Having a Blood Deficiency is not exactly something that conveys joyful, energized, or vibrant. Quite the opposite, when someone has this pattern, as many patients do, they will often share some sentiment along the lines of feeling “like a zombie,” “like death,” “run-down,” “exhausted,” or in low-spirits even without an instigating issue as one person said: “I’m depressed and I don’t even know why, there’s nothing bothering me.” Each person might have a different combination or number of symptoms associated with a Blood Deficiency, but despite the nuances, they typically share one thing in common: they feel depleted.
Their vitality is diminished which shows in their appearance, emotional affect, how they carry themselves, and of course, their health. But before I describe exactly what a Blood Deficiency is, let’s compare how blood is viewed in different medical paradigms:
Blood in Western and Traditional Chinese Medicine
In Western (allopathic) Medicine, blood is composed of red blood cells, white blood cells, platelets, plasma, nutrients, other proteins, electrolytes and water. Its functions are based on the quality/quantity of these individual components. Some of these functions include distributing hormones, carrying oxygen and energy (glucose) and supporting the immune system.
In Traditional Chinese Medicine (TCM), rather than focusing on the makeup of blood on a cellular level, the functions of blood are looked at holistically. In that sense, TCM sees blood more broadly as the red fluid inside the vessels that provides nutrition for the body. The components transported by blood-and the quality of the blood itself- are not restricted to physical materials or quantifiable amounts. Its abundance or depletion is measured by observation (looking at the skin, muscle tone, hair, nails, plus the color of the tongue), palpation (does the skin feel cold or warm; is the pulse weak, empty, or thin; or is it more broad and replete?) as well as listening for the quality of the voice plus the presence of related symptoms.
In Traditional Chinese Medicine, it is said that:
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- Blood is a denser form of Qi
- Blood is inseparable from Qi
- Blood nourishes the organs and produces Qi, but Qi gives movement to Blood
As you can see, the relationship between Blood & Qi is like that between Yin & Yang. Blood is a Yin Substance: it is the darker, fluid, nutritive, and condensed form of qi. Qi is Yang in nature: it is the activating and dynamic energy that allows our body’s systems to function properly. It moves the blood to where it is needs to be. You can think of Qi like electricity: you can’t always see it, but you know it’s running in the background to keep everything humming.
The Functions of Blood In Chinese Medicine
In Chinese Medicine, Blood is in charge of:
- Nourishing the body by flowing throughout the vessels, organs, and channels.
- Providing flexibility and moisture to the body’s tissues. As a Yin-substance, blood is dense, fluid, and lubricating: it prevents tissues/joints from drying out. With a blood deficiency, there is dryness: stiff joints/muscles, joint cracking/popping, chronically sore muscles that does not go away with rest or hydration (think of a dried-out river: when there is not enough blood to clear away debris at the bottom, metabolites and adhesions accumulate creating more pain/soreness); there can also be dry or brittle skin/hair/nails.
- Supports & anchors the Shen, our consciousness. The Shen is the “Spirit” or “Mind” of the Heart; it shapes how we perceive ourselves, others, and engage with the world around us. The Blood nourishes the Shen by supporting authentic and balanced emotional/mental activity. With deficient blood, the Shen can become disturbed showing as symptoms of vague anxiety, poor memory, cloudy thinking, slight irritability, unease, and difficulty sleeping (especially falling asleep or going back to sleep if you wake up).
What Does a Blood Deficiency Mean?
It means you do not have enough blood (low volume) in circulation and/or the quality of your blood indicates a lack of nourishment (such as low iron) so it cannot carry out these functions. It also means that you and your Acupuncturist need to discuss why the Blood Deficiency is present in the first place in order to properly support the body in creating/renewing this vital substance.
Blood Deficiency in TCM
Common Symptoms of Blood Deficiency
- Headaches (usually a dull or empty quality, worse behind the eyes)
- Menstrual-Related Migraines (worse once/after the period begins)
- Always Cold
- Numbness/Tingling in hands/feet (Restless Leg Syndrome)
- Dizziness, Fainting
- Brain Fog, Poor Memory
- Chronic Fatigue
- Depression, Mood Swings
- Anxiety, Heart Palpitations
- Difficulty Falling (or Falling Back) Asleep
- Missing Period or Light/Short Period
- Hair Loss (Excessive) or Thinning Hair
- Dry/ Scaly/Flaky Skin
- Constipation (Dry Stools)
- Nails that are brittle, ridged, or have blue/purple lunae
- Bruise Easily
- Pale Complexion
- Pale Tongue; can be swollen with or without teeth marks
- Chronic Muscle Soreness or Weakness
Causes of Blood Deficiency
It can develop for a variety of reasons, but here are the most common ones based on experience (this is not an exhaustive list):
- Physical overwork, especially strenuous cardiovascular/endurance activities. In TCM there is a saying that running consumes the blood while lifting heavy taxes the Kidneys (however strength sports are not an exception). A blood deficiency from physical overwork is most common (but not *normal or ideal*) in menstruating female athletes who notice their period disappears from the frequency or high-intensity of their workouts. From a western perspective, this can happen from a Hypothalamic-Pituitary-Adrenal (HPA) or H-P-Ovarian (HPO) Axis dysregulation (in basic terms, your nervous system is too taxed, and for women, this can be the case for Hypothalamic Amenorrhea where your period stops arriving for months), a Thyroid disorder, or primary blood deficiency (such as Iron-Deficiency anemia).
- Acute blood loss: childbirth, donating blood, injury All of the above can lead to an acute blood deficiency that, if left unchecked and un-replenished over time, can lead to more chronic symptoms.
