What is Hematuria?

Hematuria, commonly referred to as blood in urine, is a condition characterized by the presence of red blood cells in the urine, making it appear reddish or brownish. This symptom can indicate various underlying conditions, ranging from urinary tract infections to more serious diseases affecting the kidneys or urinary tract.

Hematuria can be visible to the naked eye (gross hematuria) or detectable only under a microscope (microscopic hematuria). It's a symptom that warrants medical evaluation to determine its cause.

How does TCM view Hematuria?

Traditional Chinese Medicine (TCM) approaches hematuria from a holistic perspective, focusing on the balance and flow of Qi, the body's vital energy. In TCM, hematuria is often seen as a manifestation of underlying disharmonies within the body's organ systems, particularly the Kidneys and Bladder.

Treatment in TCM aims to restore balance and address the root cause of the symptom through a combination of herbal medicine, acupuncture, dietary recommendations, and lifestyle modifications.

Root Causes of Hematuria in TCM

In TCM, hematuria is often attributed to patterns of disharmony such as Heat or Phlegm. For instance, Damp-Heat in the Bladder can lead to symptoms like blood in urine, urinary burning, and frequent urination. Similarly,

Full-Heat in the Small Intestine might present with hematuria, restlessness, and mouth ulcers. Other patterns like Phlegm in the Kidneys or Gallbladder can also manifest as hematuria. TCM practitioners tailor their approach based on the individual's specific pattern to effectively treat the condition.

Explore below more details about what might cause Hematuria according to TCM.

  • By Syndrome
  • By Organ
  • Heat
  • Mind Disturbance
  • Dampness
  • Yin Deficiency
  • Blood Deficiency
  • Phlegm
Detailed description of the cause

Heat

In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more

Heat Patterns That Can Lead to Hematuria

Common Symptoms: Restlessness Feeling Of Heat Insomnia Dark Urine Fever Scanty And Dark Urine Thirst Bitter Taste In The Mouth

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Bladder Blood in urine, Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria, Fever, Dry mouth without desire to drink, Lower abdominal fullness and pain, Feeling of heat... see more Ba Zheng San
Full-Heat in the Small Intestine Blood in urine, Restlessness, Insomnia, Tongue ulcers, Mouth ulcers, Throat pain, Deafness, Cardiac burning sensation, Abdominal pain, Craving for cold beverages, Scanty and dark urine, Hematuria, Urinary burning... see more Dao Chi San
Greater Yang Accumulation of Blood Blood in urine, Lower abdominal distension, Lower abdominal fullness, Hematuria, Restlessness Tao He Cheng Qi Tang
Heat victorious agitating Blood Blood in urine, Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria... see more Xi Jiao Di Huang Tang
Heart Fire blazing Bloody urine, Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety, Feeling of heat, Insomnia, Flushed face, Hematuria, Dark urine, Bitter taste in the mouth... see more Xie Xin Tang | Zi Xue Dan | Qing Xin Lian Zi Yin | Liang Ge San
Heat in the Blood Bloody urine, Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Cough of blood, Nosebleeds, Excessive menstruation... see more Xi Jiao Di Huang Tang | Gu Jing Wan | Shi Hui San | Bai He Di Huang Tang | Hua Ban Tang | Qing Ying Tang | Qing Re Gu Jing Tang
Kidney Yin Deficiency With Empty-Heat Blazing Bloody urine, Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms, Afternoon heat sensation, Evening heat sensation, Scanty and dark urine, Hematuria, Dry throat, Preference for sipping, Dizziness, Tinnitus, Hearing loss, Lower back pain, Nocturnal emission, Hypersexuality, Dry stools... see more Liu Wei Di Huang Wan | Zhi Bo Di Huang Wan
Damp-Heat Red urine, Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst, Feeling of heat, Feeling of heaviness, Bitter taste in the mouth, Acne... see more Long Dan Xie Gan Tang | Yi Huang Tang
Detailed description of the cause

Mind Disturbance

In TCM "Shen" refers to the mind or spirit, and a Shen disturbance is a pattern of disharmony that affects the mental and emotional state. This concept reflects the TCM belief in the deep interconnectedness of mind and body. Symptoms of Shen disturbance can vary widely but often include anxiety, insomnia, restlessness, confusion, or in severe cases, hallucinations or delirium. These symptoms indicate an imbalance in the body's energies affecting the heart, which in TCM is not only the center of blood circulation but also the seat of the mind and consciousness. The root of Shen disturbance can be traced to various factors, including emotional stress, physical illness, or an imbalance in fundamental substances like Qi, Yin, or Yang.... see more

