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TCM pattern · Blood deficiency

Blood Deficiency

血虚 Xue Xu Heart, Liver, and Spleen system

Not enough blood to feed the whole body. A pale dull face, pale lips and nails, dizziness on standing, blurry vision, numb limbs, dry skin, light sleep, and a light or late cycle. It is wider than anemia: the body can test normal and still show every sign.

Blood is the river that feeds every field. When it runs low, the far fields dry first: the fingertips, the eyes, the sleep, the cycle. You can have a normal blood count and still be running a low river.

4 formulas Updated 2026-10-12 View API data

How to recognize Blood Deficiency

The signs that point most strongly to this pattern:

  1. Pale, dull face; pale lips, nails, and eyelids
  2. Dizziness, especially on standing
  3. Blurry vision, dry eyes, floaters
  4. Numb or tingling hands and feet
  5. Light, late, or absent periods

Also common

  • Light sleep, many dreams
  • Palpitations
  • Dry skin and hair, brittle nails
  • Poor memory, poor concentration
  • Tiredness that is more mental than physical
Tongue
Pale and thin.
Pulse
Thin, or thin and weak.

Formulas for Blood Deficiency

Primary Si Wu Tang 四物汤 Four-Substance Decoction When: The base blood formula. With tiredness Ba Zhen Tang 八珍汤 Eight-Treasure Decoction When: Pale and tired together. After blood loss Dang Gui Bu Xue Tang 当归补血汤 Tangkuei Decoction to Tonify the Blood When: To rebuild quickly after heavy bleeding or childbirth. With poor sleep Gui Pi Tang 归脾汤 Restore the Spleen Decoction When: Pale, worried, sleeping badly, with weak digestion.

Herbs that matter most for Blood Deficiency

  • Dang Gui Root of Chinese Angelica Angelica, the first blood herb.
  • Shu Di Huang Prepared Rehmannia Root Prepared rehmannia, the heaviest blood tonic.
  • Bai Shao White Peony Root White peony nourishes blood and yin.
  • E Jiao Donkey Hide Gelatin Donkey-hide gelatin builds blood and stops bleeding.
  • Long Yan Rou Longan Aril Longan feeds Heart blood.
  • He Shou Wu Raw Fleeceflower Root Fo-ti builds blood and darkens hair.
  • Da Zao Chinese Date Jujube dates nourish blood gently.

How Blood Deficiency differs from its look-alikes

What drains into Blood Deficiency

  • Blood loss: periods, childbirth, surgery, injury
  • A diet short of blood-building food
  • Spleen weakness that cannot make blood
  • Long worry and mental work
  • Chronic illness
  • Vegetarian diets without planning

Food and habits that help Blood Deficiency

  • Red meat or liver in small amounts, eggs, dates, goji, black sesame, beets, dark greens, bone broth.
  • Regular warm meals; blood is made in a working kitchen.
  • Rest more than you think you need. Blood is rebuilt at rest.
  • Gentle movement, not hard sweating.

What should change as Blood Deficiency improves

  • Dizziness and the dry eyes ease within a month.
  • Lips and nails turn pink over one to two months.
  • The cycle fills out over two to three cycles.
  • If the pulse is large and empty right after blood loss, the fast rebuild formula comes first.

Conditions where Blood Deficiency shows up

Blood Deficiency Anemia Dizziness Blurred Vision Amenorrhea Menstrual Irregularities Insomnia Palpitations Hair Loss

Sources

  • Maciocia, The Foundations of Chinese Medicine, 3rd edition Blood deficiency.
  • Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Si Wu Tang and its family.

Important Note

A pattern is a picture, not a diagnosis. Most people carry two patterns at once, and the signs here are the classic ones, not a checklist. Use this page to recognize yourself, read a formula label with understanding, and ask a qualified practitioner a sharper question.