in advanced cases of AFS should be curtailed unless under professional guidance.


Acupuncture and Traditional Chinese Medicine offer a different perspective on the approach for Adrenal Fatigue Syndrome recovery. The underlying concepts are surprisingly similar to Western allopathic medicine. TCM and acupuncture look at AFS as the lack of energy from the yang qi, regardless of the stage of AFS a sufferer is in. The solution is to boost this qi. While these have some benefits for those who have mild AFS, those who are in severe and advanced AFS usually do not fare well, and in fact could get worst relatively quickly with aggressive acupuncture or TCM treatments. Some AFS sufferer are left feeling more tired after acupuncture and sometimes an increase in AFS symptoms as well.

Western medicine focuses on symptoms control. For example, sleeping pills for insomnia, thyroid hormones for fatigue, testosterone to increase libido. When all these treatments fail, steroids and anti-depressants are prescribed, after which the sufferer is abandoned if complaints continue.

Both Western allopathic and Eastern approaches are less than ideal because they do not recognize that AFS is a continuum of neuroendocrine decompensating of a body crying for help when overloaded with stress. Different approaches are needed at different stages of the condition. A one size fits all approach by both Western and Eastern disciplines often lead to retarded recovery at best among those who are in advanced stages. Clinical recovery failure is the norm.

The best approach towards long-term successful recovery is to provide the adrenal glands with gentle non-stimulating nutrients to allow the adrenal system to self-heal. This nutritional approach is exactly what the body wants. We are constantly surprised at how fast and effective this is if you give the body only the right tools.

Adrenal Fatigue sufferers need to look at starting with mild exercise if they are tired after acupunctureFor best results, start with rebuilding the body’s internal nutritional and energy reserves with gentle nutritional and lifestyle approaches fitting for the body, customized for every stage of AFS. This will help the body reach in to its own self-healing process, and offer the most likelihood for a successful recovery with the least risk of worsening the condition.

Acupuncture as well as other TCM modalities should not be used until the body’s energy reserve is stable and the nutritional reserve is sufficiently strong. With this, any potential negative unintended side effects of acupuncture are minimized. The stronger the body, the more effective acupuncture can be. We do recommend Chinese herbs and acupuncture treatment, but only at the right time during the recovery process.

Determining when the body is strong enough to start acupuncture and TCM varies from person to person; so professional guidance is the key if one seeks to incorporate TCM into the AFS recovery plan. Any time you feel extremely tired after acupuncture or a worsening of symptoms, talk with you Primary Care Provider before proceeding.

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© Copyright 2014 Michael Lam, M.D. All Rights Reserved.

Adrenal Fatigue sufferers can be left feeling tired after acupuncture
5 - "Dr. Lam,"
Dr. Lam,

Just wanted to say thank you for taking the time today to answer all my questions and help me understand my body better. You are the only doctor that I could find that even knew what was going on with myself and I`m very grateful to have you helping me through this difficult health issue.