Herbs for Anemia

Anemia is a prevalent blood disorder, impacting over 3 million Americans. This condition manifests due to a range of factors, spanning from iron deficiency to the emergence of autoimmune disorders like aplastic anemia.

Chinese medicine practitioners harness the power of herbs for anemia, to aid hematopoiesis, the body’s vital process of generating red blood cells. Furthermore, this blog will discuss anemia and its symptoms and causes, along with 5 Chinese herbal formulas that reduce the severity of anemia, their herbal compositions, and supporting scientific studies.

Table of Contents:

• What is Anemia?
• Anemia Signs and Symptoms
• What Causes Anemia
  • Blood Loss
  • Decreased Red Blood Cell Production
  • Increased Red Blood Cell Destruction
• Drug and Surgical Treatments for Anemia
• Alternative Anemia Treatments: Traditional Chinese Medicine
• Blood-Boosting TCM Herbs
  • Ren-Shen-Yang-Rong-Tang 
  • Si-Jun-Zi-Tang
  • Si-Wu-Tang
  • Dang-Gui-Yao-San
  • Siwu Decoction
• Final Thoughts

What is Anemia?

Anemia: a medical condition characterized by a deficiency in the number or quality of red blood cells, or a lack of hemoglobin (the protein in red blood cells that carries oxygen). 

Having anemia is like running a factory with too few workers on the floor. The factory (your body) is designed to produce and transport goods (oxygen), but without enough workers (red blood cells or hemoglobin), the production slows down, deliveries get delayed, and everything starts to run inefficiently. The entire operation struggles to keep up, leaving things feeling sluggish and underpowered.

Anemia Signs and Symptoms

Anemia leads to a reduced capacity of the blood to transport oxygen to the body’s tissues, causing symptoms like:

• Fatigue and Weakness – Persistent tiredness and lack of energy, even with rest.
• Pale or Yellowish Skin – Unusual paleness or a yellow tint to the skin.
• Shortness of Breath – Difficulty breathing, especially during physical activities.
• Dizziness and Lightheadedness – Feeling faint or dizzy, particularly when standing or exerting yourself.
• Rapid or Irregular Heartbeat – Heart palpitations as the heart works harder to compensate for low oxygen levels.

What Causes Anemia?

Anemia can be caused by a variety of factors, typically grouped into three main categories:

1. Blood Loss

• Heavy menstrual periods (common in women of reproductive age)
• Gastrointestinal bleeding (from ulcers, hemorrhoids, or cancers)
• Injuries or surgery leading to excessive blood loss
• Chronic conditions like inflammatory bowel disease (IBD), which can cause slow, prolonged blood loss.

2. Decreased Red Blood Cell Production

• Nutritional deficiencies such as iron, vitamin B12, or folate deficiency, which are necessary for producing healthy red blood cells.
• Chronic diseases like kidney disease, cancer, or autoimmune disorders, which can suppress the production of red blood cells.
• Bone marrow disorders such as aplastic anemia, where the body’s bone marrow fails to produce enough red blood cells.
• Hormonal imbalances (e.g., hypothyroidism) can interfere with red blood cell production.

3. Increased Red Blood Cell Destruction

• Hemolytic anemia where red blood cells are destroyed faster than they can be replaced. This can be due to genetic disorders like sickle cell disease or thalassemia.
• Autoimmune conditions in which the immune system mistakenly attacks red blood cells.
• Infections or certain medications can also cause premature destruction of red blood cells.

Each cause leads to a shortage of healthy red blood cells or hemoglobin, impairing the body’s ability to deliver oxygen efficiently.

Drug and Surgical Treatments for Anemia

 

Treatment	Use	Downsides
Iron Supplements	Treats iron-deficiency anemia by replenishing iron levels.	Gastrointestinal side effects (constipation, nausea, diarrhea), poor absorption.
Vitamin B12 and Folate Supplements	Treats anemia caused by vitamin B12 or folate deficiency.	Mild side effects like itching or diarrhea; injections needed for absorption issues.
Erythropoiesis-Stimulating Agents (ESAs)	Stimulates red blood cell production, used for chronic disease-related anemia.	Increased risk of blood clots, strokes, heart attacks; high cost.
Corticosteroids/Immunosuppressants	Reduces immune system attacks on red blood cells (autoimmune anemia).	Long-term use can cause weight gain, osteoporosis, high blood sugar, infections.
Blood Transfusions	Provides immediate increase in red blood cells for severe anemia.	Risk of allergic reactions, infections, iron overload, and transfusion complications.
Bone Marrow/Stem Cell Transplant	Replaces damaged bone marrow, used in severe cases (e.g., aplastic anemia).	High-risk procedure; risk of infection, rejection, graft-versus-host disease.
Splenectomy (Spleen Removal)	Reduces red blood cell destruction in hemolytic anemia.	Increased risk of infections, as the spleen plays a key role in the immune system.

