Types of Tired

How disharmony contributes to fatigue
In traditional Chinese medicine (TCM), there are various types of tiredness one can experience, often caused by depletion and stagnation. Between blood, spleen, and kidney qi imbalances, exhaustion represents in different ways. Identifying the type of tired you feel can help determine where your deficiency lies as well as how to properly treat the symptoms, identify the underlying cause, and support your body while healing.

Blood Deficiency

TCM looks at the functions of blood rather than the blood itself. Deficiencies are noted by observing the tongue, skin, muscle tone, hair and nails, pulse, and body temperature. The relationship between blood and Qi is like yin and yang. Blood nourishes the organs and produces Qi, but Qi gives movement to the blood. So, if blood Qi is depleted, there is blood stagnation, causing various physical and emotional ailments. In TCM, blood is responsible for nourishing the body by flowing healthy, dense, lubricating, and oxygen rich blood through the organs and vessels, and providing flexibility and moisture to tissues. If there is a deficiency, dryness will manifest. Shen, or consciousness, is nourished by the blood’s support of balanced mental and emotional states. Deficiencies in blood disturbs this support, leading to many emotional imbalances. A blood deficiency diagnosis can mean there is not enough blood in circulation, or the quality of the blood is compromised and can not provide adequate nourishment to function properly. Physical exhaustion from over strenuous activities, acute blood loss from childbirth, donating blood, or injury, regularly heavy periods, nutrient deficiencies, and genetic predispositions can all affect the quality and quantity of your blood.

Symptoms:
Dryness can cause stiff joints and muscles, cracking joints, chronically sore muscles that can not be relieved with hydration, and dry or brittle hair and nails.
Disrupted Shen can cause anxiety, poor memory, brain fog, irritability, unease, and insomnia.
Other symptoms include headaches behind the eyes, menstrual related migraines, persistent chill, numbness or tingling in hands and feel, dizziness and fainting, chronic fatigue, depression, mood swings, difficulty falling asleep or falling back asleep, menstrual irregularities like missing a period or light period, hair loss, dry skin, constipation, pale complexion, and a pale tongue.

Liver blood deficiencies are characterized by headaches behind the eyes, poor concentration and memory, visual disturbances, and tiredness that makes you feel drained by the end of the day. Heart blood deficiency will show with palpitations, anxiety, and insomnia.

Remedies:
Herbal formulas are a great tool to help nourish blood, but should be prescribed by a licensed practitioner. Adequate rest is crucial for blood recovery. This includes proper sleep, and taking time out of the day and week to rest your body and mind during the day.

Overwork can exhaust the blood, so even small breaks throughout the day are beneficial.

Dietary changes that focus on balanced and nourishing meals regularly throughout the day can build blood levels. Eat regularly throughout the day, incorporate grains, leafy vegetables, and red meat, eat cooked food, avoid raw food, drink plenty of water, and avoid food and drinks that disrupt digestion like refined sugars, dairy, excess alcohol, fried food, and spicy and bitter foods.

While exercise is crucial for preventing blood stagnation, excessive exercise while blood deficient can exacerbate symptoms. Instead, exercise multiple times a week, but not everyday, exercise to the point of sweating, but excessively sweating, and make the exercises enjoyable. Try dancing, hiking, working in the garden, or swimming to move Qi and support blood health. Hydration is key, and can come in the form of water, soups, herbal teas, and hydrating fruits and vegetables.


Spleen Qi Deficiency

When discussing deficiencies of the spleen, it is important to note that TCM’s understanding and approach focuses on functions relating to digestion, energy metabolism, emotions, seasons, flavors, and overall vitality, instead of the physiological spleen. The main function of the spleen is to assist the stomach in digestion, transforming and transporting food, allowing the body to absorb nutrients while separating out waste. The spleen is also considered the main organ for the production of blood Qi, gaining energy from ingested food and drink.

Spleen Qi deficiencies are often caused by stress, overexertion, poor dietary habits like skipping meals or over eating, emotional imbalances, irregular eating, consuming too much raw foods and drinks, worrying, or feeling anxious.

Symptoms:
Fatigue, headaches, brain fog, muscle tension, poor appetite, bloating after eating, abdominal distension, irregular bowel movements, loose stools, weakened immunity, a tendency to bruise easily, lack of energy, weakness, or prone to illness.

Remedies:
Eat warm and cooked foods, avoid cold or raw foods, and limit dairy and sugar intake. Ingesting raw food can hinder and tax digestion, whereas warm and cooked foods are easier to digest and absorb.

Foods like rice, millet, cooked vegetables, lean meats, cinnamon, cardamom, honey, ginger, basil, cloves, dill, fennel, cooked or roasted garlic, and nutmeg are all part of the proper diet to promote healthy spleen function.

Incorporate exercises like qi gong, tai chi, or yoga. Gentle movements will stimulate the spleen’s natural energy flow, and will help relieve stress, improve digestion, and cultivate a sense of mindfulness.