Mind Disturbance Patterns That Can Lead to Hematuria

Common Symptoms: Restlessness High Fever Mania Macules Vomiting Blood Nosebleeds Hematochezia Palpitations

Pattern Name Relevant Symptoms Relevant Formulas
Heat victorious agitating Blood Blood in urine, Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria... see more Xi Jiao Di Huang Tang
Heart Fire blazing Bloody urine, Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety, Feeling of heat, Insomnia, Flushed face, Hematuria, Dark urine, Bitter taste in the mouth... see more Xie Xin Tang | Zi Xue Dan | Qing Xin Lian Zi Yin | Liang Ge San
Detailed description of the cause

Dampness

"Dampness" in TCM is a concept that describes a pattern of disharmony where the body accumulates excess moisture. Imagine the heavy, sticky feeling you get on a very humid day; that's similar to what dampness feels like internally. It can manifest as a sense of heaviness, bloating, sluggishness, or even a foggy mind. This condition is often thought to arise from environmental factors like living in a damp place, dietary habits that promote moisture in the body, or internal imbalances that hinder the body's ability to process fluids properly. In TCM, dampness can obstruct the normal flow of energy and fluids in the body, leading to various symptoms.... see more

Dampness Patterns That Can Lead to Hematuria

Common Symptoms: Fever Feeling Of Heat Leukorrhea Frequent Urination Frequent And Urgent Urination Urinary Burning Urination Stopping In The Middle Of Flow Dark Urine

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Bladder Blood in urine, Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria, Fever, Dry mouth without desire to drink, Lower abdominal fullness and pain, Feeling of heat... see more Ba Zheng San
Damp-Heat Red urine, Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst, Feeling of heat, Feeling of heaviness, Bitter taste in the mouth, Acne... see more Long Dan Xie Gan Tang | Yi Huang Tang
Detailed description of the cause

Yin Deficiency

Yin deficiency in TCM is a pattern of disharmony characterized by a depletion of the body's Yin energy, which represents the cooling, moistening, and nurturing aspects of our physiology. This condition often arises from factors like chronic stress, overwork, insufficient rest, or prolonged illness. Symptoms of Yin deficiency can include a sensation of heat, especially in the afternoon or evening, night sweats, insomnia, a dry mouth or throat, and a red tongue with little coating. There might also be a general feeling of restlessness or irritability. Since Yin is essential for balancing the body's active and warm Yang energy, its deficiency leads to a relative excess of Yang, manifesting as heat or dryness symptoms.... see more

Yin Deficiency Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Kidney Yin Deficiency With Empty-Heat Blazing Bloody urine, Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms, Afternoon heat sensation, Evening heat sensation, Scanty and dark urine, Hematuria, Dry throat, Preference for sipping, Dizziness, Tinnitus, Hearing loss, Lower back pain, Nocturnal emission, Hypersexuality, Dry stools... see more Liu Wei Di Huang Wan | Zhi Bo Di Huang Wan
Detailed description of the cause

Blood Deficiency

Blood Deficiency in TCM is like when your body's tank runs low on the vital energy that blood provides. It's not exactly the same as anemia in modern medicine, which is about having too few red blood cells. Instead, Blood Deficiency in TCM is about your body not having enough of the life-giving qualities that blood brings, like nourishment and moisture. This can make you feel tired, look pale, and even feel dizzy or have blurry vision. It's like a garden not getting enough water to stay lush and vibrant. TCM sees this as an imbalance where the body isn't being nourished as it should be, impacting overall health and well-being.... see more

Blood Deficiency Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Loss of Blood Heamaturia, Bloody urine, Nosebleeds, Uterine hemorrhage, Hematuria, Hematochezia, Cough of blood, Vomiting blood, Dark menstrual clots, Excessive menstruation, Bloody sputum... see more Xi Jiao Di Huang Tang
Detailed description of the cause

Phlegm

In TCM "Phlegm" as a pattern of disharmony is a complex concept that extends beyond the physical manifestation of mucus. It represents a pathological factor that can disrupt the flow of Qi (vital energy) and blood, leading to various health issues. Phlegm in TCM is seen as a sticky, turbid substance arising from the body's inability to metabolize fluids properly, often due to a dysfunction of the spleen. It's not only associated with respiratory problems like cough and congestion but also with systemic issues. Symptoms can include a feeling of heaviness, mental cloudiness, dizziness, and in some cases, the formation of lumps or masses. Phlegm can even be "invisible," contributing to emotional disturbances like depression or stress. ... see more

