Nutritional Support for Vegetarians with Blood Deficiency and/or Anemia

Blood deficiency in Chinese medicine may or may not mean anemia. To put it another way, blood deficiency can show up when the blood isn’t as vital as we would like it to be. This occurs before someone manifests anemia. Anemia is a more advanced case of blood deficiency in TCM.

Blood deficiency often has symptoms of fatigue, a tendency to easily develop tendonitis or other wandering joint pains, suffer from diffuse headaches, tight neck and shoulders, and feeling easily frustrated or overwhelmed. If there is also a spleen and stomach qi deficiency, then individuals may bruise easily and find themselves often stuck in ruminating thoughts that cause them to worry or feel anxious. Female patients may have heavy mense. In severe cases, individuals may see brittle nails, and experience hair loss.

Insomnia- especially trouble falling asleep– is also a common symptom.

In TCM, the pattern of blood deficiency is typically liver blood deficiency. There may be some underlying spleen and stomach qi deficiency that is inhibiting the proper absorption of nutrients from food. If the building blocks for creating blood are not being absorbed, then it is pretty challenging for the body to make blood.

It is important to note that the sensations of anxiety, stress, and overwhelm from liver blood deficiency can feel quite debilitating at times. If you have liver blood deficiency, there is a real physiologic reason that you feel this way. Sometimes having an idea why we feel the way we do, can help us sit with the uncomfortable emotions or simply love ourselves a little bit more during the process.

The good news?

There is quite a bit that we can do to support and even overcome blood deficiency with nutrition based on Chinese medicine. Sometimes if it is severe or has been going on for many years, it is also helpful to seek out the care of an acupuncturists to pair with your home-based nutritional focus.

While anyone can develop blood deficiency, this post is focused on treating blood deficiency with a vegetarian or vegan diet, since it is often a little more challenge for vegetarians and vegans to address blood deficiency. It often involves a little more leg work in food combining.

From a Chinese medical nutrition angle we look at foods that support the liver and foods that look like blood to address liver blood deficiency.

Fresh beet on wooden background

Liver supporting foods: 

Foods that naturally support liver blood are:

  • Dark green leafy vegetables (spinach, swiss chard kale, collard greens, mustard greens, sorel, shiso, nettles, beet greens)
  • Other green vegetables: broccoli, cabbage, brussel sprouts
  • Beets
  • Iron rich foods
  • It is also important to drink mushroom broth almost daily. 1/2-1 cup of broth daily can help build the nutrients for healthy liver blood
Flax seeds, sunflower seeds, sesame, chia and pumpkin seeds, isolated on white background

Iron rich vegetarian foods:

Legumes– especially black eyed peas, chickpeas (these have the most), next are white beans, kidney beans, soy beans (tofu), and lentils. Peas and all other beans do have good sources of iron.

Sesame seeds (black sesame seeds have 15% more iron than regular white ones).

Other seeds: hemp seeds, pumpkin seeds, flax seeds

Nuts like cashews and almonds

Dark green vegetables (overlaps with the liver supporting foods)

Mushrooms: oyster and white mushrooms contain good levels of iron in a one cup serving.

Whole grains: amaranth, oats, spelt, and quinoa contain good amounts of iron

Improving Iron Absorption is important for Vegetarians and Vegans

To improve iron absorption, it is important to eat iron rich foods combined with vitamin C. Many of the vegetables that contain iron, also contain vitamin C. An easy way to make sure you are pairing iron foods with Vitamin C is to pair it with fresh tomatoes or tomato paste, and/or squeeze citrus over your meal.

Eating foods high in lysine also helps iron absorption. Legumes and quinoa are good examples of foods high in lysine. These not only contain iron, but they also contain lysine. It’s a win win.

Avoid eating iron rich foods with coffee or tea at meals. Drinking coffee and tea with food can decrease plant based iron absorption by 50-60%.

Finally, cooking in cast-iron can help imbue your meals with iron.

Ways to support the Stomach and Spleen/Pancreas

Root vegetables and orange/yellow produce support the Stomach and spleen/pancreas.

Eating consistently during the day also helps strengthen these organs. The stomach likes to be a creature of habit. Eating something for breakfast, lunch, dinner, and a couple healthy snacks throughout the day can fortify the stomach. If you don’t have an appetite in the morning, that is actually one of the first signs of deficiency in the stomach, spleen/pancreas organs. Once these organs become more robust, you’ll start to feel hungry within 30 minutes of waking. In the meantime, try to eat something small within the first hour of waking to help your digestive system get back on track. Good options are whole grain toast or GF bread with nut butter or mashed avocado, or a chia pudding with poached fruit (can be made the night before), or a smoothie made with half fruit, half vegetables and protein powder.

Finally, eating consistently also makes sure that you have the fuel for your body to meet all the energetic demands placed upon it throughout the day.


Lindsey Thompson is an East Asian Medicine Practitioner at the Thompson Family Acupuncture Clinic in Walla Walla, WA. She loves growing vegetables, raising chickens, and striving to get the most out of life. Practicing medicine and help people find ways to improve their health at home is one of the most fulfilling aspects of her career. Check out her Chinese medicine based lifestyle and nutrition video series, Ancient Roots: What Chinese Medicine Can Teach Us About Our Diets. Link in the side bar of the blog.

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