Part 6 of 6 in the "always tired" series; the other five are listed at the foot.
"What will they ask me?" For a lot of people, that is the real question before they tap the booking button.
The order first: the situations in part 5 go to a doctor, and once tests are clear, this is how tiredness is handled in a TCM consultation.
The short version
- The WHO's TCM terminology standard defines inquiry (问诊) as a method to collect information about the disease occurrence, progression, previous diagnosis and treatment, and present symptoms, by talking to the patient or the person accompanying them.
- The questions run in five directions: the shape and timing of the tiredness, sleep, eating and digestion, life and work, other bodily signals.
- What helps most: specific times of day and specific changes, rather than "I'm very tired".
- Bring the report, the prescribed medication, anything over the counter, and the supplement a relative gave you — say all of it.
- Assessment comes after the consultation, not before, and what follows is a direction rather than a promise. This article does not say "what the effect will be".
First, the things that cannot wait
Weight loss you did not intend, or breathlessness, palpitations or chest tightness alongside it — see a doctor for investigation first. The NHS states each separately: it is important to get it checked if you are losing weight without trying, and sometimes the cause can be cancer; and palpitations can be caused by a condition such as iron deficiency anaemia or an overactive thyroid (hyperthyroidism).
Persistently low mood, loss of interest, or thoughts of harming yourself — call 999 now, or go to the nearest hospital emergency department. To talk to someone, the Ministry of Health's Talian HEAL 15555 is open every day from 8 am to 12 midnight, public holidays included [KKM-HEAL]; Befrienders KL is open 24 hours on 03-7627 2929 [BEF]. You can also contact your doctor.
The full list, and the reason for each, are in part 5. TCM and Western medicine complement each other; it is not a choice between them.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
I. Questions from five directions
This stage has a name in the standard: inquiry (问诊) — a method to collect information about the disease occurrence, progression, previous diagnosis and treatment, and present symptoms, by talking to the patient or the person who accompanies them. The standard files it under a section called the four diagnostic methods (四诊), alongside inspection, auscultation and olfaction, and palpation.
For someone who is very tired, the inquiry usually runs in these five directions:
- The shape and timing of the tiredness — when it started, which part of the day is worst, how much rest restores.
- Sleep — falling asleep, waking at night, hours, how you feel on waking.
- Eating and digestion — appetite, how you feel after meals, bowel habit, whether you are dieting. (Part 2 explains why the theory asks this.)
- Life and work — routine, commute, shift patterns, recent pressures and changes. Three hours a day in traffic, or long-term shifts, is itself information the consultation needs.
- Other bodily signals — weight change, menstrual picture, palpitations, breathlessness, dizziness.
💡 Remember: inquiry is a method of collecting information by talking, so the more specific you are, the more this step can do.
II. How to describe it usefully
Instead of "I'm very tired", say "mornings are alright; past two or three I can't keep going"; instead of "I don't sleep enough", say "a full seven hours and I wake as though I hadn't slept"; instead of "I've been off lately", say "it started about three months ago; it wasn't like this before".
Instead of "no appetite", say "eating less than before — a few kilos down over three months" — and that one falls under part 5: see a doctor first.
Bring the report too, and say what you are taking. The company screening's blood results, prescribed medication, over-the-counter products from a pharmacy, a supplement marketed as "qi-boosting" that a relative gave you — say all of it at the consultation. Doing this safely depends on both sides knowing.
III. Assessment, then a direction rather than a promise
Pattern identification (辨证) is defined in the standard as the process of an overall analysis of clinical data to determine the location, etiological factors and nature of a disease at a certain stage. So only after seeing the whole picture does the practitioner say whether this is the qi deficiency pattern, the blood deficiency pattern, spleen deficiency with dampness, or another pattern. That step comes after the consultation, not before it.