Phlegm Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Phlegm in Kidneys or Gallbladder Bloody urine, Frequent and urgent urination, Urinary dysfunction, Hematuria Si Ni San | Pai Shi Tang
Detailed description of the cause

Bladder

In TCM the Bladder plays a crucial role beyond its basic function of storing and excreting urine. It is intimately connected with the Kidney system, helping to regulate the body's water balance and being a key component in the processing and elimination of fluids. The Bladder also influences the lower part of the body and the back. When it malfunctions or is imbalanced in TCM, it can lead to urinary issues like frequent urination, incontinence, or painful urination. Additionally, there may be problems related to its meridian pathway, such as lower back pain, stiffness, or weakness in the legs. The Bladder’s condition in TCM can also reflect emotional states, with imbalances potentially leading to feelings of fear or anxiety.... see more

Bladder Patterns That Can Lead to Hematuria

Common Symptoms: Frequent And Urgent Urination Urinary Burning Urination Stopping In The Middle Of Flow Dark Urine Cloudy Urine Fever Dry Mouth Without Desire To Drink Lower Abdominal Fullness And Pain

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Bladder Blood in urine, Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria, Fever, Dry mouth without desire to drink, Lower abdominal fullness and pain, Feeling of heat... see more Ba Zheng San
Greater Yang Accumulation of Blood Blood in urine, Lower abdominal distension, Lower abdominal fullness, Hematuria, Restlessness Tao He Cheng Qi Tang
Detailed description of the cause

Kidney

In TCM the Kidneys are regarded as the body's most fundamental reservoir of Essence, known as Jing, which influences growth, reproduction, and aging. They are not just organs for filtering blood, but a holistic system governing vital life forces. When the Kidneys malfunction in TCM, it can manifest as a variety of health issues, such as chronic fatigue, reproductive problems, imbalances in fluid metabolism leading to edema or dryness, lower back pain, and a sense of fear or insecurity.... see more

Kidney Patterns That Can Lead to Hematuria

Common Symptoms: Flushed Cheekbones Restlessness Insomnia Night Sweats Low Grade Fever In The Afternoon Heat Sensation In Palms Afternoon Heat Sensation Evening Heat Sensation

Pattern Name Relevant Symptoms Relevant Formulas
Kidney Yin Deficiency With Empty-Heat Blazing Bloody urine, Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms, Afternoon heat sensation, Evening heat sensation, Scanty and dark urine, Hematuria, Dry throat, Preference for sipping, Dizziness, Tinnitus, Hearing loss, Lower back pain, Nocturnal emission, Hypersexuality, Dry stools... see more Liu Wei Di Huang Wan | Zhi Bo Di Huang Wan
Phlegm in Kidneys or Gallbladder Bloody urine, Frequent and urgent urination, Urinary dysfunction, Hematuria Si Ni San | Pai Shi Tang
Detailed description of the cause

Small Intestine

In TCM the Small Intestine plays a critical role in receiving partially digested food from the Stomach and further separating the clear from the turbid, essentially distinguishing nutrients from waste. This process is vital for proper absorption and assimilation of food. The Small Intestine is also associated with clarity of judgment and decision-making. When it malfunctions or is imbalanced in TCM, it can lead to digestive issues such as abdominal pain, bloating, poor appetite, or irregular bowel movements. Additionally, a malfunctioning Small Intestine may manifest as mental confusion or difficulty in making decisions, reflecting its role in discernment and clarity in both physical and mental realms. ... see more

Small Intestine Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Full-Heat in the Small Intestine Blood in urine, Restlessness, Insomnia, Tongue ulcers, Mouth ulcers, Throat pain, Deafness, Cardiac burning sensation, Abdominal pain, Craving for cold beverages, Scanty and dark urine, Hematuria, Urinary burning... see more Dao Chi San
Detailed description of the cause

Heart

In TCM the Heart is considered the "emperor" of all organs, primarily responsible for governing Blood and housing the mind, known as "Shen." It plays a crucial role in maintaining mental-emotional equilibrium and controlling the circulation of Qi and blood throughout the body. When the Heart is imbalanced or malfunctions in TCM, it can lead to a range of issues like heart palpitations, insomnia, dream-disturbed sleep, anxiety, and a flushed complexion. Emotional disturbances such as excessive joy or lack of joy are also seen as signs of Heart disharmony. These symptoms reflect not just physical heart conditions but also the state of one's Shen, indicating the interconnectedness of physical and emotional well-being in TCM.... see more