Anemia can be treated with a range of drug therapies and surgical options, depending on the cause and severity. Common drug treatments include iron supplements for iron-deficiency anemia, as well as vitamin B12 or folate supplements for nutritional deficiencies. These treatments are generally effective but can cause side effects like gastrointestinal issues with iron supplements or mild reactions to B12 injections. 

Surgical options are more invasive and are typically reserved for more serious forms of anemia. A bone marrow or stem cell transplant may be needed for bone marrow failure but comes with significant risks, including graft-versus-host disease and infection. 

Ultimately, surgical interventions can help manage the condition but involve the usual surgical risks, including recovery time and potential surgical complications. 

Alternative Anemia Treatments: Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) offers a holistic approach to treating anemia by addressing its root causes rather than just alleviating symptoms. Through herbal remedies, acupuncture, and dietary therapy, TCM aims to restore balance to the body’s energy (Qi) and improve blood production.

 TCM treatments may complement conventional methods by enhancing overall well-being, reducing fatigue, and supporting long-term recovery without the side effects associated with pharmaceutical treatments.

For example, a comprehensive 2021 nationwide study conducted in Taiwan investigated the potential benefits of Chinese herbal medicine for individuals with aplastic anemia. The study identified seven clinically used Chinese herbal products, including Gui-Pi-Tang and Xian-He-Cao, that showed promise in treating this condition. Patients who used these herbal medicines had a significantly lower risk of anemia-related mortality compared to those who did not, with this benefit remaining notable even after adjusting for age, gender, comorbidities, and the use of blood transfusions.

Blood-Boosting TCM Herbs

Herb	Active Ingredients	What It Treats
Angelica sinensis (Dang Gui)	Ferulic acid, ligustilide	Nourishes blood, regulates menstruation, treats fatigue
Ligusticum chuanxiong (Chuan Xiong)	Ligustrazine, ferulic acid	Invigorates blood circulation, alleviates headaches
Paeonia lactiflora (Bai Shao)	Paeoniflorin, albiflorin	Nourishes blood, relieves pain, regulates menstruation
Poria cocos (Fu Ling)	Polysaccharides, triterpenoids	Strengthens the spleen, reduces swelling, calms the mind
Atractylodes macrocephala (Bai Zhu)	Atractylenolides, polysaccharides	Strengthens Qi, supports digestion, combats fatigue
Alisma orientale (Ze Xie)	Alisol A and B	Drains dampness, promotes urination, supports kidney function

1. Ren-Shen-Yang-Rong-Tang

Ren-Shen-Yang-Rong-Tang (also known as Ginseng Nourishing Decoction) is a traditional Chinese herbal formula commonly used to tonify Qi, nourish the blood, and strengthen overall vitality. It is often prescribed for conditions related to deficiency of both Qi and blood, which can manifest as fatigue, weakness, shortness of breath, and pale complexion—symptoms commonly seen in anemic patients.

The formula typically contains a blend of herbs, including Ren Shen (Ginseng) to boost energy and strengthen the spleen, and Dang Gui (Angelica Sinensis) to nourish the blood. Other ingredients may include Huang Qi (Astragalus), Bai Shao (White Peony Root), and Gan Cao (Licorice Root), all working synergistically to improve circulation, enhance immune function, and promote general well-being.

RSYRT may include twelve herbs:

• Dangshen (Radixcodonopsis pilosulae)
• Huanqi (Astragalus mongholicus)
• Baizhu (Rhizome atractylodes macrocephala)
• Fuling (Paria cocos)
• Chenpi (Pericarpium citri reticulatae)
• Shengdi (Radix rehmanniae)
• Baishao (Radix Paeoniae alba)
• Danggui (Angelica sinensis)
• Wuweizi (Fructus schisandrae; schixandra berry)
• Yanzhi (Radix polygalae)
• Rougui (Cortex cinnamomi; cinnamon)
• Gancao (Radix glycyrrhizae; licorice)

This potent blend aims to boost qi and blood production while enhancing overall energy levels.

Its rich combination of herbs is believed to invigorate the spleen and replenish blood, making it a valuable remedy in traditional Chinese medicine for addressing anemia by improving blood circulation, promoting red blood cell production, and restoring vitality to those experiencing symptoms of fatigue and weakness due to low blood count.

In 2007, scientists conducted an experiment using the Ren-Shen-Yang-Rong-Tang formula on animal models. Their findings revealed that this herbal formula effectively reduced the severity of anemia by safeguarding immature erythroid progenitor cells—these are the fledgling red blood cells originating from the bone marrow, typically diminished in cases of anemia.

