
5 Herbal Formulas to Resolve Anemia
Anemia is the most common blood disorder and currently affects over 3 million Americans. The disorder can be caused by a variety of issues from iron deficiency to an autoimmune disorder called aplastic anemia.
Doctors of Chinese Medicine utilize herbal formulas to support hemopoiesis, the body’s production of red blood cells, a phenomenon suppressed in anemia.

Herbs
A nationwide retrospective study in Taiwan in 2021 investigated whether Chinese herbal medicine is beneficial to patients with aplastic anemia. Aplastic anemia is a rare autoimmune form of anemia.
These patients with aplastic anemia experienced bone marrow failure and destruction of hematopoiesis. The study found seven clinically used Chinese herbal medicine products to combat aplastic anemia. These products included Gui-Pi-Tang and Xian-He-Cao.
The patients who used Chinese herbal medicines had lower risks of anemia-related mortalities in comparison to those who did not. This difference was even found after adjusting for age, gender, comorbidities, and the usage of blood transfusion therapies among others.
1. Ren-Shen-Yang-Rong-Tang

Pepper
In 2007, researchers administered the formula Ren-Shen-Yang-Rong-Tang to animal models. The study found the herbal formula lowered the severity of anemia.
The formula protected immature erythroid progenitor cells- baby red blood cells produced by the bone marrow that are reduced in anemia.
RSYRT may include twelve herbs:
- Dangshen (Radixcodonopsis pilosulae)
- Huanqi (Astragalus mongholicus)
- Baizhu (Rhizome atractylodes macrocephala)
- Fuling (Paria cocos)
- Chenpi (Pericarpium citri reticulatae)
- Shengdi (Radix rehmanniae)
- Baishao (Radix Paeoniae alba)
- Danggui (Angelica sinensis)
- Wuweizi (Fructus schisandrae; schixandra berry)
- Yanzhi (Radix polygalae)
- Rougui (Cortex cinnamomi; cinnamon)
- Gancao (Radix glycyrrhizae; licorice)
2. Si-Jun-Zi-Tang
In 1996, researchers evaluated the effect of the Chinese herbal formula Si-Jun-Zi-Tang on blood cell production in mice models. The mice first received the formula and then received radiation to decrease their white and red blood cell count.
The study found the formula to protect bone marrow stem cells and thus protect against the destruction of blood cells. These cells include leukocytes, erythrocytes, thrombocytes, and hematocrit.
The study concluded that Si-Jun-Zi-Tang had a significant benefit to these mice. Thus suggesting that Si-Ju- Zi-Tang can clinical benefit syndromes such as anemia in humans.
3. Si-Wu-Tang

Herbs
A similar study in 2006 looked at another formula in irradiated mice models for anemia. Si-Wu-Tang (SWT) traditionally includes Radix Paeoniae Alba (bai shao yao), Rhizoma Ligusticum Chuanxiong (chuan xiong), Radix Angelica Sinensis (dang gui), and Radix Rehmanniae Preparata (shu di huang). Other ingredients included are fructose, paeoniflorin, ferulic acid, and tetramethyl pyrazine.
The researchers pulled these herbs apart to see if one had a significant impact over the others. The researchers evaluated the formula’s efficacy on the number of progenitor cells in bone marrow, including colony-forming unit immature erythroids.
All the herbs alone and in combinations had slightly different effects, but the results suggested that multiple herbs contributed to SWT’s effect on hematopoiesis. The researchers interestingly noted that when combined, more effects occurred than with a single herb alone. Overall, they found an advantage of multiple herbs in a formula to support the blood.
Researchers in 2016 explored how the formulas Si-Jun-Zi-Tang (SJZT) and SWT affect blood deficiencies. They found SJZT to contain 61 ingredients and target 209 genes and SWT to include 195 ingredients and impact 243 genes.
A formula can have a complex effect because each formula contains several herbs, each of which includes many ingredients and have multiple targets. For example, the SWT formula specifically stimulates hematopoiesis in bone marrow.
A large observational study in Taiwan in 2018 assessed the application of Traditional Chinese Medicine herbs for anemia. The most common single herb prescribed was Astragalus membranaceus and the most common formula included was Si-Wu-Tang.
The study found Chinese herbal medicine to be a beneficial therapy for anemia. A total of 41,028 patients were assessed and the participants reported that Chinese herbal medicine helped relieve symptoms and signs associated with anemia.
4. Dang-Gui-Yao-San
Dang-Gui-Yao-San is another mixture of herbs traditionally used as a therapy for anemia. The mixture contains Angelicae sinenis (Oliv). Diels, Ligustucum chuanxiong Hort, Paeonia lactiflora pall, Poria cocoos (Schw.) Wolf, Atractylodis macrocephalada Koidz and Alisma orientalis (Sam.) Juzep.
An animal study in 2005 found the formula to decrease mitomycin C-mediated hemolysis, a mechanisms that protects red blood cell breakdown.
5. Siwu Decoction

Herbs
Traditional Chinese Medicine commonly uses the Siwu decoction for promoting blood circulation. The formula includes Semen Persicae, Flos Carthami, Angelica Sinensis, Radix Paeoniae Alba, Rhizoma Chuanxiong, and Radix Rehmanniae Praeparata.
In 2017, researchers assessed the efficacy of Siwu decoction on iron deficiency anemia in rat animal models. The models either received the Siwu decoction or participated in the model group. In the Siwu decoction group, blood parameters such as serum iron were increased and the extent of pallor noted on the red blood cells was decreased.
Additionally, A systematic review in 2019 summarized the cardiac effects of Siwu in animal models. The writers concluded that the cardiac improvements may be due to positive modifications in the microenvironment, explaining the potential benefits for anemia.
Final Notes
Anemia results in compromised red blood cell health. Traditional Chinese Medicine offers a variety of herbs that reduce or prevent red blood cell damage seen in anemia.