Heart Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Heart Fire blazing Bloody urine, Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety, Feeling of heat, Insomnia, Flushed face, Hematuria, Dark urine, Bitter taste in the mouth... see more Xie Xin Tang | Zi Xue Dan | Qing Xin Lian Zi Yin | Liang Ge San
Detailed description of the cause

Gallbladder

In TCM the Gallbladder has a unique role in storing and excreting bile, but more importantly, it's seen as crucial for decision-making and courage. It's closely connected to the Liver, assisting in the smooth flow of Qi (vital energy) and supporting the Liver's role in maintaining emotional balance. When the Gallbladder malfunctions or is imbalanced in TCM, it can lead to physical symptoms like gallstones, jaundice, or a bitter taste in the mouth. There might also be digestive disturbances, particularly related to fat metabolism. On an emotional level, a Gallbladder disorder can manifest as indecisiveness, timidity, or a tendency to easily succumb to stress. These symptoms highlight the TCM view of the Gallbladder as integral to both physical processes and emotional resilience.... see more

Gallbladder Patterns That Can Lead to Hematuria

Pattern Name Relevant Symptoms Relevant Formulas
Phlegm in Kidneys or Gallbladder Bloody urine, Frequent and urgent urination, Urinary dysfunction, Hematuria Si Ni San | Pai Shi Tang

TCM Herbal Formulas for Hematuria

TCM offers a range of herbal formulas for treating hematuria, depending on the underlying pattern. For Damp-Heat in the Bladder, formulas like Ba Zheng San, containing herbs like Chinese Pink (Qu Mai), are used to clear heat and expel Dampness.

In cases of Full-Heat in the Small Intestine, Dao Chi San, with Akebia Stems (Mu Tong), can be effective. For Phlegm in the Kidneys or Gallbladder, Si Ni San, which includes Bupleurum Roots (Chai Hu), is often recommended. These formulas are selected based on the specific TCM diagnosis and are part of a comprehensive treatment plan.

Explore below some TCM herbal formulas used to address hematuria, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Heat
  • Mind Disturbance
  • Dampness
  • Yin Deficiency
  • Blood Deficiency
  • Phlegm
  • Formulas that clear heat from the organs
  • Formulas that clear heat and expel dampness
  • Formulas that clear nutritive-level heat
  • Formulas that clear heat and resolve toxicity
  • Formulas that secure irregular uterine bleeding and stop vaginal discharge
  • Formulas that clear heat from deficiency
  • Formulas that nourish yin and tonify
  • Formulas that invigorate blood and dispel blood stagnation
  • Formulas that clear heat and open sensory orifices
  • Formulas that stop bleeding
  • Formulas that clear heat from qi and blood
  • Formulas that harmonize liver-Spleen
  • Formulas that tonify qi and blood

All Formulas Recommended for Hematuria Caused by Heat

Formula Patterns Suitable For
Xi Jiao Di Huang Tang Heat victorious agitating Blood, Heat in the Blood
Ba Zheng San Damp-Heat in the Bladder
Dao Chi San Full-Heat in the Small Intestine
Tao He Cheng Qi Tang Greater Yang Accumulation of Blood
Xie Xin Tang Heart Fire blazing
Zi Xue Dan Heart Fire blazing
Qing Xin Lian Zi Yin Heart Fire blazing
Liang Ge San Heart Fire blazing
Gu Jing Wan Heat in the Blood
Shi Hui San Heat in the Blood
Bai He Di Huang Tang Heat in the Blood
Hua Ban Tang Heat in the Blood
Qing Ying Tang Heat in the Blood
Qing Re Gu Jing Tang Heat in the Blood
Liu Wei Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing
Zhi Bo Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing
Long Dan Xie Gan Tang Damp-Heat
Yi Huang Tang Damp-Heat

All Formulas Recommended for Hematuria Caused by Mind Disturbance

Formula Patterns Suitable For
Xi Jiao Di Huang Tang Heat victorious agitating Blood
Xie Xin Tang Heart Fire blazing
Zi Xue Dan Heart Fire blazing
Qing Xin Lian Zi Yin Heart Fire blazing
Liang Ge San Heart Fire blazing

