Tired all the time? Could be Blood Deficiency

If you’re feeling tired all the time, several TCM patterns could be involved. Fatigue in TCM is often linked to deficiencies or imbalances in Qi, Blood, Yin, or Yang.

Today I’m going to talk about Blood deficiency.

Blood with a Capital B.

I’m not just describing a deficiency of actual blood- anaemia in the biomedical sense. In Traditional Chinese Medicine (TCM), Blood refers to a set of functions as well as being the red body fluid we are familiar with.

These are the functions of Blood in TCM:

The function of Nourishment – Blood provides sustenance to the organs, muscles, skin, and hair.

The function of Moistening – Prevents dryness in the skin, hair, eyes, and internal organs.

The function of Anchoring the Mind (and spirit or Shen) – A strong Blood supply calms emotions and supports sleep and mental clarity.

The function of Circulation and Movement – Blood, guided by Qi, supports smooth circulation throughout the body and contributes to strength and flexibility.

So rather than Blood deficiency being caused by simply being low in iron or vitamin D, it may be caused by things that affect those functions, eg poor digestion, overwork, emotional stress, grief, heartbreak or excessive bleeding.

Imagine your body is like a garden. Blood is the life-giving fluid of the garden—the rich sap that flows through every plant. It carries the nourishment from the compost, the vitality from the roots, the movement from the irrigation, and the warmth of the sun. It moistens the leaves, gives colour to the petals, and allows the whole garden to thrive with resilience and beauty.

• If there’s not enough sap (Blood Deficiency), the plants dry out, wilt, and lose their colour and strength.

• If the sap doesn’t move well (Blood Stagnation), growth is blocked, and some parts of the garden may wither or become painful knots.

• If the sap is weak in quality, the plants lack vitality even if the structure is in place.

So strong Blood is what you see when the garden is not only alive—but flourishing. It’s the result of a well-functioning ecosystem, and the substance that makes the whole garden soft, supple, and radiant.

When the Blood is weak however, we might experience:

• Fatigue with dizziness or lightheadedness

• Pale complexion and lips

• Poor concentration and memory

• Palpitations, especially at rest

• Dry skin, brittle nails, hair loss

• Scanty or absent periods (in women)

• In clinic, I might observe a pale, thin, and possibly dry tongue.

I had a patient this week with all the signs of Blood deficiency and yet their lab results came back normal. They have all the right nutients in their blood- but they are still Blood Deficient. Not only is their Blood deficient, but the systems that circulate the Blood are sluggish and tired too. We call these systems ‘Spleen Qi’ (which transforms food into Blood) and ‘Kidney Essence and Yang’ (which support growth, vitality, and your zest for life).

Again, imagine your body as a garden.

For the garden to flourish, you need five key elements: active composting organisms, deep roots, flowing water, nourishing sunlight, and warmth.

• The Spleen is like the composting crew—the earthworms, microbes, and fungi that break down organic matter into usable nutrients. In TCM, the Spleen transforms food into Qi and Blood. If the composting system is sluggish (due to cold foods, overthinking, or stress), nutrients don’t become available, no matter how good the raw materials.

• The Kidneys are like the roots—deep, strong, and foundational. They store the body’s Essence (Jing), which underpins growth, reproduction, and long-term vitality. Without strong roots, the plant withers.

• The Liver is the irrigation system, keeping everything flowing—water, nutrients, and Qi. It ensures smooth distribution and prevents stagnation. If it’s blocked, some parts of the garden become parched while others overflow.

• Yang is the sunlight and warmth. It provides the energy for everything to function—compost to transform, water to flow, roots to grow. In your body, this is your drive, warmth, and ability to digest, move, and heal.

When all of these are in balance—when nutrients are processed well, energy is strong, water flows, and warmth brings life—you feel vibrant, grounded, and full of natural vitality. That’s the picture of good Blood, strong Qi, and harmonious health in TCM.

The point is, that bone weary tiredness can be a simple lack of nutrients, but more commonly it is a mix of patterns and imbalances that all need addressing.

So what can be done? A good start is to consider taking on some of the following advice:

1. Diet:

• Nourish the Blood: Focus on foods that help build and nourish Blood. These include:

  • Dark leafy greens (spinach, kale, Swiss chard) – rich in folate, which supports blood production.

