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.

Read Part 1 Now!

© 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.


  • JULIA Cleave says:

    Hi I am an acupuncturist treating a client with AFS – what nutritional/dietary recommendations do you have?

  • Nicola Terry says:

    Hello Dr Lam,
    I assess myself to be in stage 3 of AFS and have taken your advice and stopped adaptogenic herbal supplements such as schisandra and ginseng etc and am now following your adrenal yoga programme which seems to be helpful too. I was wondering if you could advise about the use of steam/sauna facilities at this stage of AFS and whether hot and cold treatments such as these would cause further pressure on my adrenal system? Many thanks for your time.

  • Vera says:

    Hi Dr.Lam,
    I m turning 33yo, mother of 2. I just have my 6th session of my acupuncture treatments. At the begining i decided to go for acunpunture because of my backpain problem and extreme fatigue after work. But acupuncturist found out that my degeneration (of my neckbone) was led by my unbalance hormon and asked me to come back to the clinic for once or twice a weak. My 2nd and my 4th treatment were make me weaker and i rested for a day. My 6th tratment is the worst. Today is my 2nd day of my 6th treatment, I have been suffering for serious tiredness and lightness on my head, feel a tickling on my chest, my legs and arms become weak. I called the clinic and the given me chinese herb medicine, Tongren Wuji Baifen Wan. The acupuncturist said my condition is normal, because my body is adjusting with the situation. How Do u think bout this? Shoul i continue and is this condition normal? What dr. Can advice me to recover from the acupuncture’s effect? And what should i take for the next step of my backpain problem if i stop my acupuncture? Fyi. My MRI showed mild degeneration on my neck. Thanks in advance

    • Dr.Lam says:

      Acupuncture is a useful modality for the right setting provided it is done properly. There are multiple variable involved, including the technique, intensity, position, sensitivity, and in the case of AFS, the body’s state of reserve. When you are not doing well over time and getting worse, you should be on alert. I do not know enough of your body to comment specifically, but when in doubt, taking a break may be considered. While it is normal for some people to go thru a detox reaction and temporary feel worse during acupuncture, this may not be so simple in those with AFS, and may point to underlying liver congestion. Click Liver Congestion & Adrenal Fatigue Syndrome for more information.

      Dr Lam

  • Larissa Stewart, L. Ac. says:

    Hi Dr Lam,
    I am an acupuncturist and I have experienced patients crashing. It’s nice to see the phenomenon so clearly articulated. I have found that simplifying my treatments and only using one or max two points with my more fragile clients seems to help. Is your protocol for when and how to treat AFS with acupuncture and herbs available for practitioners?

    • Dr.Lam says:

      unfortunately we do not have any set protocol because when a person is weak, there are too many variables to consider and each person is therefore given a individualized plan that changes frequently along the way as the body changes during the recovery course.

      Dr Lam.

  • Slade says:

    What are the risks of infection from acupuncture, if any?

    • Dr.Lam says:

      Risk is low if proper sanitization procedures are follow at point of entry and using sterile disposal needles.

      Dr Lam

  • susan says:

    Hi I’m an acupuncturist and of course it’s very important to fully inform patients of possible risks. Feeling lightheaded after treatment does happen for people so we recommend minimising this risk by arriving for treatment hydrated, having eaten something light, and getting up slowly after acupuncture. Adverse reactions such as feeling temporarily tired, small bruising, delayed onset muscle soreness do happen but usually very mild and resolve quickly. I’m not seeing ANY citations on your article above. A lot of claims I haven’t seen before hand been made but no justification. I thin acupuncture should be evidence informed and stay within scope of practice. Criticism should also be evidence informed. Many thanks.

    • Dr.Lam says:

      Good points. Thanks for chipping in.

      When acupuncture was first introduced to the US 40 years ago, even though it has been used successfully in Asia for thousands of years in good practice, it was universally rejected. Clinical positive outcome is considered vodoo, thrown aside in favor of “scientific studies” which there is none according to western standards at that time and still very limited today. Even today, many people do not believe acupuncture. Advancement of science is a process that take a long time. Do you have time to wait?

      Does it mean that we should not endorse acupuncture while awaiting research? who is going to decide what kind of evidence and citation is acceptable? This has been and will continue to be a problem for modern medicine to wrestle with. From my perspective as a clinician, my point is the no one should be deprived modalities that has demonstrated positive clinical outcome unless there is harm. Such is the case with acupuncture and others. Even to date, what we know about acupuncture is superficial at best. Many more years of research is necessary. Those of us in the front line dealing with the most advance cases of AFS can only report what is experienced because the body never lies. Medicine will advance slowly if at all if all we do is to follow citations. If not for the forward looking acupuncturists around the world that continue the practice and force conventional medicine to reckon with its many positive outcome, it would not be accepted in America today the degree it is. As it is, America is considered very slow indeed to adopt the many positive health benefits of acupuncture and is well behind the ball.

