Natural Herb Library

TCM pattern · Blood deficiency

Qi and Blood Deficiency

气血两虚 Qi Xue Liang Xu Spleen, Heart, and Liver system

Both the energy and the blood have run low. Tired and pale at the same time: short of breath, a weak voice, dizzy on standing, palpitations, poor appetite, pale lips and nails, and a light or late cycle. The usual state after a long illness, surgery, childbirth, or a long stretch of overwork.

Qi is the worker and blood is the material. When both are short, nothing gets built. Feeding one without the other stalls, which is why the formulas for this pattern carry both.

4 formulas Updated 2026-10-12 View API data

How to recognize Qi and Blood Deficiency

The signs that point most strongly to this pattern:

  1. Tiredness with pallor
  2. Shortness of breath, weak voice
  3. Dizziness on standing, blurry vision
  4. Palpitations
  5. Pale lips, nails, and face

Also common

  • Poor appetite, loose stools
  • Light sleep
  • Numb limbs
  • Light, late, or absent periods
  • Slow healing
  • Sweating on effort
Tongue
Pale with a thin white coat.
Pulse
Thin and weak.

Formulas for Qi and Blood Deficiency

Primary Ba Zhen Tang 八珍汤 Eight-Treasure Decoction When: The eight treasures: four qi herbs and four blood herbs. With cold Shi Quan Da Bu Tang 十全大补汤 All-Inclusive Great Tonifying Decoction When: The same picture in a cold person, with slow-healing wounds. With poor sleep Gui Pi Tang 归脾汤 Restore the Spleen Decoction When: When worry and light sleep lead. After blood loss Dang Gui Bu Xue Tang 当归补血汤 Tangkuei Decoction to Tonify the Blood When: The fast two-herb rebuild right after bleeding.

Herbs that matter most for Qi and Blood Deficiency

  • Huang Qi Root of Membranous Milkvetch Astragalus tonifies qi so blood can be made.
  • Dang Shen Dang Shen Root Codonopsis restores the qi.
  • Dang Gui Root of Chinese Angelica Angelica builds blood.
  • Shu Di Huang Prepared Rehmannia Root Prepared rehmannia, the heaviest blood tonic.
  • Bai Zhu Rhizome of Largehead Atractylodes Atractylodes strengthens the Spleen that makes both.
  • Da Zao Chinese Date Jujube dates nourish qi and blood together.

How Qi and Blood Deficiency differs from its look-alikes

  • Blood Deficiency Blood alone is pale with normal energy and appetite. Add the tiredness, breathlessness, and poor appetite and the qi is low too.
  • Spleen Qi Deficiency Qi alone is tired and bloated with normal color. Add the pallor and the dizziness and the blood is low too.

What drains into Qi and Blood Deficiency

  • Long illness or long recovery
  • Surgery, childbirth, or blood loss
  • Overwork on too little food
  • Spleen weakness that cannot make qi or blood
  • Chemotherapy and other draining treatments

Food and habits that help Qi and Blood Deficiency

  • Three warm cooked meals a day, with protein at each.
  • Rest is the medicine; do less until the color returns.
  • Blood-building food: eggs, red meat or liver in small amounts, dates, longan, black sesame, bone broth.
  • Gentle walking, not training.

What should change as Qi and Blood Deficiency improves

  • Energy returns first, within two to three weeks.
  • Color in the lips and face follows over one to two months.
  • Dizziness on standing fades.
  • The cycle fills out over two to three cycles.

Conditions where Qi and Blood Deficiency shows up

Fatigue Anemia Blood Deficiency Dizziness Palpitations Immune Deficiency Amenorrhea

Sources

  • Maciocia, The Foundations of Chinese Medicine, 3rd edition Qi and blood deficiency.
  • Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Ba Zhen Tang, Shi Quan Da Bu Tang.

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.