Gui Pi Tang
Specifically for Anemia (Iron-Deficiency)
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Why it works for Anemia (Iron-Deficiency):
TCM rationale: Gui Pi Tang “augments Qi, nourishes Blood, strengthens the Spleen, and nourishes the Heart,” patterns that often co-present with fatigue, palpitations, poor appetite, and chronic/functional bleeding—symptoms that can overlap with IDA. Classical and teaching resources describe this indication and list the canonical ingredients (Panax ginseng, Astragalus, Atractylodes, Poria, Licorice [prepared], Longan, Ziziphus seed, Polygala, Angelica sinensis [dong quai], Costus, plus fresh ginger/jujube in some versions). ajtcvm.org
Mechanistic plausibility (components):
- Angelica sinensis (dong quai) and related formulas show hematopoietic effects in preclinical work. Memorial Sloan Kettering Cancer Center
- Ginseng (Panax ginseng) may affect energy/fatigue and has broad immunomodulatory actions (not specific to iron absorption). Memorial Sloan Kettering Cancer Center
Related herb-pair data that informs practice: A sister blood-tonic formula (Dang Gui Bu Xue Tang, different from Gui Pi Tang) enhanced iron uptake in cell and animal models and suggested spacing doses ~2 hours from ferrous sulfate due to interactions with iron chemistry. Clinicians sometimes extrapolate this spacing precaution to other blood-tonic formulas like Gui Pi Tang when they’re combined with iron. Dove Medical Press
How to use for Anemia (Iron-Deficiency):
1) Formula & dosage (traditional):
- A typical decoction uses the classical ingredient set; a veterinary journal’s human-oriented “formula spotlight” (helpful for exact herb amounts) lists a representative recipe:
- Ren Shen 6 g, Huang Qi 12 g, Bai Zhu 9 g, Zhi Gan Cao 3 g, Dang Gui 9 g, Long Yan Rou 12 g, Fu Shen 9 g, Yuan Zhi 12 g, Suan Zao Ren 12 g, Mu Xiang 6 g (fresh ginger/jujube often added). ajtcvm.org
- A practitioner reference details original powder method (12 g/dose) and notes most clinicians now use decoction with the “modern” per-herb gram ranges shown on the page. kamwo.com
2) Commercial granules/capsules: Many dispensaries provide Gui Pi Tang granules/capsules following similar gram-equivalents per day; the exact serving and frequency depend on brand standardization—follow label + practitioner guidance. (Examples of ingredient lists and preparation notes are provided by reputable TCM references.) sacredlotus.com
3) If you’re ALSO taking oral iron:
- Do not co-ingest with iron; separate by ~2 hours (precaution extrapolated from Dang Gui Bu Xue Tang + iron data to reduce potential interference and to avoid chelation/absorption issues). Continue your evidence-based iron plan prescribed by your clinician. Dove Medical Press
4) Duration & monitoring:
- For IDA, monitor hemoglobin, ferritin, transferrin saturation at clinically appropriate intervals while you treat the iron deficit; any herbal adjunct is evaluated against those labs and symptoms. Contemporary hematology guidance on iron repletion strategies underscores lab-guided follow-up. American Journal of Medicine
Scientific Evidence for Anemia (Iron-Deficiency):
Evidence directly testing Gui Pi Tang in iron-deficiency anemia is limited. Most data are (a) TCM-pattern studies, (b) related anemia contexts, or (c) mechanistic work on component herbs or related formulas.