Getting proper, high quality sleep will ensure that the body is able to perform all restorative functions while the body rests, like repairing damaged tissues and regulating stress hormones. Inadequate sleep can raise the levels of the stress hormone called cortisol, which can create feelings of anxiety and overwhelm. Proper sleep will ease feelings of physical and emotional stress.


Kidney Qi Deficiency

Kidneys are responsible for regulating the metabolism of water, filtering waste from the blood, removing waste from the body via urine, driving growth and development, reproductive function, and the health of the hair, bones, teeth, and ears. They are also regarded as the source for all yin and yang in the body, as well as the home of jing, the energy that is given from our parents at birth and remains with us for the rest of our lives. When in balance, kidney Qi will promote proper urinary functions, feelings of confidence, a sense of energy and alertness, the ability to think clearly, and support strong and healthy hair, nails, bones, teeth.

When out of balance, symptoms of kidney Qi, or yang, deficiency are considered “internal cold” in TCM, meaning the body is unable to warm itself. If left unattended, the body will function with less strength overtime.

On the other hand, yin deficiency in the kidney can cause symptoms that are hot in nature, like night sweats or dizziness.

Symptoms:
Yin symptoms include night sweats, dizziness,
Yang symptoms include sore joints and muscles, cold extremities, weakness in lumbar area or knees, exhaustion, sensitivity to cold, frequent urination or incontinence, diarrhea, decreased libido, feeling withdrawn, and fluid retention.

Remedies:
Acupuncture can help warm the body by improving circulation, reducing dampness, regulating fluids, and promoting healthy digestion. By stimulating certain points, the kidney can be supported, restoring yang energy and releasing stagnation.

Eat foods like goji berries, walnuts, pine nuts, grapes, raisins, rice, foods that are blue-black like eggplant, black sesame seeds, black beans, kidney beans, plums, figs, dates, or seaweed.

Cooling foods like lettuce, watermelon, bean sprouts, watercress, and fish are cooling and support kidney Yin by clearing heat from the body.

Foods like kidney beans, mushrooms, sesame seeds, celery, barley, and seaweed are used to dry out dampness, and are ideal if you are retaining too much fluid. Avoid foods that are raw, cold, sweetened with refined sugar, dairy, bread, yeast, and beer, as these all promote dampness. Salt is thought to support the kidney’s natural detoxifying functions, so adding naturally salty foods like saltwater fish, prawns, lobster, scallops, oysters, and seaweed are appropriate ways to consume nourishing salt. Make sure to drink enough pure filtered water.

Understanding each type of deficiency and how it can affect your body is the first step towards treatment and better health. The type of tired that we feel can determine the deficiency. If you experience chronic fatigue and brain fog, you may be experiencing a blood deficiency. If you are feeling fatigue paired with weakness and stress, you may have a spleen deficiency. Exhaustion paired with chills or sweats can be a kidney yin or yang deficiency, but these deficiencies are all treatable with a proper diet, adequate rest, stress management, acupuncture, and research.


Resources

● https://www.runeacupuncture.com/blog/blood-deficiency-a-dx-of-depletion

● https://www.wildearthacupuncture.com/blog/2021/12/14/spleen-qi-defiency-what-is-it-

and-how-to-deal-with-

it#:~:text=To%20address%20Spleen%20Qi%20deficiency%2C%20it's%20crucial%20to

%20adjust%20your,can%20weaken%20the%20Spleen's%20function.

● https://heavenandearthmedicine.com/blog/2023/4/10/blood-deficiency

● https://bokettowellness.com/blogs/journal/spleen-qi-deficiency-explained

● https://pinnaclepdx.com/diagnosing-patterns-yang-deficiency/

● https://www.iffleyac.co.uk/wp-content/uploads/2015/09/Food-for-Yang-Deficiency.pdf

● https://thejadecentre.co.uk/tiredness-fatigue-traditional-chinese-

medicine/#:~:text=In%20TCM%2C%20there%20are%20two,or%20an%20%E2%80%9Cex

cess%20condition%E2%80%9D.

● https://www.euyansang.com/en_US/understanding-the-role-of-the-

kidney/eystcmorgans2.html

● https://redleafwellness.ca/blog/the-signs-of-kidney-yang-deficiency/

Staying Hydrated in Winter

How to Hydrate without Water

Winter is associated with the water element, the most nourishing and essential element for sustaining life. In these long, cool months, there is a great focus on slowing down, resting, conserving, turning energy inward, and staying hydrated. In TCM, proper hydration is crucial for optimal health and balance in the body. Hydration is closely linked to keeping the body’s yin and yang balanced, regulating fluids, promoting Qi, and sustaining the kidneys. While increased water consumption is advisable in the hot summer months, moderate consumption of water in winter is important to not cause excessive cooling of the body.


Tea

In TCM, the kidneys store jing, our vital essence, and Qi, and since an imbalance in the kidneys is easy in winter, it is important to drink lots of fluids. While a hot cup of green tea is going to warm your body up initially, it actually has cooling effects on the body, making it a more suitable tea for summer. It is essential to avoid unnecessary cooling of the body in winter, so drinking the proper tea for the winter season can keep your body warm and hydrated. Teas that have warming effects on the body include rose tea, chai tea, ginger tea, and black tea.

