Healthy  spinach in a school garden (urine fertilised)

In Chinese medicine, what we call the “blood” represents much more than just that which runs through our veins. “Blood” stands for that which nourishes the organs, moistens the tissues of the body, and supports the Spirit. To this end, those who have received the Chinese medicine diagnosis of, “blood deficient” may indeed not be considered anemic to Western doctors; they can even have excess iron levels (as is seen in the case of hemochromatosis).

Blood tonics in Chinese medicine, then, are those foods and medicinals that support the building of this nourishing, and lubricating substance in the body. As the blood is created by the Spleen*, stored in the Liver*, and governed by the Heart*, these organs are largely targeted when working to nourish the blood.

*These organs do not necessarily refer to the Western organs of the same name, but are umbrella terms for physiological functions defined within the traditional Chinese medicine paradigm.

Foods to Tonify the Blood

Meats & Seafood

  • Bass
  • Beef
  • Beef stock
  • Chicken
  • Eel
  • (Gelatin)
  • Liver
  • Mussels
  • Octopus
  • Oysters
  • Perch
  • Shrimp
  • Squid
  • White fish

Fruits & Vegetables

  • Apples
  • Apricots
  • Carrots
  • Fennel
  • Grapes
  • Longans
  • Lychees
  • Plums
  • Red beets
  • Red cabbage
  • Red grapes
  • Spinach
  • Sprouts
  • Sweet cherries

Nuts & Seeds

  • Sesame seeds
  • Sunflower seeds


  • Amaranth
  • Oats
  • Rice (short-grain, glutinous)

Beverages & Other

  • Carrot juice
  • Egg yolks
  • Hibiscus tea
  • Plum juice
  • Red beet juice
  • Red grapejuice
  • Red wine (in moderation)
  • Rosehip tea
  • Royal jelly
  • Sweet cherry juice


As I mentioned earlier, the Chinese medicine diagnosis “blood deficiency” may or may not coincide with the Western diagnosis anemia. For this reason I’d like to address two other common concerns I see in my practice regarding blood deficiency: Iron deficiency and B12/folate deficiency.

Iron-Deficiency Anemia

Those who are blood deficient (Chinese medicine diagnosis), but have excess iron stores (Western diagnosis, “hemochromatosis”) will want to avoid the following foods. On the other hand blood-deficient folks who are also deficient in the mineral iron specifically, you might want to:


the following iron-containing foods:

  • Clams, steamed
  • Liver
  • Black-strap molasses
  • Beef steak, lean
  • Pumpkin seeds
  • Sesame seeds
  • Goji berries
  • Spinach, cooked
  • Navy beans, cooked
  • Swiss chard, cooked
  • Sunflower seeds
  • Chlorophyll
  • Hijiki seaweed
  • Nettles
  • Wheatgrass


the following foods when supplementing with iron as these foods impair iron absorption:

  • tea (tannins)
  • coffee (tannins)
  • dairy (calcium and phosphorus)
  • whole-grain cereals (phytates/fiber)

Iron from animal sources will be absorbed more readily than that obtained from other sources (in some cases 10 times more) due to its being bound into heme. Additionally, MFP factor found in animal-sourced irons aids the absorption of non-heme iron consumed at the same time.

Coupling any of the above plant-based foods with vitamin C from citrus or tomatoes will significantly increase the absorption of its non-heme iron (think: three times as much). Lastly, using cast-iron cookware is an excellent way to introduce (substantially) more iron into the diet.

Vitamin-Deficiency Anemia

Beyond iron deficiency, folks lacking B12 and folate can also develop anemia (as these vitamins are required to make red blood cells).


As one of the few vegetarian Chinese medicine practitioners out there, I work with a number of vegetarian and vegan patients. I explain that with this diet and lifestyle choice, comes the responsibility to maintain balanced nutrition.

Vegans do not get B12 from their diet (with the exception of small amounts from nutritional yeast and fortified foods); and for this reason they will need to supplement with B12 and folate, ideally sublingual 5-MTHF and methylcobalamin. Dairy-free vegetarians also need to be mindful of this need to supplement.


Other causes of vitamin-deficiency anemia may be related to poor absorption, stemming from any number of causes such as chronic alcoholism to lack of instrinsic factor in the gut.

When to Take Herbs

Maintaining a balanced diet rich in the nutrients we need is everyone’s first medicine. But when you start to feel off-balance or concerned with symptoms (e.g. palor, fatigue, poor sleep, brain fog, weak hair and/or nails, etc) that’s the time you want to make an appointment to see an herbalist. By getting a proper differential diagnosis you can start targeting the organ(s) affected with a formula tailored specifically to your condition and constitution.


  • “Anemia – B12 Deficiency.” MedLine Plus. (, accessed 07/14)
  • Kastner, Joerg. Chinese Nutrition Therapy. 2008.
  • Pitchford, Paul. Healing with Whole Foods. 2002.
  • Sizer, Frances and Eleanor Whitney. Nutrition: Concepts and Controversies. 2002.
  • “Understanding Anemia — Basics.” WebMD. (, accessed 07/14)