- Renal anemia (hemodialysis or ESAs): A 2023 systematic review & meta-analysis of 7 RCTs (n=489) of Gwibi-tang (the Korean spelling of Gui Pi Tang) as an adjunct in renal anemia found improvements in anemia parameters when added to standard care with erythropoiesis-stimulating agents. (Population ≠ straightforward IDA, but relevant to anemia management.) JKom
- Aplastic anemia (not IDA): A nationwide Taiwanese retrospective study of Chinese herbal medicine use in aplastic anemia found reduced overall and anemia-related mortality among CHM users; multiple classical formulas (including Gui Pi Tang) were commonly prescribed. Association ≠ proof for Gui Pi Tang in IDA, but it signals safety/utility in hematologic conditions within integrated care. Frontiers
- Iron-handling (related formula): Laboratory and translational work with Dang Gui Bu Xue Tang demonstrated increased cellular iron uptake/ferritin and a practical 2-hour spacing recommendation relative to ferrous sulfate—often borrowed as a precaution for Gui Pi Tang when used with iron. Again: DBT ≠ GPT, but it’s the best-characterized “blood-tonic” iron-handling evidence. Dove Medical Press
Specific Warnings for Anemia (Iron-Deficiency):
Because Gui Pi Tang is a multi-herb formula, consider the sum of component risks—especially dong quai (Angelica sinensis), ginseng, and licorice (Glycyrrhiza):
Bleeding & anticoagulants/antiplatelets:
- Dong quai may increase bleeding risk and has case reports of warfarin potentiation (↑INR). Avoid or use only with clinician oversight if you’re on warfarin/direct oral anticoagulants/dual antiplatelet therapy. Memorial Sloan Kettering Cancer Center
- Ginseng has reported interactions affecting coagulation and peri-operative bleeding risk; discontinue at least 1 week before surgery. Memorial Sloan Kettering Cancer Center
Blood pressure/electrolytes:
- Licorice (Zhi Gan Cao) can cause hypertension and hypokalemia; it can also interfere with antihypertensives and certain cardiac medications. Use caution in patients with hypertension, heart, kidney, or liver disease. Memorial Sloan Kettering Cancer Center
Pregnancy & lactation:
- Avoid during pregnancy (dong quai is associated with miscarriage risk) and avoid while breastfeeding. Memorial Sloan Kettering Cancer Center
Hormone-sensitive cancers:
- Dong quai shows estrogenic activity in preclinical work; discuss with your oncology team if you have hormone-sensitive conditions. Memorial Sloan Kettering Cancer Center
Stimulation/insomnia:
- Ginseng can cause insomnia, nervousness, and tachycardia in some patients—dose timing may need adjustment. Memorial Sloan Kettering Cancer Center
Pattern mismatch (TCM):
- Classic cautions advise not using Gui Pi Tang in cases of internal excess heat or yin-deficient heat (i.e., if the presentation doesn’t match Spleen-Qi/Heart-Blood deficiency). Work with a licensed practitioner for proper pattern differentiation. sacredlotus.com
General Information (All Ailments)
What It Is
Gui Pi Tang, which translates as Restore the Spleen Decoction, is a classical herbal formula from traditional Chinese medicine. It was first recorded in the Ji Sheng Fang (Formulas to Aid the Living) during the Song Dynasty. The formula combines herbs that tonify both Qi (vital energy) and Blood, strengthen the Spleen and Heart, and calm the Shen (spirit).
The standard composition typically includes herbs such as:
- Ren Shen (Ginseng) or Dang Shen (Codonopsis) – tonifies Qi
- Huang Qi (Astragalus) – strengthens Spleen and raises Yang
- Bai Zhu (Atractylodes) – supports digestion and Spleen function
- Fu Ling (Poria) – drains dampness and supports the Spleen
- Suan Zao Ren (Ziziphus seed) and Long Yan Rou (Longan fruit) – nourish Heart Blood and calm the spirit
- Dang Gui (Angelica sinensis) – nourishes Blood
- Mu Xiang (Aucklandia) – promotes Qi movement to prevent stagnation from tonics
- Zhi Gan Cao (Honey-fried Licorice) – harmonizes the formula
- Sometimes Yuan Zhi (Polygala) is added to enhance calming of the mind
It is commonly prescribed for people experiencing fatigue, poor memory, insomnia, palpitations, anxiety, or menstrual irregularities — symptoms that arise from Spleen Qi deficiency and Heart Blood deficiency.