  • Beets – considered a Blood-building food in TCM.

  • Red meats (such as beef or lamb) – these are considered to nourish the Blood and strengthen the body, particularly if you're not a vegetarian.

  • Liver – rich in nutrients that support blood production, though some people may avoid it.

  • Chicken and duck – these are also good options for Blood-building in TCM. Chicken and beef stock are also great.

  • Sweet potatoes and carrots –

    when cooked, thers are Blood-supporting more through their support of the Spleen and digestion than direct Blood tonification.

  • Adzuki beans, black beans, and red dates (jujube) – commonly used in TCM formulas to tonify Blood.

• Soups and stews made with nourishing ingredients like chicken, bone broth, and vegetables can be very beneficial.

• Avoid Overconsumption of Cold and Raw Foods: Cold drinks and raw foods can weaken digestion in TCM, leading to further Blood deficiency over time. Avoid excessive consumption of ice-cold beverages and salads.

• Moderate Caffeine and Alcohol: Excessive caffeine and alcohol can deplete the Spleen and Kidney Yin, exacerbating Blood deficiency. Limit these or enjoy them in moderation.

2. Rest and Sleep:

• Get adequate rest: Blood deficiency is often associated with fatigue and weakness, so it’s important to get enough restorative sleep each night. Aim for 7-9 hours of sleep. As we build your blood it will be easier to sleep through.

• Avoid overexertion: Excessive physical or mental strain can deplete Blood further. Encourage a balanced lifestyle with time for relaxation.

3. Gentle Exercise:

• Encourage moderate exercises that gently promote circulation and energy, such as Tai Chi, Qi Gong, walking, or gentle yoga.

• Avoid over-exercising: Intense exercise without proper nourishment can further drain the Blood, so encourage balance and rest.

• Movement supports the circulation of both Qi and Blood, helping reduce stagnation and promote vitality.

  
  

4. Emotional Well-being:

• Emotional balance: In TCM, the Liverstores the Blood, and emotional stress or frustration can deplete it. Encourage practices that support emotional health, such as mindfulness, meditation, journaling, or spending time in nature.

• Relaxation: Activities that calm the mind and promote relaxation, like deep breathing exercises or aromatherapy, can be helpful.  Here's where you open yourself to the possibility of finding something creative to do.  It could be cooking or gardening or taking up a new hobby.

  

  
  

5. Consult a Chinese Herbalist

6. Acupuncture and Acupressure:

• Acupuncture can be effective for tonifying Blood and improving the circulation of Qi. A licensed acupuncturist may focus on points that strengthen the Spleen, Kidneys, and Liver, as these organs are key players in Blood production and nourishment.

• Acupressure: Specific acupressure points can also be helpful. For example, the Spleen 6 (SP6) and Liver 3 (LV3) are points known to support the Spleen and Liver and may be beneficial for blood deficiency.  Let me know if you’d like me to show you how to do this.

  
  

7. Stay Warm:

• Avoid excessive cold exposure: Cold can constrict the flow of Qi and Blood, so ensure the body stays warm, especially in cooler weather. Use warm clothing and blankets if needed.

• Warm drinks: Hot herbal teas, such as ginger tea or cinnamon tea, can help warm the body and support digestion, which in turn supports the production of Qi and Blood.  Add ginger to your stir fries.  You could strew apples and add cinnamon to them rather than eating them raw.

8. Hydration:

• Drink warm fluids: Drink room temperature or warm water throughout the day to aid digestion. Avoid icy beverages, which can weaken the Spleen and digestion.  Try out herbal teas.  Or even just leaving a slice of fresh ginger in hot water to seep for a while and then have ginger tea.

It can seem a little overwhelming. Maybe pick one thing to focus on each week and keep re-reading to see if you can add anything as time goes on. Over time these changes will build up your blood and you will feel stronger, more resilient, and full of vitality.

#Acupuncture #TCM #TraditionalChineseMedicine #HolisticHealing #BloodTonic #HerbalMedicine #NaturalHealth #BalanceYourBody #WellnessJourney #SelfCare