Hypothyroidism - Liver Depression with Spleen Deficiency Pattern

Dr. Li Wei, DACM

Hypothyroidism · Liver Depression with Spleen Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Liver Depression with Spleen Deficiency is a common pattern in hypothyroidism, particularly associated with Hashimoto’s thyroiditis, fatigue, depression, and stress-related immune dysfunction. The core pathogenesis is chronic stress causing Liver Qi depression, which overacts on the Spleen, leading to immune dysregulation and progressive thyroid dysfunction.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, depression, irritability, poor appetite, thyroid enlargement |

| Associated Symptoms | Stress-related symptom exacerbation, chest tightness, frequent sighing, bloating |

| Tongue and Pulse | Pale red tongue with thin white coating, wiry pulse |

| Pathogenesis | Liver depression and Spleen deficiency leading to immune dysregulation |

| Etiology | Chronic stress, emotional distress, autoimmune thyroiditis (Hashimoto’s) |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver Qi |

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen Qi |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |

| Qimen (LR14) | On the chest, 4 cun lateral to the midline, below the nipple | Front-Mu point of Liver meridian; regulates Liver Qi |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Regulates Qi and Blood; harmonizes Liver and Spleen |

Clinical Recommendation: Filament needle, reducing method for Liver points, reinforcing method for Spleen points; combine with stress reduction techniques.

Herbal Formula

Base Formula: Xiao Yao San (逍遥散) + Liu Jun Zi Tang (六君子汤)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Angelica (Dang Gui), Atractylodes (Bai Zhu), Poria (Fu Ling), Pinellia (Ban Xia), Tangerine Peel (Chen Pi), Licorice (Gan Cao), Mint (Bo He)

Action: Soothes Liver Qi, strengthens Spleen Qi, and harmonizes the body.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Thyroid enlargement | Add Xia Ku Cao, Zhe Bei Mu to soften and resolve masses |

| Depression | Add Yu Jin, He Huan Pi to relieve depression |

| Stress-related exacerbation | Add Huang Qi, Dang Shen to strengthen the immune system |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

Western Mechanism Reference

Autoimmune thyroiditis (Hashimoto’s) with stress-induced immune dysregulation and progressive thyroid dysfunction. Liver Depression with Spleen Deficiency corresponds to Hashimoto’s thyroiditis, where chronic stress and immune dysregulation contribute to autoimmune thyroid destruction and progressive hypothyroidism.

References

  1. Internal Medicine of TCM - Goiter with Liver Depression and Spleen Deficiency.

  2. DB-XJB: Chai Shao Liu Jun Zi Tang.

  3. WHO. (2023). Thyroid disorders. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for thyroid health.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM endocrine health.