Fire and Water: A Chinese Medicine Guide to Understanding Adrenal Fatigue

Fire and Water: A Chinese Medicine Guide to Understanding Adrenal Fatigue

To really understand any state of imbalance, syndrome or disease I find it best to start with a Chinese Medicine understanding of what how a healthy body should be functioning. I like to start with the heart’s role in the body system but because the whole thing is a big feedback loop, it can begin anywhere you like.


Chinese medicine teaches us that the heart muscle is where the body’s heat is generated. The thermal energy created by the constant pumping of this organ creates the body temperature or as we say in Chinese medicine, yang. Heat rises inside the body, just like it does outside of the body. Unless the heat is acted upon by some other force, it will flare upward leaving the vital organs below the heart too cold for optimal health, when an organ is functionally “cold” we say that this organ has a yang deficiency. The body uses yang as a catalyst for all of the biological processes that need to happen, so we need this heat to reach all of our organs in optimal amounts if we want them to work properly.


The lungs are positioned perfectly to help keep the upper body cool and full of healthy moisture while also pushing the yang down into the lower body. Because yang is energy (like heat), and does not have a physical form, it travels throughout the body within the blood stream. Blood is more viscous than body fluid or gas in the body, and as such is the best material substance for yang anchor in. The yang is pushed from the heart through the abdominal aorta within the bloodstream, and moves into the organs of the lower body from there. The kidneys and adrenal glands directly receive yang and blood from the heart this way, giving them the strength they need to perform their functions. This relationship also creates a very direct and important link between the heart and the kidneys. Within the Chinese Medicine framework these two organ systems represent the elements of Fire (heart) and Water (kidneys) respectively.


Chinese medicine attributes a different natural element to each of the body’s organ systems, which can help us understand these organs’ function within the body. Fire is the element of the heart and water is the element of the kidneys. These two opposing forces can work against each other when out of balance, causing dysfunction and uncomfortable symptoms in the body. On the other hand, their opposing nature also works in our favor as they keep one another in check, helping us to find homeostasis. We can influence the balance of the elements within the body using Chinese herbal medicine, acupuncture, lifestyle and dietary practices.


When the heart’s fire (yang) is being pushed down into the cold water of the kidneys, the fire will heat up the water, creating movement within the fluid of the lower body. The same way that heat rises, cold water sinks down, so when water isn’t acted upon by fire, it will accumulate in the lower body. When fire is introduced to the water, the kidneys and bladder should have the energy to work together to filter and eliminate waste fluid from the body. This should leave no room for old water retention or incomplete urination. As the fire from the heart stimulates adequate heat within the kidneys, the water continues to heat up and healthy body fluid “evaporates” or moves upward throughout the body’s interstitial pathways.


Now this functional body fluid is circulating through the upper body as well, providing a healthy moisture to the lungs. If you recall, the lung’s proximity to the heart’s fire leaves them vulnerable to drying out and over-heating, so this moisture is vital to the lungs health and to keeping the fire in check. The moisture and the lungs help push the heart’s fire downward and on the cycle goes. The symptoms listed below are traditionally attributed to the kind of imbalance that happens when the fire from the heart doesn’t have the ability to descend into the water of the kidneys. The kidneys and adrenals become cold and sluggish, the body and mind become tired and heavy.


Over time the water can accumulate to a degree that the heart can no longer generate the necessary fire because you can’t light a match under water. This is a negative cycle set in motion. This is described as Adrenal Fatigue in holistic western medicine, and in Chinese Medicine as Kidney Yang deficiency or at a more advanced stage as Kidney Essence Deficiency.


Chinese culture has a long history of using special herbal and food based “longevity tonics” traditionally believed to keep the energy of the kidneys strong as we age and endure the stresses of life. Chinese medicine describes the process of aging literally as loss of kidney essence. To understand this perspective you can think of your kidneys as having two fuel tanks. The smaller tank of kidney energy (or qi) can be used up each day and replenished by nourishment and rest as we go. The second tank, our kidney essence (also called jing), is our larger reserve tank. When we use more than our daily allotment for kidney qi and don’t have the ability to refuel as we go, we start pulling from the reserve tank. The more we use the reserves, the faster we experience the symptoms of aging.



Chinese medicine seeks to slow this process down by helping to refuel the daily tank and prevent the premature use of the reserve tank. The over-use or premature use of this reserve tank of Kidney Essence will culminate in the symptoms of premature aging and Adrenal Fatigue, as western culture explains it. Of course, the kidneys and adrenal glands are very closely connected, and Chinese Medicine considers them all a part of the Kidney Organ System, so when I talk about Kidneys here, I mean the kidneys, adrenal glands, and the kidney’s energetic pathway throughout the body or meridian. So let’s talk about the symptoms of Adrenal Fatigue from a Chinese Medicine perspective.


