Hypothyroidism - Spleen-Kidney Yang Deficiency Pattern

Dr. Li Wei, DACM

Hypothyroidism · Spleen-Kidney Yang Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Spleen-Kidney Yang Deficiency is a core pattern in hypothyroidism, characterized by reduced basal metabolic rate, fatigue, cold intolerance, myxedema, and weight gain. The core pathogenesis is Spleen and Kidney Yang deficiency failing to warm and transform the body, leading to reduced metabolism, fluid retention, and systemic hypofunction.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, cold intolerance, weight gain, myxedema (swelling) |

| Associated Symptoms | Poor appetite, loose stools, frequent urination, cold extremities, pale complexion |

| Tongue and Pulse | Pale and swollen tongue with thin white coating, deep and weak pulse |

| Pathogenesis | Spleen-Kidney Yang deficiency failing to warm and transform |

| Etiology | Congenital deficiency, chronic illness, overwork, cold food intake |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Shenshu (BL23) | Lower back, 1.5 cun lateral to L2 | Back-Shu point of Kidney meridian; warms Kidney Yang |

| Mingmen (GV4) | On the midline, between L2 and L3 spinous processes | Warms Kidney Yang and strengthens the body |

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

| Guanyuan (RN4) | 3 cun below the umbilicus | Warms Yang and supplements Qi |

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

Clinical Recommendation: Filament needle, reinforcing method; heavy moxibustion is strongly recommended to warm Spleen and Kidney Yang.

Herbal Formula

Base Formula: Fu Zi Li Zhong Tang (附子理中汤) + You Gui Wan (右归丸)

Composition:

Aconite (Fu Zi), Dried Ginger (Gan Jiang), Ginseng (Ren Shen), Atractylodes (Bai Zhu), Rehmannia (Shu Di), Cinnamon (Rou Gui), Deer Antler Glue (Lu Jiao Jiao), Licorice (Gan Cao)

Action: Warms Spleen and Kidney Yang, tonifies Qi, and strengthens the body.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe cold intolerance | Add Ba Ji Tian, Yin Yang Huo to warm Yang |

| Myxedema (swelling) | Add Fu Ling, Zhu Ling to promote diuresis |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |

Western Mechanism Reference

Thyroid hormone deficiency causing reduced basal metabolic rate, glycosaminoglycan deposition, and myxedema. Spleen-Kidney Yang Deficiency corresponds to hypothyroidism with significant metabolic and fluid retention symptoms, where reduced thyroid hormone levels lead to decreased metabolism and glycosaminoglycan accumulation.

References

  1. Internal Medicine of TCM - Fatigue with Spleen-Kidney Yang Deficiency.

  2. DB-TCMJB: Kidney Yang Deficiency/Spleen-Qi Deficiency.

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

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