All Formulas Recommended for Hematuria Caused by Dampness

Formula Patterns Suitable For
Ba Zheng San Damp-Heat in the Bladder
Long Dan Xie Gan Tang Damp-Heat
Yi Huang Tang Damp-Heat

All Formulas Recommended for Hematuria Caused by Yin Deficiency

Formula Patterns Suitable For
Liu Wei Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing
Zhi Bo Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing

All Formulas Recommended for Hematuria Caused by Phlegm

Formula Patterns Suitable For
Si Ni San Phlegm in Kidneys or Gallbladder
Pai Shi Tang Phlegm in Kidneys or Gallbladder

All "formulas that clear heat from the organs" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Dao Chi San Full-Heat in the Small Intestine
Qing Xin Lian Zi Yin Heart Fire blazing
Long Dan Xie Gan Tang Damp-Heat

All "formulas that clear nutritive-level heat" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Xi Jiao Di Huang Tang Heat victorious agitating Blood, Heat in the Blood, Loss of Blood
Qing Ying Tang Heat in the Blood

All "formulas that clear heat and expel dampness" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Ba Zheng San Damp-Heat in the Bladder
Pai Shi Tang Phlegm in Kidneys or Gallbladder

All "formulas that secure irregular uterine bleeding and stop vaginal discharge" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Gu Jing Wan Heat in the Blood
Yi Huang Tang Damp-Heat

All "formulas that clear heat and resolve toxicity" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Xie Xin Tang Heart Fire blazing
Liang Ge San Heart Fire blazing

All "formulas that clear heat from deficiency" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Bai He Di Huang Tang Heat in the Blood
Qing Re Gu Jing Tang Heat in the Blood

All "formulas that nourish yin and tonify" recommended for hematuria

Formula Patterns Suitable For (if applicable)
Liu Wei Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing
Zhi Bo Di Huang Wan Kidney Yin Deficiency With Empty-Heat Blazing

Acupoints for Hematuria

Acupuncture, another cornerstone of TCM, involves stimulating specific points on the body to restore balance. For hematuria, acupoints in the Bladder Channel like Pishu BL-20 and Shenshu BL-23 are used to strengthen the spleen and kidney functions, respectively. In the Kidney Channel, points like Fuliu KID-7 help resolve dampness and tonify the kidneys.

The Heart Channel's Tongli HE-5 point calms the mind and benefits the bladder, while the Spleen Channel's Yinbai SP-1 and the Liver Channel's Dadun LIV-1 have actions tailored to stop bleeding and regulate Qi. These points are selected based on their specific actions that correspond to the diagnosed pattern of disharmony causing hematuria.

Explore below some acupoints used to address hematuria, organized by meridian.

  • By Meridian
  • Bladder Channel
  • Kidney Channel
  • Heart Channel
  • Spleen Channel
  • Liver Channel
  • Directing Vessel
  • Lung Channel
Pishu BL-20

Pishu BL-20

1.5 cun lateral to the lower border of the spinous process of the 11th thoracic vertebra (T11).

Sanjiaoshu BL-22

Sanjiaoshu BL-22

1.5 cun lateral to the lower border of the spinous process of the 1st lumbar vertebra.

Shenshu BL-23

Shenshu BL-23

1.5 cun lateral to the lower border of the spinous process of the 2nd lumber vertebra (L2).

Xiaochangshu BL-27

Xiaochangshu BL-27

At the level of the 1st posterior sacral foramen, 1.5 cun lateral to the posterior midline.

Fuliu KID-7

Fuliu KID-7

2 cun directly above Taixi KID-3, on the anterior border of Achilles tendon.

Tongli HE-5

Tongli HE-5

On the radial side of the tendon of flexor carpi ulnaris muscle, 1 cun above the transverse crease of the wrist when the palm faces upward.

Yinbai SP-1

Yinbai SP-1

On the medial side of the big toe, about 0.1 cun posterior to the corner of the nail.

Dadun LIV-1

Dadun LIV-1

On the lateral side of the dorsum of the great toe terminal phalanx, between the lateral corner of the nail and interphalangeal joint.

Guanyuan REN-4

Guanyuan REN-4

On the midline of the abdomen, 3 cun below the umbilicus.

Lieque LU-7

Lieque LU-7

Above the styloid process of the radius, about 1.5 cun proximal to the wrist crease (wrist joint space) in a V-shaped depression.