Abnormal Bloodwork, Normal Scans — How Can TCM Treat What Western Medicine Can't Handle?

A  Patient with Unexplained Symptoms: How Chinese Medicine Provided Answers

On April 27, 56-year-old Ms. LM was accompanied by her husband on a several-hour drive from San Jose in Northern California to my clinic in Diamond Bar, Southern California. She reported that she had recently seen her primary care physician (PCP) due to dizziness, headache, brain fog, extreme fatigue, poor concentration, memory decline, nighttime dry mouth and bitter taste, frequent hiccups (which brought temporary relief), diarrhea, inability to tolerate cold foods, constant hunger pangs, and an unintentional weight loss of 15 pounds over two years.

When her blood test results came back on April 21, her PCP called and told her that multiple values were abnormal and instructed her to go to the emergency room immediately. She followed the advice and went to the ER, where she underwent an EKG, X-ray, abdominal CT, and liver fibrosis scan — all of which came back normal. The ER doctor prescribed no medication and sent her home.

Because her PCP had sent her to the ER, but all tests found no cause, and she was given no treatment, the patient was under tremendous stress and didn't know what to do. Although there are many acupuncturists in the Silicon Valley area, she didn't know which one was trustworthy. Her husband, who had been treated by me several years ago for severe palpitations, depression, and anxiety with excellent results, suggested she make the trip to Diamond Bar to see me.

She said that even after sleeping 9 hours a night, she still woke up feeling exhausted and fatigued, and the constant hunger pangs were extremely distressing.

The patient appeared depressed, lethargic, and her complexion was sallow. History-taking revealed that she had been diagnosed as a hepatitis B carrier in 2023 and had been taking tenofovir disoproxil fumarate since then. In addition, she had been diagnosed with H. pylori last year and took a one-week course of antibiotics.

Upon reviewing her bloodwork, I found that the abnormal values were not as severe as I had anticipated. It was likely the combination of complex symptoms and significant weight loss that prompted her PCP to send her to the ER.

Laboratory Findings (April 21):

Parameter                          Result                   Normal Range                Status

WBC                                       3.5                            4-11                              Low

Neutrophil %                     30%                         40-70%                          Low

Lymphocyte %                46%                         22-44%                          High

TCM Pattern Differentiation:

Spleen yang deficiency with internal cold-dampness accumulation, liver qi stagnation invading the stomach and spleen, qi and blood deficiency, and failure of clear yang to ascend to the head.

Possible Contributing Factors:

Hepatitis B carrier status + H. pylori history → Liver and Spleen disharmony

In TCM, the hepatitis B virus is often classified as "damp-heat epidemic toxin." Long-term viral carriage can damage the Liver and Spleen. In addition, antibiotic treatment for H. pylori further compromised Spleen yang. Since the Spleen and Stomach are the source of qi and blood production, damage to these organs leads to qi and blood deficiency.

Treatment Strategy:

Warm the Spleen and transform dampness, supplement qi and nourish blood, soothe the Liver and regulate qi.

The patient came to the clinic in person twice, receiving both herbal medicine and acupuncture at each visit, with one telehealth follow-up in between. Due to the distance, each prescription was for 20 days.

April 27 — Initial Visit

Tongue: white, thick, and moist coating.

Pulse: Both pulses were floating and wiry.

Pattern differentiation: Cold-dampness trapping the Spleen, Liver qi stagnation, qi and blood deficiency.

Treatment Focus: Warm the Spleen and transform dampness, soothe the Liver and regulate qi, supplement qi and nourish blood.

May 14 — Telehealth Follow-up (Patient couldn't come in person)

Patient Feedback: Headache significantly reduced; dizziness improved by about 1/3 (only occurs when hungry); diarrhea resolved. Still fatigued, sleepy, hiccupping, and easily hungry. The hunger pangs were so intense they made her restless and uncomfortable.

Tongue (photo): Thick coating (especially on the back half), white with a light yellow tinge in the center → Cold-dampness gradually transforming, internal heat beginning to manifest.