How It Works
In the TCM framework, the Spleen governs transformation of food into Qi and Blood, while the Heart governs Blood circulation and mental activity. When the Spleen is weak, it cannot generate sufficient Blood; when the Heart is under-nourished, emotional and cognitive symptoms arise.
Gui Pi Tang works through multiple synergistic actions:
- Tonifying Spleen Qi: Ginseng, Astragalus, and Atractylodes enhance digestive function and energy production, helping to rebuild Qi and support nutrient assimilation.
- Nourishing Heart Blood: Angelica sinensis, Longan fruit, and Ziziphus seed replenish Blood and moisten dryness that may disturb the Heart.
- Calming the Shen: The combined action of nourishing Blood and using tranquilizing herbs like Suan Zao Ren settles the mind, reducing anxiety and improving sleep.
- Harmonizing and Circulating Qi: Mu Xiang ensures that the rich tonic herbs do not cause stagnation or digestive heaviness, maintaining smooth Qi flow.
- Supporting overall vitality: The interaction of Qi and Blood tonics restores balance, leading to improved focus, emotional stability, and resilience to stress.
From a modern biomedical view, research suggests Gui Pi Tang may influence the nervous system, endocrine regulation, and immune modulation, possibly explaining its calming, adaptogenic, and restorative effects.
Why It’s Important
Gui Pi Tang is important because it addresses a common TCM pattern known as Spleen-Heart deficiency, which manifests in physical exhaustion and emotional fragility. It has been widely used for:
- Chronic fatigue and weakness from overwork or stress
- Insomnia, poor memory, and anxiety due to mental strain
- Palpitations or irregular menstruation from Blood deficiency
- Recovery support after illness, childbirth, or prolonged mental exertion
By strengthening both Qi and Blood, the formula nourishes the foundation of vitality and supports the integration of body and mind. It remains a cornerstone prescription for individuals who feel “drained,” “forgetful,” or “on edge” from both physical and emotional overuse.
Considerations
While Gui Pi Tang is gentle and restorative, several considerations apply:
- Pattern Differentiation: It should be used only when signs clearly indicate Spleen Qi and Heart Blood deficiency (e.g., fatigue, pale complexion, poor appetite, weak pulse). It is not suitable for conditions involving excess heat, dampness accumulation, or acute infections.
- Individualization: Dosage and specific herb substitutions (e.g., Ginseng vs. Codonopsis) should be tailored by a licensed practitioner to the person’s constitution and current symptoms.
- Duration of Use: The formula is designed for gradual, tonic support, not rapid symptom relief. It may be used for several weeks or months under supervision.
- Possible Side Effects: Rarely, if taken in excess or in individuals with sluggish digestion, it may cause bloating or fullness due to its tonifying nature.
- Modern Interactions: As it may affect energy metabolism and stress response, it should be used cautiously alongside stimulants, antidepressants, or immune-modulating drugs; consultation with a qualified healthcare provider is advised.
- Lifestyle Integration: For best results, users are encouraged to combine it with rest, proper diet (warm, easily digestible foods), and balanced emotional habits — all of which reinforce the Spleen’s role in TCM physiology.
Helps with these conditions
Gui Pi Tang is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Alzheimer's
TCM rationale. Gui Pi Tang (GPT) “tonifies Spleen-Qi and Heart-Blood” and “calms the Shen,” traditionally used for poor memory, insomnia, anxiety, fat...
Anemia (Iron-Deficiency)
TCM rationale: Gui Pi Tang “augments Qi, nourishes Blood, strengthens the Spleen, and nourishes the Heart,” patterns that often co-present with fatigu...
Brain Fog
TCM pattern logic. Brain fog often overlaps with poor concentration, forgetfulness, fatigue, insomnia, and anxiety. In TCM this commonly maps to Splee...
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