Rose tea can be enjoyed by steeping organic rose hips or petals in hot water for about 20 minutes. This tea boosts Qi, enriches blood, enhances mood, and is related to yin, making it the perfect tea to enjoy through the winter blues.

Chai tea is full of warming ingredients like black tea, cardamom, ginger, cinnamon, clove, nutmeg, black peppercorn, and sometimes chillies. These spices are added to milk and sugar to create a spicy tea that will keep your body warm. Chai tea can also be enjoyed sugar and milk free.

Ginger tea is warming and is used to boost the immune system, aid digestion, and enhance the

abundance and circulation of yang energy. Even though yang essence retreats during winter, this season is all about conservation to better prepare for the expansiveness of spring and summer, so yang support is still important. Add ginger to hot water and honey to taste, and enjoy a cup to battle colds or the flu.

Black tea is also warming, and improves digestion and boosts metabolism. Steep loose leaf or tea bag in hot water, add your favorite milk and honey, or enjoy black. Teas that are best left for the other months include oolong, chrysanthemum, jasmine, and green tea.

Golden Turmeric Tea Recipe
Turmeric is a warming and anti-inflammatory root that can ease any aches from wintery chills. Each ingredient of this tea has healing properties; turmeric invigorates the blood, alleviates pain, and promotes Qi circulation, black pepper warms digestion, dispels internal cold, ginger is warming, honey nourishes yin, and cinnamon warms the kidneys.

Ingredients:

● 2 cups of milk, preferably dairy free.

● 1 tsp turmeric

● 1 teaspoon raw honey or more to taste

● Pinch of ground black pepper

● ¼ inch fresh ginger, peeled or grated on a zester

● 1 tsp cinnamon

Directions:

Pour all ingredients into a saucepan and heat for 3-5 minutes over medium heat until hot but not boiling. Whisk while heating to mix all ingredients. Drink immediately. Recipe serves two.


Food

Warming or cooling foods are not categorized by their temperature, but rather by the effect they have on the body after consumption. In winter, eating foods with a high water content like bone broth with sea or himalayan salt will provide the body with all necessary nutrients while helping the body retain water and warmth. Focus on foods that share qualities of the water element, like dark colors, salty taste, and high water content. These foods include walnuts, almonds, chestnuts, seeds, oats, legumes, lentils, brown rice, lamb, chicken, salmon, shellfish, salt water fish, seaweed, spirulina, dark colored berries, root vegetables, black beans, mushrooms, onions, leeks, scallions, chives, sweet potato, whole grains, stews, soups, ginger, garlic, cardamom, cinnamon bark, clove, turmeric, warm cooked foods, and limiting cold and raw foods. Avoid cooling foods like raw salads, sushi, iced drinks, and dairy, as they all require extra energy to metabolize.


Healing TCM Soup Recipe

Ingredients:

Broth

● 1 whole 4-5 lb chicken, quartered and skin removed OR 3 large portobello mushrooms

cut into 1 inch pieces

● 1 gallon filtered water

● 2 cloves chopped garlic

● 3 stalks celery chopped

● 2 carrots chopped

● 1 large cucumber diced

● 2-3 inches fresh ginger, cut in half

● 1-2 inches fresh galangal, cut in half

● 2 tbsp apple cider vinegar


Soup

● 4 celery stalks

● 4-5 shiitake mushrooms, chopped

● 3 carrots chopped

● 1 bunch scallions, chopped

● 1 bunch cilantro, chopped

● Salt and pepper

Directions
To make the broth, add all ingredients in a pot and bring to a boil. Lower heat, cover, and simmer for 1.5-2 hours on low heat. Once done, pour through a colander and separate veggies from the chicken. Discard veggies, and pour broth back into the pot, bringing it to a simmer. Add in all soup ingredients except for the green onion and cilantro. Cover and simmer for 30 minutes.

While the broth is simmering, remove all meat from chicken, cut into small pieces, and add to the soup. Add scallions for the last 5 minutes of cooking. Serve with chopped cilantro sprinkled on top, and add salt and pepper to taste.

This winter, take advantage of the longer nights to slow down, rest, turn inwards, enjoy warm cups of tea, and hearty bowls of soup. Conserving energy now is important for maintaining it through the expansive summer months where depletion is easy, so like water, flow with the season and stay warm and hydrated.


Resources


● The Water Element: A TCM Approach to Winter Wellness — Balance Acupuncture -

Charleston, SC

● Staying Hydrated from a TCM Perspective - Mend Acupuncture

● TCM Winter Health Tips to Reflect & Recharge.

● https://urbanremedy.com/healing-traditional-chinese-medicine-soup-recipe-for-winer/

● ​​A TEA FOR ALL SEASONS - Rebalance Traditional Chinese Medicine

● Discover 8 Warming Teas as Defined by Traditional Chinese Medicine

● Winter Nourishment | TCM NYC | The Yinova Center

● Golden Turmeric Tea – Watertown Acupuncture