I always find it interesting and a bit heartwarming when western medicine outlines symptoms that are correlated or lumped in with different syndromes but remain unexplained by their theories. The idea that a collection of random symptoms can reliably happen in the body and will be called a Syndrome when present, but these symptoms have no connection or underlying cause to me indicates a failure to step outside of ones given framework. It is important that we look at the body through more than one lens if we want to be able to truly have a positive impact on its health. This means understanding symptoms not only from a western scientific perspective, but also through an eastern perspective. Eastern medicine, specifically Chinese Medicine (because that’s what we’re talking about here) takes our internal and external environments and the effects of their subtle energies and interplay into account when looking at our health. It is all relevant to these complicated bodies we inhabit and learning from the wisdom of ancient cultures alongside modern scientific advances allows us to best achieve our health and quality or life goals. There is no magic pill to help one heal, most often we get into states of imbalance and disease due to many factors over a long period of time, and to regain our health and find balance again we must employ a multi-perspective, multi-faceted, and multi-modal approach to support our health.

For a recap on the holistic western perspective see Part 1 of this blog series on Adrenal Fatigue here.

  • Allergies: when Kidney yang is weak, it also means that the yang of the digestive system is weak. Depending on one’s constitution and life experiences the symptoms may show up more in one organ system than another, but the underlying deficiency will always effect both systems. When the digestive system is lacking in yang this means the digestive organs are getting less oxygenated blood flow than they need to optimally receive, digest, and assimilate the nutrients from food. Lack of blood flow also means there is a strong tendency toward inflammation. Inflammation in the gut creates the perfect set up for food allergies, sensitivities and an over-all hyper-reactive immune system. You’ve probably read about how closely linked our gut health is to our immune system. When we are living with inflammation in our digestive organs our immune system becomes easily over or under active, meaning we either experience all to frequent common cold symptoms (under-active immunity) or seasonal and food allergies (over-active immunity).
  • Dizziness or light-headedness:
    • 1) when we absorb less of our nutrients than we need for long enough we become blood deficient (and sometimes anemic). Blood deficiency leaves us feeling dizzy or light headed, especially when changing positions quickly.
    • 2) our kidneys have a lot to do with regulating our blood pressure, when they are lacking in yang they are functioning less than optimally which can often cause the body to hold fluid, increasing blood pressure. Alternatively, lack of kidney yang can also cause frequent urination in some people, causing us to lose valuable minerals and electrolytes, leading to low blood pressure. Both situations can cause dizziness and light-headedness.
    • 3) Nervous system imbalance due to chronic stress can lead to lower oxygen levels in the brain (Chinese Medicine says that the brain and cognitive function is controlled by the kidneys!), and a constant flooding of the system with stress hormones can lead to feelings of light headedness.
  • Sensitivity to light and sound: We check for healthy pupillary response (the black part in the center of your eye) in a Chinese Medicine exam to determine the health of kidney and adrenal yang. A healthy pupil should contract with light shone on it and dilate in the dark to let more light in. When the kidneys lack yang, this is reflected in the pupils, they do not have the strength to contract appropriately and depending on the severity they will either only partially contract with a bright light shone on them, or they will not respond at all. This leaves with eyes that are letting too much light in, and it becomes very intense and uncomfortable. People with kidney yang deficiency often wear sunglasses. Sound is similar, in Chinese Medicine we also say that the ears (like the brain) are controlled by the kidneys. When the kidneys are over-taxed and deficient in yang, the hearing becomes more sensitive as well. People often experience tinnitus or ringing in the ears, because the yang that is generated by the heart, and is supposed to be pushed down into the kidneys is unable to be anchored in the lower body. When this yang flares upward it harasses the upper body causing among other symptoms inflammation in the ear drum and ringing in the ears.
  • Sleep issues: when the body is unable to send the Yang that is being generated by the heart (fire) down into the Kidney organ system (water) the Yang will flare upward, as fire does. This is experienced for many as racing thoughts, over active mind, inflammation in the upper body that causes difficulty getting comfortable, possibly a racing heart or palpitations that all make falling asleep very difficult. Chronic and erratic stress hormone production mean that the body can be getting surges or adrenaline at any time of the day or night wreaking havoc on the body’s circadian rhythm. The presence or adrenaline at night will keep the body from producing helpful sleepy hormones like melatonin on its own as well. Anxiety and restlessness often lead people to cope with poor sleep hygiene, further exacerbating the problem. Of course lack of quality rest keeps the vicious cycle of chronic fatigue and Kidney yang deficiency going.
  • Craving salt: salt is the flavor associated with the Kidneys in Chinese Medicine. Often due to lowered kidney function, we see frequent urination that flushes valuable mineral salts from the body, or a reduction in absorption of nutrients in the first place. Good quality, mineral-rich unrefined sea or rock salt is vital to supporting kidney function. No refined table salt!