Pulse: Both pulses were floating and wiry

Pattern differentiation: Cold-dampness is gradually transforming, and stomach heat is beginning to manifest externally

Treatment Focus: Continue core Spleen-strengthening and Liver-soothing herbs to consolidate the foundation; add heat-clearing herbs.

June 15 — Second In-Person Visit

Patient Feedback: Dizziness, hiccups, and hunger pangs completely resolved; sleep is good; mental and physical energy significantly improved; weight gradually returning. However, she still feels fatigued, has a dry mouth and bitter taste in the morning, discharge in the inner corners of her eyes with blurred vision at the outer corners, and cold insteps at night. These symptoms had been present all along but were previously overshadowed by her more severe complaints.

Tongue: Still white, thick, moist coating.

Pulse: Floating and wiry

Pattern differentiation: Cold-dampness has not yet been fully resolved, with upper heat and lower cold, Liver heat, and qi deficiency

Treatment Focus: Continue Spleen-strengthening and Liver-soothing; add herbs to supplement qi, disperse Liver heat, and warm Kidney yang (targeting eye discharge and blurred vision). The patient is currently taking this prescription.

TCM Treatment Features and Advantages

1. Dynamic Pattern Differentiation with Treatment Based on Stage

All three prescriptions focused on strengthening the Spleen, supplementing qi, and soothing the Liver — but with different emphases:

• Initial visit: Warming and transforming cold-dampness as the priority

• Second visit: Adding heat-clearing herbs

• Third visit: Warming yang, clearing Liver heat, and brightening the eyes

2. Combination of Acupuncture and Herbs

• Internal herbal medicine: Regulates the body's qi mechanism

• Electro-acupuncture + cupping: Unblocks the channels and collaterals

3. Holistic Regulation — Not Just Looking at Lab Numbers

Western medicine focuses on "abnormal values," while Chinese medicine focuses on the "patient's state." Although the patient hasn't yet had a follow-up blood test, her quality of life has already improved dramatically — which exemplifies the TCM approach of "treating the person" rather than just "treating the disease."

Key Takeaways for Readers

• Abnormal blood tests don't necessarily mean "you're sick," nor does "normal" mean you're healthy. When Western medicine cannot find a clear cause, TCM pattern differentiation can offer a different perspective.

• "Nothing found on tests" doesn't mean nothing is wrong. This patient underwent a full ER workup and ultimately found answers through TCM.

• Cold-dampness constitution is becoming increasingly common — eating cold/raw foods, a sedentary lifestyle, chronic sleep deprivation, and overuse of air conditioning all quietly damage our Spleen yang.

• "Upper heat, lower cold" is a common modern-day pattern — dry mouth/bitter taste (upper heat) + cold feet/diarrhea (lower cold) indicates the middle jiao (Spleen/Stomach) is blocked, preventing yang qi from communicating between the upper and lower body.

• Healing takes time. This patient improved significantly in under two months, but her tongue, pulse, and fatigue have not fully normalized — indicating the root cause still needs further consolidation.

Conclusion

• This patient went from "emergency room workup" to "significant symptom reduction" in less than two months. Her case teaches us:

• When modern medicine can't find the answer, TCM's "pattern differentiation and treatment" can often provide a unique entry point.

• Not all problems come from "organic pathology." Many bodily signals — fatigue, dry mouth, dizziness, diarrhea — are actually "distress calls" from dysfunctional internal organs. By regulating organs, harmonizing qi and blood, and unblocking the channels, TCM helps the body restore its own balance.

• If you or your loved ones are struggling with similar "medically unexplained" symptoms, consider giving TCM a try — it may offer a turning point, just as it did for this patient.

  
  

  Disclaimer: This case is based on real medical records, with all identifying information anonymized. TCM treatment requires individualized pattern differentiation. For health concerns, consult a reliable licensed TCM practitioner or specialist.

  
  

  Reminder: Experience and knowledge between TCM practitioners or specialists vary. Please be careful when you select.