2. Si-Jun-Zi-Tang

Si-Jun-Zi-Tang, a classic Chinese herbal formula, is often utilized in traditional medicine to address anemia. Comprising a blend of four medicinal herbs—ginseng, poria, atractylodes, and licorice—this formula primarily focuses on strengthening the spleen and replenishing qi.

By enhancing the digestive system and supporting the body’s ability to absorb nutrients, Si-Jun-Zi-Tang aims to improve the production of red blood cells and enhance the overall vitality of individuals experiencing anemia-related symptoms, such as fatigue and weakness.

Its balancing properties help:

• boost energy levels
• stimulate appetite
• aid in the restoration of blood health

In 1996, researchers evaluated the effect of the Chinese herbal formula Si-Jun-Zi-Tang on blood cell production in mice models. The mice first received the formula and then received radiation to decrease their white and red blood cell count.

The study found the formula to protect bone marrow stem cells and thus protect against the destruction of blood cells. Therefore, this study suggested that Si-Ju- Zi-Tang can clinically benefit syndromes such as anemia in humans.

Read More: 5 Surprising Facts About Ginseng

3. Si-Wu-Tang

Si-Wu-Tang is another herbal formula known for its usefulness in treating anemia. Composed of four key herbs—Chinese peony, Chinese angelica root, white peony root, and rehmannia—this blend is specifically designed to nourish and invigorate the blood.

A large 2018 observational study assessed the application of Traditional Chinese Medicine herbs for anemia. The most common single herb prescribed was Astragalus Membranaceus and the most common formula included was Si-Wu-Tang. The study found Chinese herbal medicine to be a beneficial therapy for anemia. A total of 41,028 patients were assessed and the participants reported that Chinese herbal medicine helped relieve symptoms and signs associated with anemia.

Si-Wu-Tang aims to:

• regulate menstrual cycles
• alleviate blood deficiency symptoms
• promote overall blood circulation
• address fatigue, pallor, and irregular menstruation 

Herbal formulas can have complex effects because each formula contains several herbs, each of which included many ingredients and had multiple targets. For example, researchers in 2016 explored how the formulas Si-Jun-Zi-Tang (SJZT) and SWT affect blood deficiencies, and found the SWT formula specifically stimulates hematopoiesis in bone marrow.

Additionally, a study in 2006 looked at another formula in irradiated mice models for anemia. Researchers pulled Si-Wu-Tang herbs apart to see if one had a significant impact over the others. All the herbs alone and in combinations had slightly different effects, but the study’s results suggested that multiple herbs contributed to SWT’s effect on hematopoiesis.

Read More: 10 Incredible Uses of Astragalus | Astragalus for Kidneys

Watch: Ancient Herbalism – How Healing Formulas are Constructed

4. Dang-Gui-Yao-San

Dang-Gui-Yao-San is a traditional Chinese herbal formula commonly used to treat anemia. This mixture contains several well-known herbs, including:

• Angelica sinensis (Oliv.) Diels
• Ligusticum chuanxiong Hort
• Paeonia lactiflora Pall
• Poria cocos (Schw.) Wolf
• Atractylodes macrocephala Koidz
• Alisma orientale (Sam.) Juzep. 

It is particularly effective in alleviating symptoms of anemia such as fatigue, pallor, and irregular menstruation, while also enhancing overall vitality and restoring blood health. In TCM, this formula is considered a powerful remedy for those suffering from blood depletion or poor circulation.

A 2005 animal study found that Dang-Gui-Yao-San significantly reduced hemolysis (the breakdown of red blood cells) mediated by mitomycin C, indicating a protective effect on red blood cells. This research highlights the formula’s potential to support red blood cell health and improve anemia symptoms.

5. Siwu Decoction

TCM commonly uses Siwu decoction for promoting blood circulation. The formula includes:

• Semen Persicae
• Flos Carthami
• Angelica Sinensis
• Radix Paeoniae Alba
• Rhizoma Chuanxiong
• Radix Rehmanniae Praeparata

Siwu Decoction is widely valued in traditional Chinese medicine for addressing anemia-related concerns such as fatigue, pallor, and irregular menstruation. By harmonizing blood production and circulation, it serves as an effective remedy for anemia, aiding in the restoration of vitality and blood health.

In 2017, researchers assessed the efficacy of Siwu decoction on iron deficiency anemia in rat animal models. The models either received the Siwu decoction or participated in the model group. In the Siwu decoction group, blood parameters such as serum iron were increased, and the extent of pallor noted on the red blood cells was decreased.

Additionally, A systematic review in 2019 summarized the cardiac effects of Siwu in animal models. The writers concluded that the cardiac improvements may be due to positive modifications in the microenvironment, explaining the potential benefits for anemia.

Read More: How to Make Traditional Chinese Medicine Herbal Formulas, Decoctions, and Teas

Final Notes