Liver Blood Deficiency

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At a glance

Key attributes

Chinese name: 肝血虚, 肝血亏虚      Pinyin name: Gān Xuè Xū, Gān Xuè Kuī Xū

Pattern nature: Empty

Common combinations: Spleen and Liver Blood Deficiency Liver and Heart Blood Deficiency

Causes

Precursor patterns: Blood Deficiency Kidney Essence Deficiency Gallbladder Deficiency and three other possible precursors

Common causes: 1. Diet, 2. Emotional stress, 3. Physical over-exertion, 4. Profuse Blood lose

Diagnosis

Common symptoms: Insomnia Dry hair Dry skin Pale lips Dizziness and thirteen other symptoms

Pulse type(s): Choppy (Se), Fine (Xi)

Tongue description: Pale tongue, especially on the sides with thin, dry and white coating

Treatment

Treatment principle: Tonify the Liver, nourish the Blood in the Liver.

Common formulas: Si Wu Tang Bu Gan Tang

Pathology

This pattern has all the general manifestation of the Blood Deficiency, such as dizziness, pale lips, dull pale face. The Liver stores Blood, that is the reason any Blood Deficiency often involves the Liver. 

This pattern has an impact on areas the Liver relates to, such as the eyes, the sinews, the nails, women's menstruation and Ethereal Soul. 

First of all, the Liver opens to the eyes, thus the symptoms of blurred vision and diminished night vision because the eyes are not nourished and moistened by sufficient Blood. 

Secondly, the Liver controls the sinews which includes tendons, cartilages and ligaments of the limbs. If Liver Blood is Deficient, malnutrition of the sinews results, causing muscular weakness, cramps, stiffness, rigidity, joint pain, as well as numbness and tremors of the limbs. 

Then the Liver manifests in the nails, hence the withered and brittle nails as they are not moistened properly. 

The Liver also supplies Blood to Directing (Ren Mai) and Penetrating Vessels (Chong Mai) so as to produce monthly periods. If there aren't enough Liver Blood, it results in scanty period or even absence of periods.

The patients may also suffer from insomnia and dream disturbed sleeps because the Ethereal Soul (Hun) fails to be anchored and housed in the Liver at night. 

Causes

Precursor patterns: Liver Blood Deficiency can derive from Blood Deficiency Kidney Essence Deficiency Gallbladder Deficiency Liver Qi Deficiency Spleen Blood Deficiency Spleen and Heart Blood Deficiency

Diet: The Spleen is responsible for making Blood which then get stored in the Liver. The Spleen function can be largely weakened due to a diet poor in nutrition or lacking in Blood generating foods, such as red meat or grains. As a result, less Blood for the Liver.

Emotional stress: Emotional stress such as sadness and grief can consume Liver Blood directly.  On the other hand, these emotions may also first harm Qi, which then resulting in poor Blood formation.

Physical over-exertion: Excessive physical exercise mainly harms the Spleen Yang. As a result, the Spleen's foods transforming and transporting function is impaired, thus less Blood can be generated and stored in the Liver.  Excessive exercise also injures the sinews. Since the Liver controls, moistens and nourishes sinews, which in long run, can give rise to Liver Blood Deficiency. 

Profuse Blood lose: The Liver stores the Blood. Therefore a serious haemorrhage (such as during childbirth or long term heavy periods) can also lead to Deficiency of Live Blood.

Diagnosing Liver Blood Deficiency

Pulse type(s): Choppy (Se) or fine (Xi)

Tongue description: Pale tongue, especially on the sides with thin, dry and white coating

Main symptoms: Insomnia Dry hair Dry skin Pale lips Dizziness Amenorrhea Depression Blurred vision Scanty periods Muscle weakness Floaters in eyes Tingling of limbs Dull-pale complexion Numbness in the limbs Dream disturbed sleep Feeling of aimlessness Diminished night vision Withered and brittle nails

Diagnosis commentary: Key characteristic symptoms of this pattern are the blurred vision, scanty periods and dull-pale face.

Treating Liver Blood Deficiency

Treatment principle

Tonify the Liver, nourish the Blood in the Liver. 

Herbal formulas used to treat Liver Blood Deficiency

Si Wu Tang

Source date: 846 AD

Number of ingredients: 4 herbs

Key actions: Restores and nourishes Blood. Stimulates Blood circulation.

