Updated: May 8, 2020
Exhausted? Mental Fog? Poor appetite? Pale?
Blood deficiency in some form is one of the most common patterns affecting our female patients. To best understand blood deficiency, how it presents in women and how we can treat it we need to start with a good understanding of how Traditional Chinese Medicine (TCM) views the blood and its role in woman’s overall health and well being.
Blood and Traditional Chinese Medicine
In Western Medicine and biology blood has a multitude of functions critical to our survival. These include supplying oxygen to our tissues and cells. Transporting essential nutrients to our cells and removing harmful waste products. When we discuss Blood in Traditional Chinese Medicine (TCM) theory the interpretation is somewhat different to the Western Medicine point of view. In TCM theory Blood is one of the Five Vital Substances. These Five Vital Substances are;
1. Essence (Jing)
2. Blood (Xue)
3. Moisture (Jin-Ye)
4. Energy (Qi)
5. Spirit (Shen)
Known in TCM as Xue, (pronounced “Shway”) our blood is considered to be a fluid that travels within our vessels and carrying vital nourishment. Its main purpose is to provide moisture, nourishment and strength throughout the body. It is the foundation for bone formation, nerves, organs, and muscles. In addition to this TCM theory looks beyond the physical study of the body it also acknowledges the blood’s role in maintaining optimal mental health function and strengthening of the mind. Our ‘Shen’, a strong spirit and clear focused mind rely on a healthy supply of blood.
Xue is yin in nature and is obtained through our food and our Jing.
How do we derive our Blood (Xue) from food?
The Stomach and Spleen are essential for the production of healthy blood. Our food as it is digested by the body is turned into Food Qi by the Stomach and Spleen. Once it has been transformed by the Stomach and the Spleen it is then transported to the Lungs where it is pushed to the Heart and turned into blood.
How do we derive our Blood (Xue) from Jing?
Our Jing is our ‘essence’. It is stored in the Kidneys. Jing is Yin in nature. It travels the eight major vessels in woman to create menstrual blood and bone marrow. The creation of bone marrow contributes to the production of the blood. In men, Jing is critical in the formation of semen.
How does our Blood (Xue) interact with our organs?
The Spleen produces Food Qi forming the base for blood production. The Spleen also holds the Blood in the vessels. The Food Qi created by the Spleen and Stomach is transported to the Lung.
The Lung assists the Spleen in moving the Food Qi to the Heart. It then supports the Heart in moving the blood through the vessels.
The Heart is where our Food Qi is made into blood.
The Liver is where the blood is stored. When we are active and moving the Liver governs blood flow out to our muscles and tendons. When we are at rest the blood returns to the Liver. The Liver moistens the eyes and provides lubrication to the joints and sinews around the body. The Liver also provides the uterus with blood making it extremely important to women’s health gynaecology and menstruation.
The Kidneys house the Original Qi which is needed to transform Food Qi into Blood. The Kidney also stores our Jing. Our Jing produces marrow which in turn also contributes to the formation of blood.
The Blood (Xue) and Women’s Health
In TCM the support of Women’s Health is dominated by Blood. Blood is not only the source of periods but the foundation of fertility, conception, pregnancy and childbirth.
The onset of a woman’s first period generally occurs in the early teenage years with menopause occurring around the age of 50 years old. These figures are rough of course with variances of several years still being considered within ‘normal’ ranges. From a Traditional Chinese Medicine perspective, a woman’s menstrual cycle should be within 26 – 32 days with a bleed of 4-6 days and irregularity of cycle length or bleed from month to month is interpreted as abnormal.
We identify four distinct phases within the menstrual cycle. These are as follows:
Menstrual Phase – This is the time of a woman’s period. This moving of blood relies on strong flow of Liver Qi and Liver Blood. This phase is between 4-6 days. The priority at this time in support of women’s health is to move the blood if the period is not strong and healthy. Where the flow is too heavy, we aim to reduce the strength of the bleed.
Post-menstrual Phase (Follicular Phase) – In this first 7 days after the woman’s period we find the Blood and Yin to be relatively empty. Currently estrogen is the dominant hormone in a woman’s body. Estrogen is a “cool” hormone. This means that during this phase your body temperature will be slightly cooler. This is a time where nourishing the woman’s Blood and Yin is important to help it build in the next phase of the cycle.
Mid Cycle Phase (Ovulation Phase) – Also lasting approximately 7 days this is a time of building where Blood and Yin levels restore. During this time, in a balanced cycle ovulation occurs. During mid cycle we are wanting to promote ovulation and we do this by nourishing the Kidneys and in turn the Essence.
Pre-menstrual Phase – During this week Yang Qi rises and Liver Qi begins to move in preparation for the period. Like the menstrual phase strong Liver Qi is essential at this time. This is a time where we would aim to move any stagnant Liver Qi to promote optimal flow of Qi and Blood and Tonify Yang if it appears to be deficient.
These phases are important as they can help us to identify different areas of deficiency and excess specific to a woman’s cycle. They also can dictate the optimal time for us to apply and our patient to receive specific supporting treatments.
In clinic so much can be learnt about a female patient’s overall state of health by investigating and understanding her cycle. For example, the condition of a woman’s Liver Xue is extremely important for the menstrual cycle. Where there is deficiency of Liver Xue we will find conditions such as amenorrhea or in the case of stagnation of Liver Xue we will often have reports of cyclic pain and dysmenorrhea.
What does Blood (Xue) deficiency look like?
As we know blood has a multitude of important supporting, nourishing, warming and moisturizing functions for the body. What we find is that when our Blood is not nourished and supported it becomes deficient and stagnant.
Some manifestations of Blood deficiency are as follows:
Pale skin tone
Dizziness upon standing
Floaters in your eyes
Loss of appetite
Some ways Blood deficiency can impact mental health are:
Post birth and Blood deficiency
When a woman is pregnant generally, she and those who surround her supportive of her health and the health of her unborn child. Post childbirth is a time where blood deficiency is common. It is also a time where less emphasis is given to mother care and the focus shift solely to the needs of the newborn child. Traditional Chinese Medicine observes a traditional postnatal practice called ‘sitting the month’ or in Japanese culture it is referred to as ‘sango no hidachi’ This period of time which varies between culture to culture and typically lasts between one month and 100 days. It is an important time of postnatal recuperation and includes bed rest, ritual, TCM therapy and herbal medicine. Post-partum care in the time immediately after birth is called ‘Mother Warming’ this is something we are strong advocates of at Red Bridge. When supporting women through pregnancy and birth preparation we will always discuss the importance of postnatal treatment. Taking place around a week after birth we use Acupuncture, TCM therapies such as moxibustion and herbal medicine to replenish Qi and Blood, encourage repair and introduce warmth back into the pelvic area. Read the following link to learn more about 'A Healthy Pregnancy with Traditional Chinese Medicine'