Hypothyroidism - Liver Depression with Spleen Deficiency
TCM differentiation and treatment for hypothyroidism with
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 |
|---|
appetite, thyroid enlargement |
| Associated Symptoms |
|---|
tightness, frequent sighing, bloating |
| Tongue and Pulse |
|---|
pulse |
| Pathogenesis |
|---|
immune dysregulation |
| Etiology |
|---|
thyroiditis (Hashimoto's) |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Taichong (LR3) |
|---|
metatarsals | Source point of Liver meridian; soothes Liver Qi |
| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 |
|---|
of Spleen meridian; strengthens Spleen Qi |
| Zusanli (ST36) |
|---|
to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |
| Qimen (LR14) |
|---|
the nipple | Front-Mu point of Liver meridian; regulates Liver Qi |
| Sanyinjiao (SP6) | 3 cun above the medial malleolus |
|---|
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 |
|---|
masses |
| Depression | Add Yu Jin, He Huan Pi to relieve depression |
|---|
| Stress-related exacerbation |
|---|
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.
Related TCM Patterns for Hypothyroidism
Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.