Nourishing the blood is one of the strategies that I use most often in my clinic. It is an underlying and often missed issue in multiple disease conditions, especially those related to inflammation and circulation. Any body tissue, vessel or organ that is in distress depends upon a healthy supply of fresh blood to heal, so this strategy is used as part of many healing regimens. It becomes very important in diseases where adequate blood supply is essential to deliver nutrients and immune cells, such as cancer therapy, wound healing and vision problems.
This condition is more common in women, especially middle age or post-menopausal women, because, in TCM theory, the woman’s body has to generate more blood throughout life due to menstruation. And when hormones decline after menopause, blood circulation is affected because the hormones vitalize the blood circulation.
Common symptoms of what is called “blood deficiency” by TCM doctors, and ojaskshya or raktakshya by Ayurvedic doctors include low blood pressure (or high blood pressure if there is arterial hardening restricting blood flow), various forms of ischemia, cold fingers and toes (including Raynaud’s syndrome, both primary and secondary), and mental or physical fatigue (high blood pressure for other reasons may also be present).
Other slightly less common symptoms include thinning hair, heart palpitations or tachycardia, dizziness upon standing (postural hypotension) or vertigo (especially if there is hypoglycemia), falling asleep of arms or legs (especially when pressure is applied when sleeping), restless legs or leg cramps (especially at night), frequent infections, menstrual cramps, headaches of various sorts, slow healing, low sex drive, sinus issues, ringing in the ears, nails that break easily or grow slowly, and low blood sugar. Infertility is also an issue here, as the uterus requires adequate blood.
In some cases, if the blood deficiency has progressed to a more advanced Yin deficiency, then there will be heat signs instead of coldness.
Joints, ligaments and connective tissue are also sensitive to blood deficiency, as they get a more indirect supply than other tissues. This condition is similar to anemia, but different in many respects. Often there are no signs of true anemia, but rather an underlying drop in total blood volume or delivery to tissues. With blood deficiency, the fingers and toes are often the first joints to have problems.
Nerve tissue is especially sensitive to blood deficiency, and so nourishing blood is a very important strategy for many neurological issues, including mild anxiety, stress issues, memory and concentration issues, nervousness, dryness syndromes and tremors or spasms (sometimes severe).
Pain or neurological syndromes after injury that seem to persist without cause may occur also, as the tissues and nerves cannot heal properly in this deficiency state. Because fibromyalgia is related to pain signals from the nerves that can be the result of blood deficiency (circulation to the muscles), I often nourish blood to treat this form of pain. Blood deficiency is more common in people with Vata natures (thin, sensitive ectomorphs).
Moreover, when circulation to tissues is deficient (low level ischemia) the immune system will step in and release inflammatory cytokines in a measured way to induce nitric oxide synthase (eNOS) to relax and dilate vessels to restore the circulation the tissue needs to survive.
However, this same mechanism, which is beneficial in the short run, becomes destructive over time if the underlying cause of the ischemia is not addressed. The constant presence of inflammatory cytokines can lead to autoimmune tissue damage. Blood deficiency leads to chronic ischemia in the tissues. This can be observed in ordinary life when taking a brisk walk in clean air and boosting circulation to the whole body quickly creates a sense of well being and refreshment.
Common causes of blood deficiency include dysbiosis (digestive problems), side effects of chemotherapy, digestive weakness or poor appetite, blood loss due to fibroids, severe stress and overwork, and thryoid problems. However, even otherwise healthy athletes can get this condition, one sign in women being scanty or absent periods. Poor digestion or dieting is another culprit.
It is important to understand that the many herbs that affect circulation are not all the same. Ginkgo leaf, for example, while excellent for circulation, does not provide the same nourishing qualities found in shou wu or dang gui root.
TCM doctors have a unique application that demonstrates the power of this herbal treatment. They use herbs to nourish the hair roots and treat alopecia (hair loss). At our clinic we have seen many, many women and some men restore hair loss using herbs over the course of three months to a year or more.
TAM doctors differentiate conditions and the appropriate herbal treatment by determining what is causing the hair loss. If the hair is simply falling out it is more of an inflammatory condition, and should be treated as such. If the hair is fragile and breaks off, it is more of a deficiency condition that requires nourishment.
The same herbs used to nourish and bring healthy blood to the hair roots are beneficial direct or adjunct treatments for cold fingers and toes, as well as eyes (including glaucoma and macular degeneration), sense of taste, smell or hearing, skin (including acne), joints and muscles.
They are also very beneficial when there is stagnant or insufficient blood contributing to blocked or inflammed arteries or veins, wounds that do not heal, dry skin or scalp, vision problems, constipation, chronic infections, weak functioning or chronic inflammation (including autoimmune inflammation of skin, joints, eyes etc.) in any internal organ or body area. Breathing often improves with these herbs due to effects on oxygen delivery to the lungs.
Recommended Herbal Treatments for Hair Loss
• I use a base formula of eclipta, shou wu root, raw rehmannia, cooked rehmannia, salvia root, schisandra fruit, dang gui root, mu gua fruit (Chaenomelis lagenaria), chiang huo rhizome (Notopterygium species) and dang shen root (Codonopsis pilosula) to nourish the hair roots. The dose is two grams of concentrated granules twice per day. This can be given in concentrated herbal granule extracts, or with pills.
• If the patient is hypothyroid or has a tendency toward coldness (Yang deficiency), I add deer antler to the base formula, as well as DHEA and thyroid gland extracts. Alternately, supplements for the thyroid can be used.
• If there are signs that the condition is more inflammatory, I will add herbs to clear liver heat to the base formula, such as scute root, burdock root or dandelion root.
• Essential oils can be a good adjunct treatment for alopecia. In a study published in the Archives of Dermatology, 44% of patients who massaged essential oils (thyme, rosemary, lavender, and cedarwood) in a mixture of carrier oils (jojoba and grapeseed) into their scalp daily had improvement (Hay et. al 1998).
• Alternatively, various Ayurvedic hair oils can be applied a few times a week at bedtime, usually consisting of sesame oil with gotu kola leaf and/or eclipta herb.
• Herbal treatments for hair loss based upon nourishing blood usually work better for women than men. The reason may be related to DHT, an inflammatory testosterone metabolite. Herbalist David Winston, AHG, and Dr. James Duke, Ph.D. both report theoretical and anecdotal evidence that using saw palmetto berry can be of help due to its effect on the inflammatory DHT, which apparently kills off or otherwise compromises hair follicles (Winston, 1999, Duke, 1997). Small amounts of progesterone cream may be another way to do this.