  • Low energy and Extreme Exhaustion: inappropriate release of stress hormones, lack of quality sleep, chronic sympathetic nervous system state due to stress, and lack of nutrient absorption are all typically present with Kidney Yang deficiency and culminate in poor energy. Depending on the severity of the yang deficiency this can feel like lower than ideal energy to deathly exhaustion.
  • Low Libido: lack of blood flow and Yang to the lower body will result in a lowered sex drive or function for all genders.
  • Reduced Athletic Performance: muscle weakness and lack of endurance are common symptoms of Kidney yang deficiency. The body doesn’t have the ability to release the appropriate stress hormones (even for good stress, like exercise), and it doesn’t have the yang to support spending energy (yang) on activities that are non-vital to its survival (for example digesting food is a priority for your body over jogging down the street).
  • Frequently Sick: When we are living with inflammation in our digestive organs our immune system becomes easily over or under active, meaning we either experience all to frequent common cold symptoms (under active immunity) or seasonal and food allergies (over active immunity).
  • Body Pain: chronic systemic inflammation due to poor nutrient absorption, hormone imbalance, lack of quality rest, blood deficiency and poor blood circulation can leave the body feeling hyper sensitive to physical discomfort. This can snowball into fibromyalgia type symptoms or chronic pain.
  • Anxiety and Depression: Chinese Medicine tells us that the brain, cognitive ability and brain chemistry are all controlled by the Kidney organ system. Fear or anxiety is the emotion most closely linked with Kidney Yang deficiency. The physical imbalance will lead to the emotional imbalance and the reverse is also true. Living with chronic Kidney Yang Deficiency will eventually lead to depression for most people due to the negative impact it has on one’s life and energy, on top of the nervous system imbalance that triggers anxiety.
  • Blood Sugar Regulation Problems: chronic stress and erratic release of adrenaline and cortisol will lead to trouble with blood sugar regulation. When the body is constantly preparing you for running for fighting (fight or flight) it is making sure you have the blood sugar to use as energy. This leads to spikes and drops in blood sugar as our stress hormones become more erratic the further our Kidney yang becomes depleted.
  • Hormonal Imbalance: hormonal imbalance leading to menstrual problems, menopausal symptoms, low testosterone and so many more uncomfortable disruptions in the body can be caused by chronic adrenaline and cortisol release in the body. When the Kidney Yang is deficient the hormonal messengers in the body become out of balance with one another and are unable to perform their tasks effectively for reproduction or other vital roles.
  • Brain Fog, ADD, Trouble Focusing, and Poor Memory: the Kidney organ system controls the brain. These are classic symptoms of Kidney Yang deficiency
  • Dark circles under the eyes and dull, ashen complexion: In Chinese Medicine we learn a lot about the interior of the body and its function by looking at the skin and complexion. The under-eye area is very thin skin and as such gives us a clear view of what is going on internally. A dark color under the eyes (regardless of skin-tone, this is a comparative darkness to the rest of the skin) is indicative of lack of good Kidney Yang. Black is the color of the Kidneys, and when we see this tone under the eyes we know that there is a yang deficiency happening in this organ system. When the over-all complexion has a dull or ashen tone to it indicates that this yang deficiency has gone on long enough that it is affecting other organ systems as well. This is often linked to low blood flow to the digestive system and blood deficiency.
  • Shortness of breath or difficulty taking a deep breath: In Chinese Medicine we say “the Kidneys grasp the Qi of the Lungs”. What this means is that when these two organ systems are in balance with each other they work together so that the lungs not only help to push the yang from the heart down through the abdominal aorta into the kidneys and adrenals, but that when the kidneys are strong and healthfully receiving this yang, they help to pull it down as well. It’s a positive feedback loop. When the Kidneys and Lungs are not working together, however, the Kidneys fail to “grasp the qi of the lungs” a very common symptoms you will experience is a shortness of breath for no apparent reason, a difficulty catching your breath, or a sensation like no matter how deep you try to breathe your breath is trapped in your chest and is unsatisfying.

The kidneys are such a vital point for our health from a Chinese medicine perspective and we should be working to protect them in everything we do. After (or during) experiencing a prolonged period of stress, exhaustion, illness or any other scenario that has caused us to spend more energy than we are able to replenish it is important to give the kidneys and adrenals some nourishment and care. If we continue to push ourselves without support, by living in “fight or flight” mode, not getting enough sleep, not eating the right foods, existing in a state of stress, the kidney yang will suffer and eventually the essence will become depleted. The ancient texts that first taught us about Chinese Medicine explain that this exhaustion of kidney energy will show up as aching along the kidney meridian (the low back, knees, and soles of the feet), premature greying of hair, fatigue, anxiety or fear, body fluid retention, sexual dysfunction, poor memory or declining cognition, bone density issues, insomnia and more.



