Kidney and Liver Yin Deficiency
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
At a glance
Preliminary reading: What is a pattern? The Kidneys in Chinese Medicine The Liver in Chinese Medicine The concept of Yin The concept of Deficiency
Key attributes
Chinese name: 肝肾阴虚 Pinyin name: Gān Shèn Yīn Xū
Pattern nature: Empty combined pattern
Pattern(s) it combines from: Kidney Yin Deficiency Liver Yin Deficiency
Causes
Precursor patterns: Liver Blood Deficiency Liver Yin Deficiency
Common causes: 1. Emotional problems, 2. Overwork, 3. Excessive sexual activity, 4. Depletion of Body Fluids, 5. Blood loss, 6. Chronic illness, 7. Overdose of Kidney-Yang tonic herbs, 8. Diet lacking in Blood-forming foods
Diagnosis
Common symptoms: Tinnitus Insomnia Dry eyes Dry hair Dry skin and eighteen other symptoms
Pulse type(s): Empty (Xu), Floating (Fu)
Tongue description: Normal-coloured without coating or with rootless coating
Treatment
Treatment principle: Nourish Liver and Kidney Yin
Common formulas: Zuo Gui Wan Qi Ju Di Huang Wan Liu Wei Di Huang Wan and two other formulas
Pathology
The Liver stores Blood while the Kidneys store Essence.
Liver Blood depends on Essence for nourishment, while Essence depends on Blood for replenishment. Both have a common source: Grain Qi derived from the Spleen. In terms of Five Elements, the Kidneys nourish the Liver.
A long term Liver Blood Deficiency (Blood is Yin in nature) can cause Kidney Yin Deficiency. Usually this appears as a Liver and Kidney Yin Deficiency
Dry eyes are one of the most distinctive symptoms of Liver-Yin deficiency, due to the Yin of the Liver being unable to moisten the eyes.
Dream-disturbed sleep, insomnia, limbs numbness, blurred vision and scanty menstruation (or amenorrhea in the worse cases) are all symptoms of Liver Blood Deficiency, which is part of Liver Yin Deficiency.
The headache is also due to Liver Blood deficiency. It tends to be either occipital or vertical (on the vertex of the head).
The infertility, which is mostly seen in women, is because of deficient Liver Blood failing to nourish the Uterus and to deficient Kidney Essence unable to promote conception.
The absence of coating on the tongue is a key sign of Yin Deficiency.
Causes
Precursor patterns: Kidney and Liver Yin Deficiency can derive from Liver Blood Deficiency Liver Yin Deficiency
Emotional problems: Anger, frustration and depression may over the long-term lead to this pattern.
Overwork: Working excessively long hours for many years weakens Kidney Yin and may lead to this pattern
Excessive sexual activity: Excessive sexual activity, especially masturbation, depletes Kidney Essence and Kidney Yin.
Depletion of Body Fluids: Depletion of Body Fluids, for instance if they are dried up by Heat after a febrile disease, may lead to Kidney Yin Deficiency.
Blood loss: Loss of blood over a long period of time (such as from chronic excessive menstrual bleeding) can cause Liver Blood Deficiency, which, in turn, can lead deplete Kidney Yin.
Chronic illness: A long chronic illness may lead to Kidney Yin Deficiency.
Overdose of Kidney-Yang tonic herbs: If Kidney Yang is overstimulated by the administration of hot herbal medicine, Kidney-Yin will be injured
Diet lacking in Blood-forming foods: A diet poor in nourishment or lacking in Blood-forming foods (such as meat and grains) can lead to Liver Blood Deficiency and subsequently this pattern
Diagnosing Kidney and Liver Yin Deficiency
Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners. In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors as well as learn to read from a long list of seemingly unrelated symptoms.
Pulse type(s): Empty (Xu) or floating (Fu)
Tongue description: Normal-coloured without coating or with rootless coating
Main symptoms: Tinnitus Insomnia Dry eyes Dry hair Dry skin Dizziness Dry throat Dry vagina Dry stools Amenorrhea Infertility Night sweats Blurred vision Scanty periods Delayed period Lower back pain Tingling of limbs Diminished hearing Vertical headaches Occipital headaches Nocturnal emissions Numbness in the limbs Withered and brittle nails
Diagnosis commentary: Dry eyes, dry throat, back pain and a tongue without coating are enough in and of themselves to diagnose Kidney and Liver Yin Deficiency. Together with night sweats and scanty menstruation they're they main characteristic symptoms of this pattern.
Treating Kidney and Liver Yin Deficiency
Treatment principle
Nourish Liver and Kidney Yin
Herbal formulas used to treat Kidney and Liver Yin Deficiency
Liu Wei Di Huang Wan
Source date: 1119 AD
Number of ingredients: 6 herbs
Key actions: Enriches the yin and nourishes the Kidneys.
Formula summary
Liu Wei Di Huang Wan is a 6-ingredient Chinese Medicine formula. Invented in 1119 AD, it belongs to the category of formulas that nourish Yin and tonify.
Besides Kidney and Liver Yin Deficiency, Liu Wei Di Huang Wan is also used to treat Blood Deficiency or Yin Deficiency.