- Ongoing blood lossUnless you are donating blood often (which, is not recommended in Chinese Medicine, especially if this is part of your constitution), menstruating women are more susceptible-especially if heavy periods and/or periods that last more than 7-10 days.
- Nutrient Deficiency This is one of the most common underlying causes I see in clinic from habitually (even if unintentionally) just not eating enough, disordered eating, malnutrition from a poor diet or low appetite, intentional fasting, dietary restrictions, post-bariatric surgeries (which are designed to decrease appetite), and (here’s a big one) **inadequately supplemented** vegetarian and vegan diets. When relying on mostly processed carbs with little-to-no protein, actual vegetables, or supplementation of vitamins/minerals that are inherently more abundant & absorbable from animal protein, these diets can be inherently depleting to the system. Even when earnestly pursued with a variety of vegetables and whole-food non-animal protein sources, vegetarian (and especially vegan) diets do require extra diligence to ensure you are getting the most *bioavailable* nutrients you can without meat like Vitamin B12 (which you need for red blood cell production, converting food into fuel, brain health, and nerve myelination) and Iron. There are many vegetables that contain iron, but not in the heme form, which is more recognized and efficiently assimilated in the body. All in all: you do not need to give up a plant-based lifestyle, make sure you are getting what your body needs to thrive. More Info: Vitamin B-12 Deficiency & Foods for Vegetarians & Vegans
- Drug-Induced Nutrient Depletions Did you know certain drugs interfere with your body’s ability to absorb nutrients from what you eat? Frustrating but true. This means that even if your diet is nutrient-dense, your medications can be blocking them and back-firing on your health. Here are just some examples…Hormonal Birth Control depletes Folic Acid/B9, B2, B6, B12, Vitamins C & E, Zinc, Selenium, & Magnesium PMID: 23852908Proton-Pump-Inhibitors depletes Vitamins B12 & C, Iron, Calcium, and Magnesium while decreasing gut flora biodiversity PMID:25083257Statins for High Cholesterol depletes Antioxidant CoQ10 PMID: 29558445Anti-Hypertensives for high blood pressure can block different nutrients depending on the mechanism: ACE Inhibitors deplete Zince while Calcium Channel Blockers deplete Potassium PMID: 29558445Antidepressants depletes Calcium and Vitamin D PMID: 29558445Stimulants (such as Adderral, Vyvanse, Ritalin, etc) deplete Potassium, Iron, Vitamin D, Zinc, Magnesium Do not adjust/discontinue any medications without talking to your prescribing physician first
- Genetic Predisposition: MTHFR variation prevents absorption of B9, B12, Folic Acid (synthetic = folate) and requires testing from a MD, NP, FNP, or FMD to confirm . There can also be other types of anemias present such as (Sickle-Cell or Thalassemia aka “Mediterranean” anemia) that can be hereditary.
Is Anemia Different?
Because TCM looks at the function and quality of blood more broadly, you can have a Blood Deficiency but not be anemic. However, if you have been diagnosed with anemia or blood test levels are on the “low end of normal,” in TCM this still qualifies as a Blood Deficiency; if there is anemia in your medical history, we want to pay close attention to make sure that is not currently an issue.
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Related Western Medical Conditions:
When patients seek care through Acupuncture for symptoms associated with a Blood Deficiency, oftentimes they have been previously diagnosed with or treated for the following conditions:
- Menorrhagia
- Endometriosis
- Primary Amenorrhea
- Hypothalamic Amenorrhea
- Chronic Fatigue
- Anxiety + Depression + Bipolar
- Postpartum Anxiety + Depression
- Heart Palpitations + Arrhythmia
- Iron Deficiency Anemia
- Anemia (all other types)
- Anorexia/Bulimia
Due to the prevalence of anemia (especially undiagnosed) and psychiatric conditions linked to it, bringing awareness to this insidious underlying cause to mental and emotional distress is important to me & the community of patients I care for.
Spiritual Effects
Since we are spiritual as well as physical beings, our thoughts, attitudes and emotions affect our health at least as much as the physical world. Profound healing becomes possible when we address both the spiritual and the physical aspects of a condition.
- Anemia: Giving up. Feeling powerless and angry everyone else seems to have so much power.
- Aggressive anxiety disorder: Pattern of lashing out at others either physically or verbally when feeling unable to control a situation.
- AIDS (Autoimmune deficiency syndrome): Many believe this condition is a punishment sent by God. It is not (see unconditional love). Can occur in the presence of utter despair or deep shame, or where there is a complete lack of self-esteem or sense of self-worth. Can occur if we have been deprived of approval from our caregivers and/or loved ones. Can occur when we are the victim of someone's selfish lack of regard for others.
Spiritual well-being is a less-discussed but just as vital part of health in Chinese Medicine. So if any of these symptoms click for you AND you value having a comprehensive approach to feel like yourself again, I would be happy to support you. Because there are so many causes and unique ways a Blood Deficiency can manifest for each person, my suggestions and approach is personalized for each patient. This includes strategies to make sustainable shifts in your health in addition to individualized treatments using the wisdom of Chinese Medicine (Acupuncture, Eastern Nutrition, and Herbal Medicine)-all of which gently and naturally facilitate your body’s own healing process.
My intention through collaborating together is for you to not only experience relief from your health concerns, but to gain a holistic understanding of your body, clarity of what your symptoms are trying to tell you, as well as the tools to adopt beyond the treatment setting so you can take your health into your hands and thrive.
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Disclaimer: Information contained in this article is not meant to diagnose or treat any medical symptoms/condition. None of these claims are intended to infer prevention of the flu, common cold, or other respiratory illnesses. If you have any health concerns or an emergency, seek out medical attention.