Then a direction, not a promise. The options a practitioner may raise include the kind of routine adjustments in part 4, acupuncture, and herbal medicine. Which suits you, and whether to use any, is decided between you and the practitioner at the consultation. This article does not say "what the effect will be", because that belongs to an individual assessment, not to an article.
If you take prescribed medication, are pregnant or trying, are breastfeeding, are under 12, are a senior, have surgery coming up, or have a chronic condition under review — say so at the start of the consultation. Never stop prescribed medication on your own. On taking Chinese herbs alongside Western medication, see: can Chinese herbs be taken with Western medicine.
💡 Remember: tests first, then routine, then assessment, and only then a direction. Reverse that order and you have the "just start TCM care and see" mistake.
IV. Keep a seven-day log before the consultation
One table is enough:
| Date | Time to bed | Time awake | How you felt on waking | Worst part of the day | Kopi / tea: how many, when | Notes (overtime, exercise, period) |
|---|---|---|---|---|---|---|
| Mon | ||||||
| Tue | ||||||
| … |
Seven days of notes beat recall — that is this article's suggestion, not a rule from any source. Add the company screening report and the medication you are taking, and the first step of the consultation is already done. See also: what to prepare before an online consultation.
The words in this part
All four come from the WHO's TCM terminology standard.
- Inquiry (问诊) — collecting information about the disease occurrence, progression, previous diagnosis and treatment, and present symptoms, by talking to the patient or the person accompanying them. That run of questions at a consultation has this name.
- The four diagnostic methods (四诊) — a section name in the standard, holding four categories: inspection, auscultation and olfaction, inquiry, and palpation. Inquiry is one of them, not all of them.
- Pattern identification (辨证) — the process of an overall analysis of clinical data to determine the location, etiological factors and nature of a disease at a certain stage. It is the process.
- Pattern (证) — a pathological summarization of the disease location, etiological factors, nature, severity and prognosis in a certain stage. It is the result of the assessment, not the thing that caused the tiredness (part 3 covers this).
Frequently asked
What should I record before the consultation? Seven days: time to bed, time awake, how you felt on waking, the worst part of the day, how many kopi and tea and when, overtime or exercise (the table above). Add the company screening report and the medication you are taking. Never stop prescribed medication on your own because you are going to see a TCM practitioner.
Will the practitioner just tell me I have qi deficiency? Not before the consultation. The definition of pattern identification is the process of an overall analysis of clinical data, so the conclusion comes at the end. The same kind of tiredness can point to different patterns in the theory, and which one applies is the practitioner's judgement after seeing the whole picture — parts 2 and 3 go into that.
The other five parts
- Part 1: First, which kind of tired; then what a blood test can tell you
- Part 2: What 「气」 and 「血」 refer to in TCM theory, and where they come from
- Part 3: 「血虚」 is not anaemia — one is a category, the other a number
- Part 4: Setting your routine: TCM theory's position beside the public-health numbers
- Part 5: When to see a doctor first — each sign, and what it can indicate
👉 If you are not sure "where to even start describing this kind of constant tiredness", you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you; if anything in "First, the things that cannot wait" above or in part 5 applies, see a doctor first.
Sit with a licensed TCM practitioner from wherever you are.
HansMed Modern TCM
For general wellness education only — not medical advice. Consult a registered TCM practitioner for personal guidance.
Sources
- World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 — https://www.who.int/publications/i/item/9789240042322
- NHS, Unintentional weight loss, page last reviewed 28 July 2025 — https://www.nhs.uk/symptoms/unintentional-weight-loss/
- NHS, Heart palpitations, page last reviewed 17 March 2026 — https://www.nhs.uk/symptoms/heart-palpitations/
- Ministry of Health Malaysia, Hospital Pendang (Kedah State Health Department), Info Kesihatan 2024 — https://jknkedah.moh.gov.my/hpendang/index.php?option=com_sppagebuilder&view=page&id=139
- Befrienders Kuala Lumpur — https://www.befrienders.org.my/