Zuo Gui Wan
Source date: 1624 AD
Number of ingredients: 8 herbs
Key actions: Nourishes the Yin. Strengthens the Kidneys. Fills the Essence. Augments the marrow.
Formula summary
Zuo Gui Wan is a 8-ingredient Chinese Medicine formula. Invented in 1624 AD, it belongs to the category of formulas that nourish Yin and tonify.
Besides Kidney and Liver Yin Deficiency, Zuo Gui Wan is also used to treat Kidney Essence Deficiency or Yin Deficiency.
Qi Ju Di Huang Wan
Source date: 1350 AD
Number of ingredients: 8 herbs
Key actions: Nourishes Kidney and Liver Yin. Improves vision.
Formula summary
Qi Ju Di Huang Wan is a 8-ingredient Chinese Medicine formula. Invented in 1350 AD, it belongs to the category of formulas that nourish Yin and tonify.
Besides Kidney and Liver Yin Deficiency, Qi Ju Di Huang Wan is also used to treat Liver Yang Rising or Interior Wind.
Diet recommendations
Eat plenty of grains, vegetables and a little meat (preferably white meat). Avoid spicy, greasy and fried foods, caffeinated foods and drinks including coffee, black tea, cocoa, alcohol, drugs, chips of all kinds, turkey and red meats.
Rest is extremely important in nourishing Yin, as is meditation, contemplation and prayer. Avoid excessive mental and sexual activity as well as overwork.
When it comes to exercise stretching and light movement are beneficial, such as Yoga, Tai Chi, Qi Gong, swimming and walking.
Related conditions
Please keep in mind that a Western Medicine condition can be caused by several Chinese Medicine patterns of disharmony and vice versa. As such a patient suffering from one of the conditions below will not necessarily be suffering from Kidney and Liver Yin Deficiency, it is just one pattern that's commonly associated with the condition. Click on a condition to learn what other patterns it's associated with.
Vaginal itching Menopausal syndrome Absence of menstruation Chronic hepatitis Hypertension Cirrhosis Perimenopausal syndrome Atherosclerosis Pulmonary tuberculosis Hyperthyroid Coronary artery disease Chronic glomerulonephritis Chronic nephritis Prostate diseases Urinary tract infection Renal tuberculosis Diabetes mellitus Diabetes insipidus Cataract Glaucoma Central retinopathy Optic nerve atrophy Optic neuritis Retarded growth in children Neurasthenia Failure to thrive
Special highlight: the link between absence of menstruation and Kidney and Liver Yin Deficiency
Dong Quai (Dang Gui) is the key herb for Tiao Gan Tang, a formula used for absence of menstruation caused by Kidney and Liver Yin Deficiency
Typical symptoms for absence of menstruation caused by Kidney and Liver Yin Deficiency: Fatigue Tinnitus Insomnia Dry eyes Dizziness Dry mouth Night sweats Blurred vision Lower back pain
Recommended herbal formulas: Tiao Gan Tang, Gui Shao Di Huang Tang, He Che Da Zao Wan, Zuo Gui Yin, Si Wu Tang
Liver and Kidney Yin Deficiency are some of the most common Yin Deficiency pattern. Blood is a Yin elements and Yin Deficiency dries the 'Sea of Blood' of the Penetrating Vessel. Therefore the menstruation ceases. This pattern is the result of overwork, chronic disease or giving birth to too many children too close together. It happens more amongst women who are over 30 years old, in contrast to the patterns of Kidney Essence and Liver Blood Deficiency which happens more to younger girls.
Special highlight: the link between menopausal syndrome and Kidney and Liver Yin Deficiency
Prepared Rehmannia (Shu Di huang) is the key herb for Qi Ju Di Huang Wan, a formula used for menopausal syndrome caused by Kidney and Liver Yin Deficiency
Typical symptoms for menopausal syndrome caused by Kidney and Liver Yin Deficiency: Tics Tinnitus Dry eyes Dry skin Dizziness Sore back Headaches Amenorrhea Joint pain Hot flushes Night sweats Blurred vision Spontaneous and nocturnal emissions
Recommended herbal formulas: Qi Ju Di Huang Wan, Liu Wei Di Huang Wan, Gui Shao Di Huang Tang, Zuo Gui Yin
The symptoms under this pattern are very similar to those under Kidney Yin Deficiency but the condition is much more severe. The Kidney Yin is so Deficient that it dries up the Liver Yin.
Prolonged Yin Deficiency leads to Liver Yang Rising, as the Yang can not be kept under control. Sometime it can even agitate Liver Wind Internally. Then symptoms such as dizziness, tics, headache and tinnitus appear. Blurred vision is also a typical sign, as Liver opens into the eyes. The Liver houses the...Read more about menopausal syndrome
Consequence patterns
The most common consequence of this pattern is the development of Empty-Heat
The Liver stores the Blood and the Kidneys stores the Essence. Both elements are interdepended. Both Organs are closely related. The Yin Deficiency of one Organ can leads to the same Empty pattern for the other. Both pattern can develop further to Liver Yang Rising.
Liver Wind agitating internally due to Liver Yang Rising
Kidney and Liver Yin Deficiency can cause Liver Yang Rising. If it is not treated for many years, it agitates internal Liver Wind.