By restoring the balance between fire and water, supplementing the kidney energy, and anchoring the yang in the lower body, we can make sure that the organ systems of the upper and lower body have the power they need to work in harmony. Chinese herbal medicine, in my experience is the most effective and powerful tool we have to achieve this balance, but there are other ways that help to keep this balance in such a chaotic world, once we’ve found it.

  • Dietary Choices: An essential part of maintaining strong kidney yang is a whole food based diet, filled with all the goodness of fresh fruits and vegetables, whole grains and the nourishment of warming spices. This kind of eating is more of a lifestyle than a diet. The food we put into our body literally becomes the cells with which our bodies function, and how healthy and functional these cells are is determined by their building blocks. Choose foods that support your goals, not work against them. Kidney support foods are often black or dark colored, salty or savory in flavor, and much more common in Asian cuisine than the typical American diet.
  • Try including foods in your diet like black sesame seeds, kelp, seaweed, dark leafy greens, eggplant, unrefined sea salt or pink Himalayan salt, bone broth, sardines, anchovies, black fungus or dark colored mushrooms, kidney beans, black beans, organ meats, oysters, black garlic, heirloom varieties of root veggies with purple or otherwise dark flesh, and wild rice. If you need help understanding your body’s patterns and dietary needs, please reach out to us. We offer customized Chinese medical dietary counseling and support to help you nourish your body in a way that supports your health goals.
  • Lifestyle Habits:
    • mindfulness practices like meditation, prayer, qi gong, tai chi, breathwork and deep breathing techniques, leisurely walks, time in nature, Epsom salt baths, balanced exercise and yoga can all be very helpful in reducing our daily stress and thereby allowing us to use less of our daily allotment of kidney qi. These types of practices also help to revitalize our kidney organ system when it has become over taxed, support our nervous system back into the calm parasympathetic state, and recharge our adrenal energy.
    • Establishing healthy sleep habits is another essential aspect of healing depleted kidney energy and adrenal fatigue. To start cultivating healthy sleep hygiene try implementing some of these practices on a daily basis: a consistent dinner time no later than 3-4 hours before bedtime, a “no screens” policy for at least an hour or 2 before bedtime (the longer the better!), opt for podcasts, relaxing music, light conversation, reading, writing, drawing, coloring or other analog activities in the evenings as often as possible, have a cup of your favorite relaxing herbal tea an hour or so before bed as a loving ritual to tell your nervous system that you’re winding down.
    • Put the “night time mode” or orange tinted cover on your phone or computer screens if you absolutely need to use them. The blue light that is emitted from our screens (and TVs) is interpreted by our brains as the same light that comes off the sun, it sends the message to our brains that its noon and we should be awake and energetic! Try not to send your body mixed messages at bed time, avoid the blue light when you can.


  • If you are really suffering from insomnia consider working with a practitioner or program for “Cognitive Behavioral Therapy for Insomnia” to help you create a customized sleep hygiene plan that works best for you. It makes a huge difference in breaking the cycle, I promise. You CANNOT cultivate stronger kidney and adrenal energy or refill your tank without good quality sleep, make it your priority.
  • Holistic Healthcare Practices: acupuncture, massage, chiropractic care, craniosacral therapy, somatic therapy, mindfulness based counseling and so many other professional healthcare modalities can assist us in finding the balance we need, relieving stress, releasing trauma patterns that are wearing us down, and cultivating a healthier relationship with the stressors in our lives. Our bodies hold onto stress and trauma. Sometimes this shows up as mental/emotional symptoms, sometimes as physical symptoms and often as both. We can’t always release this pattern on our own, sometimes having a trusted holistic healthcare practitioner to guide us through this is essential to strengthening and balancing our system. It takes a village, and that truth doesn’t stop at adulthood. The constant overwork of our kidneys and adrenals that holding onto trauma or chronic stress forces them into can be devastating to our overall health.
  • Herbal Medicine: there are many herbs that support kidney and adrenal health, stress relief, and sleep. For light every day support try incorporating herbal teas of Tulsi (or holy basil), Passionflower, Reishi, Cordyceps or Chaga mushrooms, Chamomile or many others into your diet. When you are experiencing long-term or extreme symptoms of Adrenal Fatigue you’ll benefit from the more targeted and potent approach that Chinese Herbal Medicine offers.
  • Seek out a qualified Chinese Medicine Practitioner that prescribes Chinese Herbal formulas, or reach out to us. We can help with that if you don’t already have a practitioner you work with. You can also use our Chinese Herbal formula “Recharge” to, well, recharge your adrenal energy. Find more information about it here.
To your health! Hayley Gardner MSOM, LAc
Back to blog

Leave a comment

Please note, comments need to be approved before they are published.