      Just because new discoveries are not cited does not make them irrelevant. Sufferers of advance stages of AFS is an isolated crowd that is abandoned by the world because no one understand them because they are so sensitive and they crash easily. They suffer daily. They should not be deprived of any information that advances their understand of the condition in my humble opinion. Many go to acupuncturist with benefit, but some get worse. That is normal. Like any healing art, there is no perfection, and there are plenty of exceptions. Acupuncture has its role, but it is not perfect.

      I am an avid believer in acupuncture for the right person at the right time with the right intensity. The weaker the adrenals , the greater the risk of things go wrong. That has been my experience as someone who takes care of them after failure in acupuncture. Bear in mind that I deal with the most sensitive cases where people have been to all kinds of healers, including acupuncture and conventional medicine, and fail. Many are near bedridden. They crash after acupuncture and can be bed-bound for weeks. Their experience is real. Also bear in mind that the population base I am exposed to is not what a normal acupuncture office would encounter. They are often too weak to go to acupuncture. Those that go often cannot tolerate and stop continued treatment after a few sessions as they crash. Some are due to inexperienced practitioners being too aggressive, but more often then not, their body is simply too weak. I am reporting these as alert to help sufferers and practitioners alike to be more aware.

      • danielle says:

        I love this response. I had acu four days ago and i was bedridden three years ago and have taken minerals and went gluten free among other things to get well. I am about 70% healed. I have somewhat of a life again. when i had the acu done i was veryyyy dizzy, nauseated and lightheaded. It got a little better a few hours later but now i have had bad dizzy spells and worse fatigue as the days wear on. I have read everywhere that symptoms usually subside by 48hrs. that is not in my case. I knew there was something wrong. Im so glad i ran across your article. I am so sensitive to EVERYTHING! You are doing many ppl a great service by providing REAL information and not sugar coating everything. We need to know these things. THANK YOU! I dont think i will be doing anymore acu. I dont want to undo all of the progress i have made over these three years!! Its been wayyy too much work to throw it under the bus!! Hugs!!

        • Wichaya says:

          I was wondering if your symptoms of fatigue after the acupuncture subsides at all? And if so, how long did it take? I am experiencing the same thing. I wasn’t able to sleep all night after the session yesterday although i am so tired.

      • Anonymous says:

        Thank you Dr. Lam for all your work to aid those who suffer from AFS, for providing a guide. You give me hope that if I listen to my body and give it what it needs, I may one day recover. Most doctors prefer to treat patients where there is much less unknown. I personally am extremely thankful for the work you do

  • Dean says:

    Hi, great article Dr. Lam. I have been interested in acupuncture for some time but can’t quite bring myself to go through with the whole needle thing. How effective is acupressure for adrenal fatigue?

    • Dr. Lam says:

      It has its place at the right time. More often then not, it actually can make AFS worse not because the modality is not good but because the lack of understanding how the body behaves especially in advance stages, triggering crashes as a result.

      Dr Lam.

      • Veronika Reznova says:

        Dr. Lam,

        I am national and state licensed acupuncturist who specializes in patients dealing with autoimmune diseases, chronic fatigue, fibromyalgia, and adrenal fatigue. There are different styles of acupuncture and a seasoned practitioner is aware that for a person who is struggling from severe adrenal fatigue the correct approach is few needles, plenty of moxibustion, and dietary and herbal modifications rather than a deeper needling style that is popular in China as well as with orthopedic patients. With the right needling style and a treatment that is modified to the patient, I have seen patients with absolutely no energy recover enough to begin to exercise. With the help of acupuncture, I have seen patients with severe adrenal fatigue gain full time jobs after being too weak to work, regrow lost hair, improve sleep, eliminate joint aches and pains, and improve their quality of life. To say that acupuncture is not the best modality for sufferers of severe adrenal fatigue is invalid. Yes- certain styles of acupuncture such as heavy needling are not indicated for patients with adrenal fatigue but that does no negate the fact that an appropriate style of acupuncture can indeed be life changing for an adrenal fatigue sufferer.

        Veronika Reznova, L.Ac, NCCAOM

        • Dr.Lam says:

          In general, the more advance the AFS, the higher the risk. The right practitioner should be able to adjust for it, as you mention, but those are not very common. Good for you.

          Dr Lam