Formula summary

Si Wu Tang is a 4-ingredient Chinese Medicine formula. Invented in 846 AD, it belongs to the category of formulas that tonify Blood.

Besides Liver Blood Deficiency, Si Wu Tang is also used to treat Blood Deficiency or Blood Stagnation.

Read more about Si Wu Tang

Bu Gan Tang

Source date: 1742 AD

Number of ingredients: 7 herbs

Key actions: Tonifies and regulates the Blood. Nourishes the Liver Yin.

Formula summary

Bu Gan Tang is a 7-ingredient Chinese Medicine formula. Invented in 1742 AD, it belongs to the category of formulas that tonify Blood.

Besides Liver Blood Deficiency, Bu Gan Tang is also used to treat Liver Wind agitating Internally due to Liver Blood Deficiency or Liver Yin Deficiency.

Read more about Bu Gan Tang

Diet recommendations

Try lamb, Dong quai and Ginger soup, bone soups, milk, black and aduki beans, congee, all cooked foods. Also be careful to not skip meals.

Try other therapies such as contemplation, meditation, breathing exercises, oil massage, moxibustion over the lower abdomen and Kidneys. 

Try light aerobic and stretching exercises including Yoga, Tai Chi and Qi Gong. 

Working on emotional issues. 

Avoid Saunas and hot tubs, over-work, over-exercises or excessive sexual activities. 

 

Consequence patterns

Spleen Blood Deficiency

If left untreated Liver Blood Deficiency can lead to Spleen Blood Deficiency

Spleen and Heart Blood Deficiency

Liver Blood Deficiency may lead to Heart and/or Spleen Blood deficiency, so that a deficiency of Blood of all three organs (Heart, Liver and Spleen) may occur at the same time.

Heart Blood Deficiency

Heart Blood Deficiency is the most common Pathological development of Liver Blood Deficiency for two reasons.

First of all, since the Liver is responsible for storing the body Blood,  a general Blood Deficiency usually starts with Liver Blood Deficiency. Heart Blood Deficiency follows too as the Heart governs Blood.  

Secondly, according to the Five Phases Theory, the Liver is the Mother of the Heart. Therefore, a Liver pathology is easily transferred to the Heart. For instance, just like Liver Blood Deficiency can easily affect the Heart, Liver Fire can also impact the Heart, resulting in Heart Fire

Liver and Heart Blood Deficiency

Heart Blood Deficiency often happens alongside Liver Blood Deficiency

Kidney and Liver Yin Deficiency

If left untreated Liver Blood Deficiency can lead to Kidney and Liver Yin Deficiency

Blood Deficiency

The Liver stores the Blood, so the lacking of Blood in the Liver gives rise to the general Blood Deficiency. 

Liver Qi Stagnation

Liver Blood and Liver Qi mutually impact each other as they are the Yin and Yang aspect of the Liver. The Qi drives the Blood, while the Blood supplies Qi. 

Liver Yang Rising

For female patients, Liver Blood Deficiency is
the most common cause of Liver Yang Rising. The typical symptom is headache. The patients often have two kinds of headaches, a mild one from Liver Blood Deficiency and occasional attacks of a severe, throbbing headache from Liver Yang rising. 

Kidney Essence Deficiency

The Liver and Kidneys share a very close physiological relationship. One of the Liver's main function is to store Blood and it plays an important role in forming Essence which are mainly stored in the Kidneys

Therefore, Liver Blood Deficiency can cause lacking of Essence in the Kidneys or vice versa, especially for women. For example, these with prolonged heavy periods are more likely to have Kidneys Essence Deficiency, because the Blood is essential for preserving and generating Essence. 

Liver Yin Deficiency

Prolonged Liver Blood Deficiency is always the precursor of Liver Yin Deficiency. 

Liver Wind agitating Internally due to Liver Blood Deficiency

When Liver Blood is Deficient, it leads to Liver Yang Rising. If not treated for some years, it agitates the internal Liver Wind. 

Liver Blood Stagntion

Deficient Liver Blood leads to Deficient Qi, which then fails to move Blood and thus cause Liver Blood Stagnation. 

Liver Qi Deficiency

Blood supplies to generate Qi, hence the Liver Qi Deficiency pattern. 

Kidney Yin Deficiency

In women, a long-standing Deficiency of Liver Blood may lead to Kidney Yin Deficiency.