Hypothyroidism - Phlegm-Dampness Internal Obstruction Pattern

TCM differentiation and treatment for hypothyroidism with

Hypothyroidism · Phlegm-Dampness Internal Obstruction Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body


Pattern Overview

Phlegm-Dampness Internal Obstruction is a common pattern in

hypothyroidism, characterized by **glycosaminoglycan deposition,

myxedema, heavy sensation, sticky mouth, and fluid retention**. The core

pathogenesis is accumulation of Phlegm-Dampness in the body due to

impaired Spleen transformation, leading to interstitial fluid retention

and myxedema.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

mouth, weight gain |

Associated Symptoms

loose stools |

Tongue and Pulse

coating, slippery pulse |

Pathogenesis Phlegm-Dampness accumulating in the body
Etiology

hypothyroidism |


Acupuncture Point Prescription

Point Location Function
Fenglong (ST40)

to the tibial crest | Transforms Phlegm and Dampness |

Pishu (BL20) Lower back, 1.5 cun lateral to T11

of Spleen meridian; strengthens Spleen Qi |

Zhongwan (RN12) 4 cun above the umbilicus

Stomach; harmonizes the Stomach |

Yinlingquan (SP9) Below the medial condyle of the tibia

Transforms Dampness and promotes diuresis |

Zusanli (ST36)

to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |

Clinical Recommendation: Filament needle, even method; moxibustion

may be applied to Pishu and Zhongwan to strengthen Spleen and transform

Dampness.


Herbal Formula

Base Formula: Er Chen Tang (二陈汤) + Wu Ling San (五苓散)

Composition:

Pinellia (Ban Xia), Tangerine Peel (Chen Pi), Poria (Fu Ling),

Atractylodes (Bai Zhu), Alisma (Ze Xie), Polyporus (Zhu Ling), Cinnamon

Twig (Gui Zhi), Licorice (Gan Cao)

Action: Transforms Phlegm, drains Dampness, and promotes diuresis.

Modifications

Associated Symptoms Additions/Subtractions
Severe myxedema Add Fu Ling, Zhu Ling to promote diuresis
Heavy sensation Add Huo Xiang, Pei Lan to transform Dampness
Sticky mouth Add Cang Zhu, Hou Po to dry Dampness
Chest tightness

distension |


Western Mechanism Reference

Glycosaminoglycan deposition causing interstitial fluid retention,

myxedema, and serous cavity effusions. Phlegm-Dampness Internal

Obstruction corresponds to hypothyroidism with myxedema and fluid

retention, where glycosaminoglycan accumulation and reduced metabolism

contribute to interstitial fluid retention.


References

1. Internal Medicine of TCM - Phlegm-Fluid with Phlegm-Dampness.

2. DB-XJB: Er Chen Tang.

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


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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.